The identification of competencies for anNHS response to chemical, biological, radiological,nuclear and explosive (CBRNe) emergencies

Andrew C.S. Linney, George Kernohan, Ray Higginson

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Emergency planning is a new science and there is a lack of UK standardisation in regard to NHSemergency planning. A first step to achieving standardisation within emergency planning is elucidationof national training competencies.Aim: This study was designed to find consensus amongst multi-agency chemical, biological,radiological, nuclear and explosive (CBRNe) experts on the factors that must be included infuture NHS CBRNe competencies.Methods: Data was collected using an anonymised online Delphi study. Two rounds of studywere completed. Experts were selected through a combination of purposive and snowball sampling.In total 43 experts agreed to take part in this study. Twenty-one experts responded to thefirst round’s single open-ended question. Fourteen experts responded to the second which contained64 Likert-scored questions. Consensus was achieved in 46 questions.Results: The consensus of expert opinion generated 10 suggested core training competencies.Conclusion: There is an urgent need to standardise national planning, training and evaluationof NHS staff who are expected to respond to CRBNe and other emergencies. Further research isneeded to identify training and response templates so that lessons can be learned from theseexperiences and fed back to improve future response.
LanguageEnglish
Pages96-105
JournalInternational Emergency Nursing
Volume19
DOIs
Publication statusPublished - 5 Apr 2010

