Nursing Curriculum Plan
for Emergency Preparedness
The competencies developed by the NEPEC provide the framework for curriculum development for nurses in mass casualty education. Dr. Betsy Weiner, Associate Director of the NEPEC, has received several grants for the development of online modules developed from the competencies. She worked in conjunction with Little Planet Learning (www.littleplanet.com).
The grid below is the modular layout of cases by identified objectives. Other developers should identify objectives met by their programs, but are free to organize these objectives to meet their own needs.
| The Tipping Point |
| CONCEPTS Paradigm Shift |
OBJECTIVES | AWARENESS I5. Describe accepted principles specific to mass casualty incidents. VI1. Define and distinguish the terms disaster and mass casualty incident (MCI) in relation to other major incidents or emergency situations. VI2. Define relevant terminology: weapons of mass destruction; triage V14. Describe the local emergency response system for disasters. X1. Discuss the cultural, spiritual, and social issues that may affect an individual’s response to a MCI. |
| Incident Management System |
| CONCEPTS Unified Incident Command Risk Communication Treatment (includes maintenance of regular health care) Response Support |
OBJECTIVES |
AWARENESS IIA3. Describe general signs and symptoms of exposure to selected chemical, biological, radiological, nuclear, and explosive agents (CBRNE). V12. Define relevant terminology, including: chain of command and management system for emergency response; comprehensive emergency management. IIA4. Demonstrate the ability to access up-to-date information regarding selected nuclear, biological, chemical, explosive, and incendiary agents. IV1. Describe the local chain of command and management system for emergency response during a MCI. IV7. Identify appropriate resources for referring requests from patients, media, or others for information regarding MCIs. IV8. Describe principles of risk commun-ication to groups and individuals affected by exposure during a MCI. V1. Identify possible threats and their potential impact on the general public, emergency medical system, and the health care community. I1. Use an ethical and nationally approved framework to support decision-making and prioritizing needed in disaster situations. I2. Use clinical judgment and decision-making skills in assessing the potential for appropriate, timely individual care during a mass casualty incident. I4. Describe at the pre-disaster, emergency and post-disaster phases the essential nursing care for: individuals, families, special groups, e.g. children, elderly, pregnant women; and communities. VI5. Describe the interaction between local, state and federal emergency response systems. |
| Your Role in Emergency Preparedness |
| CONCEPTS Unified Incident Command Safety Risk Communication |
OBJECTIVES |
AWARENESS IV4. Identify one’s own role in the emergency response plan for the place of employment. IV3. Locate and describe the emergency response plan for one’s place of employment and its role in community, state, and regional plans. XI2. Identify the most appropriate or most likely health care role for oneself during a MCI. IV2. Identify your role, if possible, within the emergency management system. IV5. Discuss security and confidentiality during a MCI. X13. Identify the limits to one’s own knowledge/ skills/abilities/ authority related to MCIs. VIII1. Describe use of emergency communication equipment that you will be required to use in a MCI response. III10. Demonstrate use of emergency communication equipment and information management techniques required in a MCI response. XI1. Describe the nursing roles in MCIs: Researcher, Investigator/ epi-demiologist, EMT or First Responder, Direct care provider, generalist nurse, Direct care provider, advanced practice nurse, Director/ coordinator of care in hospital/nurse administrator or emergency department nurse manager, On-site coordinator of care/incident commander, On-site director of care management, Information provider or educator, particularly the role of the generalist nurse, Mental health counselor, Member of planning response team, Manager or coordinator of shelter, Member of decontamination team, Triage officer. XI4. Describe essential equipment for responding to a MCI, e.g. stethoscope, registered nurse license to deter imposters, packaged snack, change of clothing, bottles of water. X15. Recognize the importance of maintaining one’s expertise and knowledge in this area of practice and of participating in regular emergency response drills. X16. Participate in regular emergency response drills in the community or place of employment. X2. Discuss the diversity of emotional, psycho-social and socio-cultural responses to terrorism or the threat of terrorism on one’s self and others. |
| Chemical Case |
| CONCEPTS Agency Role & Interactions Safety Decontamination Evidence Preservation Treatment |
OBJECTIVES |
