Homeless Population Discussion Read chapter 28 of the class textbook and review the attached PowerPoint presentations. Once done, answer the following ques

Homeless Population Discussion Read chapter 28 of the class textbook and review the attached PowerPoint presentations. Once done, answer the following questions.

1. Identify and discuss the types of disasters.

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2. Mention and discuss two natural or man-made disasters that recently occurred and discuss how they affect the community health.

3. Discuss the stages of disaster management.

4. Describe and discuss the role and responsibilities of nurses in relation to disasters.

As stated in the syllabus present your assignment in an APA format word document, Arial 12 font attached to the forum in the discussion tab of the blackboard titled “Week 7 discussion questions”. A minimum of 2 evidence-based references besides the class textbook must be used. A minimum of 700 words is required. Chapter 22
Substance Abuse
and Misuse as
Community Health
Problems
Definitions of Substance Abuse
• Substance abuse: the use of any drug
(alcohol, street drugs, prescription and
over-the-counter medications) that results
in a loss of control over the amount taken
and when it is taken
• Dependence or addiction: present when
there are physiological symptoms that
occur with withdrawal of the substance
Scope of Substance Abuse
• Illicit drug use
• Use of alcohol
• Use of Tobacco
Impact of Substance
Abuse on Society
•
•
•
Preventable morbidity and mortality
Healthcare costs
Costs to society
Impact of Substance
Abuse on the Individual
•
•
•
•
•
•
•
•
Loss of job
Divorce
Health problems (acute and chronic)
Nutritional deficiences
Low self-esteem
Depression
Anxiety
Death
Risk Factors for
Substance Abuse
•
•
•
•
Society’s influence
The family’s influence
The workplace’s influence
Personal factors
Nursing Assessment
• Nurses’ attitude self-assessment
• Drug history
• Recognizing the signs of substance abuse
Interventions
• Society’s response
– Healthy People 2020
– Primary prevention
– Secondary prevention
– Tertiary Prevention
• Interventions with special populations
Chapter 28
Natural and Man-Made Disasters
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
Disaster Definitions
?
A disaster is any event that causes a level of
destruction, death, or injury that affects the
abilities of the community to respond to the
incident using available resources.
?
?
?
Mass casualty involves 100+ individuals
Multiple casualty involves 2 to 99 individuals
Casualties can be classified as a direct victim,
indirect victim, displaced person, or refugee
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
2
Types of Disasters
?
?
?
Natural disasters
Man-made disasters
Combination disasters
?
NA-TECH (natural/technological) disaster: a
natural disaster that creates or results in a
widespread technological problem
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
3
Types of Disasters (Cont.)
(from Textbook, Box 28-1)
Natural Disasters
?
?
?
?
?
?
?
?
?
?
Avalanches
Blizzards
Communicable disease
epidemics
Droughts, wildfires
Earthquakes, tsunamis
Hailstorms
Heat waves
Hurricanes
Tornados, cyclones
Volcanic eruptions
Man-Made Disasters
?
?
?
?
?
?
?
?
?
?
Terrorism
Civil unrest (riots)
Explosions, bombings
Fires
Structural collapse (bridges)
Airplane crashes
Toxic or hazardous spills
Mass transit accidents
Pollution
Wars
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
4
Acts of Terrorism
Terrorism is
?
?
“the unlawful use of force and or violence against
persons or property to intimidate or coerce a
government, the civilian population, or any segment
thereof, in furtherance of political or social
objectives.” (FBI, 2013)
“is premeditated, politically motivated violence
perpetrated against noncombatant targets by subnational groups or clandestine agents.” (CIA, 2013)
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
5
Weapons of Mass Destruction
?
?
?
Any weapon that is designed or intended to
cause death or serious bodily injury through
release, dissemination, or impact of toxic or
poisonous chemicals, or their precursors
Any weapon involving a disease organism
(biological agents)
Any weapon that is designed to release
radiation or radioactivity at a level
dangerous to human life (chemical agents)
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
6
Characteristics of Disasters
?
?
?
?
?
?
Frequency
Predictability
Preventability/mitigation
Imminence
Scope and number of casualties
Intensity
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
7
Prevention in Disasters
?
Primary prevention
?
Aimed at preventing the occurrence of a disaster
or limiting the consequences when the event itself
cannot be prevented (mitigation)
? Nondisaster stage: period before a disaster occurs
? Predisaster stage: actions taken when a disaster
is pending
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
8
Prevention in Disasters (Cont.)
?
Nondisaster activities include:
• Assessing communities to determine potential disaster
•
•
•
•
•