Fingerprint

Emergencies
Delphi Technique
Expert Testimony
Research

Keywords

  • CBRNe
  • Delphi study
  • Emergency department
  • Major incident

Cite this

@article{22999b38da8d4b769883549472e47a1e,
title = "The identification of competencies for anNHS response to chemical, biological, radiological,nuclear and explosive (CBRNe) emergencies",
abstract = "Emergency planning is a new science and there is a lack of UK standardisation in regard to NHSemergency planning. A first step to achieving standardisation within emergency planning is elucidationof national training competencies.Aim: This study was designed to find consensus amongst multi-agency chemical, biological,radiological, nuclear and explosive (CBRNe) experts on the factors that must be included infuture NHS CBRNe competencies.Methods: Data was collected using an anonymised online Delphi study. Two rounds of studywere completed. Experts were selected through a combination of purposive and snowball sampling.In total 43 experts agreed to take part in this study. Twenty-one experts responded to thefirst round’s single open-ended question. Fourteen experts responded to the second which contained64 Likert-scored questions. Consensus was achieved in 46 questions.Results: The consensus of expert opinion generated 10 suggested core training competencies.Conclusion: There is an urgent need to standardise national planning, training and evaluationof NHS staff who are expected to respond to CRBNe and other emergencies. Further research isneeded to identify training and response templates so that lessons can be learned from theseexperiences and fed back to improve future response.",
keywords = "CBRNe, Delphi study, Emergency department, Major incident",
author = "Linney, {Andrew C.S.} and George Kernohan and Ray Higginson",
note = "Reference text: Adini, B., Goldberg, A., Laor, D., Cohen, R., Zadok, R., Bar-Dayan, Y., 2006. Assessing levels of hospital preparedness. Prehospital and Disaster Medicine 21 (6), 451–457. Adini, B., Goldberg, A., Laor, D., Cohen, R., Bar-Dayan, Y., 2007. Factors that may influence the preparation of standards of procedures for dealing with mass-casualty incidents. Prehospital and Disaster Medicine 22 (3), 175–180, <http://pdm.medicine. wisc.edu/22-3{\%}20PDFs/adini.pdf> (accessed 27.07.08). Alexander, D., 2005. Towards the development of a standard in emergency planning. Disaster Prevention and Management 14 (2), 158–175. ALSG, 2009. Advanced Life Support Group. Online Link Showing Map of Countries across the World that Subscribe to ALSG. <http:// www.alsg.org/en/?q=overseas> (accessed 23.10.09). Anathallee, A., Curphey, A., Beeching, N., Carley, S., Crawford, I., Mackway-Jones, K., 2007. Emergency departments (EDs) in the United Kingdom (UK) are not prepared for emerging biological threats and bioterrorism. Journal of Infection 54, 12–17. Armstrong, 2006. Delphi Decision Aid. Online Free Access www Delphi Study Program. <http://armstrong.wharton.upenn.edu/ delphi2/> (accessed 12.11.08). Auf der Heide, E., 2006. The importance of evidence-based disaster planning. Annals of Emergency Medicine 47 (1), 34–49. Carley, S., Mackway-Jones, K., 2005. Major Incident Medical Management and Support: The Practical Approach in the Hospital. Advanced Life Support Group, Blackwell Publishing. Clayton, M., 1997. Delphi: a technique to harness expert opinion for critical decision-making tasks in education. Educational Psychology. An International Journal of Experimental Educational Psychology 17 (4), 373–386, <http://www.informaworld.com/smpp/ content~content=a757635110&db=all> (accessed 22.08.09). Crawford, I., Mackway-Jones, K., Russell, D., Carley, S., 2004a. Planning for chemical incidents by implementing a Delphi based consensus study. Emergency Medicine Journal 21, 20–23. Crawford, I., Mackway-Jones, K., Russell, D., Carley, S., 2004b. Delphi based consensus study into planning for chemical incidents. Emergency Medicine Journal 21, 24–28. Curtis, T., 2009. Educational program emergency planning. Radiologic Technology 80/6/51580, 515–522, <http://www.radiologictechnology. org/cgi/reprint/80/6/515> (accessed 22.08.09). Delaney, L., 2009. Descriptive statistics: simply telling a story. British Journal of Cardiac Nursing 4 (6), 283–289. DoH Emergency Preparedness Division, 2005. NHS Emergency Planning Guidance. Gateway Ref.: 5638. <http://www.dh.gov. uk/dr_consum_dh/groups/dh_digitalassets/@dh/@en/documents/ digitalasset/dh_4121236.pdf> (accessed 23.08.08). DoH, 2008. The NHS in England: The Operating Framework for 2009–10. <http://www.dh.gov.uk/en/Publicationsandstatistics/ Publications/PublicationsPolicyAndGuidance/DH_091445> (accessed 30.05.09). Doughty, E., 2009. Investigating Adaptive Grieving Styles: A Delphi Study. Death Studies, 1091–7683, vol. 33, no. 5, 2009, pp. 462– 480. <http://www.informaworld.com/smpp/content~db=all ~content=a910570528> (accessed 22.08.09). Health Care Commission, 2007. Information for healthcare providers. NHS Acute, 06–07, Meeting Core Standards, Public Health, Emergency Planning (accessed 23.07.08). Heptonstall, J., Gent, N., 2008. CRBN Incidents: Clinical Management & Health Protection. Health Protection Agency, London. Version 4, September 2008. <http://www.hpa.org.uk/web/ HPAwebFile/HPAweb_C/1194947377166> (accessed 17.05.09). Home Office, 2004. The Decontamination of People Exposed to Chemical, Biological, Radiological or Nuclear (CBRN) Substances or Material: Strategic National Guidance. Home Office. second ed., May 2004. HPA, 2006a. Emergency Planning College. Emergency Preparedness – A Foundation. Module 1. Morning Lecture: ‘‘Integrated Emergency Management’’ Course: 2006/21/DOS. 23rd May 2006. Central City Training Venue. London. HPA, 2006b. Emergency Planning College. Emergency Preparedness – A Foundation. Module 1. Afternoon Lecture: ‘‘The Bigger Picture. Lines of Communication within and beyond the Health Service Community.’’ Course: 2006/21/DOS. 23rd May 2006. Central City Training Venue, London. HPA, 2006c. Emergency Planning College. Emergency Planning Liaison Officer Training. Module 2 – Hazard Mapping, Risk Identification & Mitigation. Course: 2006/30/DOS. 25th July 2006. Central City Training Venue, London. HPA, 2009. Reports of Swine Flu in Mexico and US. HPA Press Release, 24th April, 2009. <http://www.hpa.org.uk/web/HPAweb& HPAwebStandard/HPAweb_C/1240530351364> (accessed 25.05.09). Lachance, D., Plante, E´., Bouchard-Thomassin, A.-A., Champetier, S., Roussel, E´., Drolet, M.-C., Couet, J., Arsenault, M., 2009. Moderate Exercise Training Improves Survival and Ventricular Remodelling in an Animal Model of Left Ventricular Volume Overload Circ Heart Fail in American Heart Association. Published June 15, 2009. doi:10.1161/CIRCHEARTFAILURE.108.845487. <http://circheartfailure.ahajournals.org/cgi/content/abstract/ CIRCHEARTFAILURE.108.845487v1> (accessed 22.08.09). NEPEC, 2003. Educational Competencies for Registered Nurses Responding to Mass Casualty Incidents. Nursing Emergency Preparedness Education Coalition. Vanderbilt University, Nashville, Tennessee, USA. <http://www.nursing.vanderbilt.edu/ incmce/competencies.html> (accessed 29.10.09). NVivo8, 2008. Qualitative Data Analysis Software; QSR International Pty., Ltd., Version 8, 2008. <http://www.qsrinternational.com/ support_faqs_detail.aspx?view=11> (accessed 23.10.09). Oren, M., 2009. Medical Complications. CBRNe World. Falcon Communications Ltd., Autumn 2009, pp. 94–95. Powell, C., 2002. The Delphi technique: myths and realities. Journal of Advanced Nursing 41 (4), 376–382. Rosatto, C., 2009. Crystal Ball. CBRNe World. Falcon Communications Ltd., Autumn 2009, pp. 110–111. Ru¨ter, A., 2006. Disaster Medicine – Performance Indicators. Information Support and Documentation: A Study of an Evaluation Tool. Linko¨ping University Medical Dissertations No. 972, Sweden. <http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva- 7990> (accessed 08.07.08). Sundnes, K., Birnbaum, M., 2003. Health disaster management: guidelines for evaluation and research in the Utstein style. Prehospital and Disaster Medicine 17 (Suppl. 3). UK Resilience, 2009. Civil Contingencies Act, 2004. Cabinet Office, London. <http://www.cabinetoffice.gov.uk/ukresilience/preparedness/ ccact.aspx#part1> (accessed 30.05.09). WADEM, 2009. World Association for Disaster and Emergency Medicine. <http://www.wadem.org/mission.html> (accessed 30.08.09).",
year = "2010",
month = "4",
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doi = "10.1016/j.ienj.2010.04.001",
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pages = "96--105",
journal = "International Emergency Nursing",
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}

