Title : Pediatric evacuation drills: The process, the implementation and the learnings
Abstract:
Pediatric patients in a hospital setting are an at-risk population that require safe and efficient evacuation in the event of a natural disaster. Since 2014 there have been 278 Natural Disasters in the United States (Em-Dat). At Nemours Children’s Hospital, Delaware (NCH-D), a Level 1 Pediatric Trauma Center, nationally ranked in 9 specialties, and a 3-time Magnet Facility, our unit has implemented an annual simulation-based curriculum focusing on the evacuation of medical complex pediatric patients in a disaster. 3 West is a 24-bed unit that cares for orthopedic patients, patients in need of acute rehabilitation of traumatic brain injury, spinal cord injury, and comprehensive rehabilitation, as well as ventilator-dependent patients with tracheostomies. For the past 37 years, we have held the accreditation through The Commission on Accreditation of Rehabilitation Facilities (CARF). As the only CARF-certified rehabilitation program for pediatrics in the region, to maintain our certification, our nurses are required to perform evacuation drills yearly. Preparation for the drill begins in the months prior to the exercise starting with a web-based training on the use of med sleds. Med sleds facilitate a safe and rapid vertical evacuation down a stair-well. The nurses are also educated on the designated meeting area outside of the hospital. The goals of the evacuation drill are to educate the staff, execute the drill, and evaluate the process. Following the drill, we perform an interdisciplinary debrief. This includes nurses, nursing assistants, physical therapists, respiratory therapists, public safety officers, the Emergency Preparedness Coordinator, and executive leadership. We implement changes based on feedback from those who participated in the drill as healthcare team members, patients, and observers. Every year lessons are learned. The nurses recognize barriers and offer recommendations for improvements. Sometimes the barriers are physical, for example part of the facility, or individual, such as patients with mobility impairments and technology dependence who will need special consideration. The interventions developed during the debrief help advance nurses knowledge and self-confidence concerning disaster education and evacuation. Nurses are heroes. We need the education and skills for disaster preparedness to be able to safely evacuate our pediatric patients. Preparing and implementing disaster drills gives our nurses and vulnerable patients the ability to have hope, resources, and processes in place to keep them safe.