hazards
Developing disaster plans at local, state, and federal
levels
Conducting drills to test the plan
Training volunteers and health care providers
Providing educational programs of all kinds
Developing risk maps and resource maps
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
9
Prevention in Disasters (Cont.)
?
Predisaster activities include:
• Notification of the appropriate officials
• Warning the population
• Advising what response to take
?
voluntary or mandatory evacuation
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
10
Prevention in Disasters (Cont.)
?
Secondary prevention
?
?
?
Implemented once the disaster occurs
Aimed at preventing further injury or destruction
“Safety before search and rescue.”
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
11
Prevention in Disasters (Cont.)
?
Tertiary prevention
?
Focuses on recovery and restoring the community
to previous levels of functioning and its residents
to their maximum functioning
? Aimed at preventing a recurrence or minimizing
the effects of future disasters through debriefing
meetings to identify problems with the plan and
making revisions
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
12
Nurses Need to …
… be involved in all stages of prevention and
related activities
… educate others about disasters and how to
prepare for and respond to them
… keep up to date on latest recommendations
and advances in life-saving measures
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
13
Questions Nurses Should Ask
1. What kind of disasters threaten the
2.
3.
4.
5.
communities where I live?
What injuries should I expect from different
disaster scenarios?
What are the evacuation routes?
Where are shelters located?
What warning systems are used so I can
respond effectively, personally, and
professionally during different types of
disasters?
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
14
Disaster Management
?
?
A collaborative interdisciplinary team effort is
needed between a network of agencies and
individuals.
Develop a disaster plan.
?
?
?
Communities can respond more quickly, more
effectively, and with less confusion.
Ensures that resources are available.
Delineates roles and responsibilities of all
personnel and agencies, both official and
unofficial.
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
15
Governmental Responsibilities
?
Local government (first responders)
?
?
State government (Office of Emergency
Management)
?
?
Responsible for the safety and welfare of its citizens.
Involved when a disaster overwhelms the local community’s
resources.
Federal government (Department of Homeland
Security and CDC)
?
A single department focusing on protecting the American
people and their homeland
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
16
U.S. Department of Homeland
Security (DHS)
?
DHS has three primary missions:
?
?
?
?
Lead the unified national effort to secure America
Prevent and deter terrorist attacks
Protect against and respond to threats and
hazards to the nation
DHS goal (2011):
Sets the “vision for nationwide preparedness”
? Identifies the core capabilities and targets
necessary to achieve preparedness across five
mission areas: Prevention, Protection, Mitigation,
Response, and Recovery.
?
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
17
NIMS
?
NIMS (National Incident Management
System) provides a systematic, proactive
approach for all levels of governmental and
nongovernmental agencies to work
seamlessly to prevent, protect against,
respond to, recover from, and prevent the
effects of disasters.
– Federal Emergency Management Agency (FEMA) (2012)
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
18
FEMA
?
Mission is to support citizens and first
responders to ensure that, as a nation,
everyone works together to build, sustain,
and improve the capacity to prepare for,
protect against, respond to, recover from, and
mitigate all hazards.
?
?
Established National Terrorism Advisory System
• Threat alert: elevated or imminent threat
FEMA published in-depth guide for citizen
preparedness: Are You Ready?
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
19
Partnerships in Disasters
?
?
?
?
?
?
Department of Homeland Security (DHS)
Federal Emergency Management Agency
(FEMA)
Department of Health and Human Services/
Centers for Disease Control and Prevention
Public Health System (PHS)
American Red Cross (ARC)
Other local, state, and federal agencies
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
20
Disaster Management Stages
?
?
?
?
Prevention stage
Preparedness and planning stage
Response stage
Recovery stage
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
21
Prevention Stage
?
Identify potential disaster risks.
?
?
Educate citizens regarding what actions to
take to prepare for disasters.
?
?
Create risk maps
Individual, family, and community level
Develop a plan for meeting the potential
disasters identified.
?
Create resource maps
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
22
Community Risk Map
(from Textbook, Figure 28-1)