AWARENESS VI2. Define relevant terminology, including: scene assessment. IIA5. Describe the essential elements included in a mass casualty incident (MCI) scene assessment. III5. Assess the need for and initiate the appropriate CBRNE isolation and decontamination procedures available, ensuring that all parties understand the need. V13. Describe the four phases of emergency management: preparedness, response, recovery, and mitigation. V17. Discuss principles related to a MCI site as a crime scene, e.g. maintaining integrity of evidence, chain of custody IV5. Discuss security and confidentiality during a MCI. VIII2. Discuss the principles of containment and decontamination. VIII3. Describe procedures for decontamination of self, others, and equipment for selected CBNRE agents. |
| Biological Case | ||
| CONCEPTS Event Recognition Safety & Protection (PPE/ Isolation/ Quarantine) Treatment Recovery Operation |
OBJECTIVES |
AWARENESS VI2. Define relevant terminology, including: PPE IIA2. Identify possible indicators of a mass exposure (i.e., clustering of individuals with the same symptoms). IIA6. Identify special groups of patients that are uniquely vulnerable during a MCI, e.g. the very young, aged, immuno-suppressed. IIB1. Conduct a focused health history to assess potential exposure to CBRNE agents. III5. Assess the need for and initiate the appropriate CBRNE isolation and decontam-ination procedures available, ensuring that all parties understand the need. III6. Demonstrate knowledge and skill related to personal protection and safety, including the use of Personal Protective Equipment (PPE) for: Level B protection, Level C protection, and respiratory protection. VI6. Describe the legal authority of public health agencies to take action to protect the community from threats, including isolation, quarantine, and required reporting and documentation. IIB2. Perform an age-appropriate health assessment, including: airway and respiratory assessment, cardiovascular assessment, including vital signs and monitoring for signs of shock, integumentary assessment, particularly a wound, burn, and rash assessment, pain assessment, injury assessment from head to toe, gastrointestinal assessment, including specimen collection, basic neurological assessment, musculoskeletal assessment, and mental status, spiritual, and emotional assessment. III2 Demonstrate the safe administration of immunizations, including smallpox vaccination. III3 Demonstrate knowledge of appropriate nursing interventions for adverse effects from medications administered. IV6. Demonstrate appropriate emergency documentation of assessments, interventions, nursing actions and outcomes during and after a MCI. |
| Radiological Case | ||
| CONCEPTS Safety Treatment Psych & Cultural Support Transportation |
OBJECTIVES |
AWARENESS IIA1. Assess the safety issues for self, the response team, and victims in any given response situation in collaboration with the incident response team. III5. Assess the need for and initiate the appropriate CBRNE isolation and decontamination procedures available, ensuring that all parties understand the need. IIB6. Describe the psychological impact on responders and health care providers. IV9. Identify reactions to fear, panic and stress that victims, families, and responders may exhibit during a disaster situation. IV10. Describe appropriate coping strategies to manage self and others. IIB3. Assess the immediate psychological response of the individual, family, or community following a MCI. IIB4. Assess the long-term psychological response of the individual, family, or community following a MCI. IIB5. Identify resources available to address the psychological impact, e.g. Critical Incident Stress Debriefing (CISD) teams, counselors, Psychiatric/ Mental Health Nurse Practitioners. III8. Assess and prepare the injured for transport, if required, including provisions for care and monitoring during transport. III9. Demonstrate the ability to maintain patient safety during transport through splinting, immobilization, monitoring, and therapeutic interventions. |
| Nuclear Case | ||
| CONCEPTS Safety Treatment Fatality Management |
OBJECTIVES |
AWARENESS III5. Assess the need for and initiate the appropriate CBRNE isolation and decontamination procedures available, ensuring that all parties understand the need. IX1. Identify and discuss ethical issues related to MCI events: -Rights and responsibilities of health care providers in MCI's, e.g. refusing to go to work or report for duty, refusal of vaccines. - Need to protect the public versus an individual’s right for autonomy, e.g. right to leave the scene after contamination. - Right of the individual to refuse care, informed consent. - Allocation of limited resources. - Confidentiality of information related to individuals and national security. - Use of public health authority to restrict individual activities, require reporting from health professionals, and collaborate with law III7. Implement fluid/nutrition therapy, taking into account the nature of injuries and/or agents exposed to and monitoring hydration and fluid balance accordingly. V112. Describe, using an interdisciplinary approach, the short term and long term effects of physical and psychological symptoms related to disease and treatment secondary to MCIs. IX2. Describe the ethical, legal, psychological, and cultural considerations when dealing with the dying and or the handling and storage of human remains in a mass casualty incident. |