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
23
Community Resource Map
(from Textbook, Figure 28-2)
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
24
Preparedness/Planning Stage:
Individual and Family Preparedness
?
?
?
?
Training in first aid
Assembling a disaster emergency kit
Establishing a predetermined meeting place
away from home
Making a family communication plan
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
25
Preparedness/Planning Stage:
Community Disaster Planning
?
Plans must include:
?
?
?
?
?
Authority
Communication
Logistical coordination of:
• Supplies and equipment
• Human resources
• Evacuation and rescue
Plans must be dynamic and change as
needed.
Plans must be tested in different disaster
scenario drills.
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
26
Disaster Planning Principles
(from Textbook, Box 28-8)
1.
2.
3.
4.
5.
6.
7.
8.
9.
Measures usually taken are not sufficient for major disasters.
Plans should be adjusted to people’s needs.
Planning does not stop with development of a written plan.
Lack of information causes inappropriate responses by
community members.
People should be able to respond with or without direction.
Plans should coordinate efforts of the entire community, so large
segments of the citizenry should be involved in the planning.
Plans should be linked to surrounding areas.
Plans should be general enough to cover all potential disaster
events.
As much as possible, plans should be based on everyday work
methods and procedures.
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
27
Disaster Planning Principles (Cont.)
(from Textbook, Box 28-8, Cont.)
10. Plans should specify a person’s responsibility for implementing
segments by position or title rather than by name.
11. Plans should develop a record-keeping system before a
disaster occurs, regarding:
•
Supplies and equipment
• Records of all present at any given time (to account for everyone
and to identify the missing)
• Identification of victims and deceased, conditions and treatment
documented, and to which facility victims are sent
12. Backup plans need to be in place for the following:
•
Disruption of telephone and cell phone lines
• Disruption of computer data (should be downloaded weekly and
stored off site)
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
28
Response Stage
?
?
Response stage begins immediately after the
disaster incident occurs.
May include:
?
Shelter in place
? Evacuation
? Search and rescue
? Staging area
? Disaster triage
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
29
Areas of Operation in Disaster
Response
Figure 28-3
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
30
Disaster Triage
?
START triage system
?
?
?
“Simple Triage And Rapid Treatment”
Used in multicasualty or mass casualty incident
Triage of injured person should occur in less than
1 minute based on:
•
•
•
?
?
?
Respirations
Perfusion
Mental status
Uses people with minor injuries to assist
Person is tagged with a colored triage tag
Victims moved to the treatment area
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
31
START Color-Coded Triage Tag
Green = walking wounded
Yellow = systemic but not yet
life-threatening complications
Red = life-threatening conditions
that can be stabilized and have
a high probability of survival
Black = deceased or injuries so
extensive that nothing can be
done to save them
Figure 28-4
Source: http://www.mettag.com.
Reprinted with permission.
Hazmat tag = contaminated
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
32
Psychological Triage
?
Four keys to gauging mental health impact:
?
?
?
?
?
Extreme and widespread property damage
Serious and ongoing financial problems
High prevalence of trauma in the form of injuries,
threat to life, and loss of life
When human intent caused the disaster
In addition, panic during the disaster, horror,
separation from family, and relocation or
displacement may play a part
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
33
Public Health Activities
?
While search and rescue is going on …
?
Surveil for threats (e.g., contaminated water,
vectors, and air quality).
? Disseminate data on what has been found.
? Relate health information to officials, the media,
and the public as appropriate.
? Gather epidemiological information.
? Allocate resources and work to prevent further
adverse health problems.
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
34
Responses to Disasters
?
Community
?
?
?
?
Heroic phase
Honeymoon phase
Disillusionment
phase
Reconstruction phase
?
Individual
?
Cognitive
? Emotional
? Physical
? Behavioral
? PTSD
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
35
Recovery Stage
?
?
Begins when the danger from the
disaster has passed.
All local, state, and federal agencies
are present in the area.
?
Help victims rebuild their lives
? Restore public services
? Cleanup of damage and repair begins
? Evaluation and revision of the disaster
plans
? Understand the financial impact
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
36

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