The identification of competencies for anNHS response to chemical, biological, radiological,nuclear and explosive (CBRNe) emergencies. / Linney, Andrew C.S.; Kernohan, George; Higginson, Ray.

In: International Emergency Nursing, Vol. 19, 05.04.2010, p. 96-105.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The identification of competencies for anNHS response to chemical, biological, radiological,nuclear and explosive (CBRNe) emergencies

AU - Linney, Andrew C.S.

AU - Kernohan, George

AU - Higginson, Ray

N1 - Reference text: Adini, B., Goldberg, A., Laor, D., Cohen, R., Zadok, R., Bar-Dayan, Y., 2006. Assessing levels of hospital preparedness. Prehospital and Disaster Medicine 21 (6), 451–457. Adini, B., Goldberg, A., Laor, D., Cohen, R., Bar-Dayan, Y., 2007. Factors that may influence the preparation of standards of procedures for dealing with mass-casualty incidents. Prehospital and Disaster Medicine 22 (3), 175–180, <http://pdm.medicine. wisc.edu/22-3%20PDFs/adini.pdf> (accessed 27.07.08). Alexander, D., 2005. Towards the development of a standard in emergency planning. Disaster Prevention and Management 14 (2), 158–175. ALSG, 2009. Advanced Life Support Group. Online Link Showing Map of Countries across the World that Subscribe to ALSG. <http:// www.alsg.org/en/?q=overseas> (accessed 23.10.09). Anathallee, A., Curphey, A., Beeching, N., Carley, S., Crawford, I., Mackway-Jones, K., 2007. Emergency departments (EDs) in the United Kingdom (UK) are not prepared for emerging biological threats and bioterrorism. Journal of Infection 54, 12–17. Armstrong, 2006. Delphi Decision Aid. Online Free Access www Delphi Study Program. <http://armstrong.wharton.upenn.edu/ delphi2/> (accessed 12.11.08). Auf der Heide, E., 2006. The importance of evidence-based disaster planning. Annals of Emergency Medicine 47 (1), 34–49. Carley, S., Mackway-Jones, K., 2005. Major Incident Medical Management and Support: The Practical Approach in the Hospital. Advanced Life Support Group, Blackwell Publishing. Clayton, M., 1997. Delphi: a technique to harness expert opinion for critical decision-making tasks in education. Educational Psychology. An International Journal of Experimental Educational Psychology 17 (4), 373–386, <http://www.informaworld.com/smpp/ content~content=a757635110&db=all> (accessed 22.08.09). Crawford, I., Mackway-Jones, K., Russell, D., Carley, S., 2004a. Planning for chemical incidents by implementing a Delphi based consensus study. Emergency Medicine Journal 21, 20–23. Crawford, I., Mackway-Jones, K., Russell, D., Carley, S., 2004b. Delphi based consensus study into planning for chemical incidents. Emergency Medicine Journal 21, 24–28. Curtis, T., 2009. Educational program emergency planning. Radiologic Technology 80/6/51580, 515–522, <http://www.radiologictechnology. org/cgi/reprint/80/6/515> (accessed 22.08.09). Delaney, L., 2009. Descriptive statistics: simply telling a story. British Journal of Cardiac Nursing 4 (6), 283–289. DoH Emergency Preparedness Division, 2005. NHS Emergency Planning Guidance. Gateway Ref.: 5638. <http://www.dh.gov. uk/dr_consum_dh/groups/dh_digitalassets/@dh/@en/documents/ digitalasset/dh_4121236.pdf> (accessed 23.08.08). DoH, 2008. The NHS in England: The Operating Framework for 2009–10. <http://www.dh.gov.uk/en/Publicationsandstatistics/ Publications/PublicationsPolicyAndGuidance/DH_091445> (accessed 30.05.09). Doughty, E., 2009. Investigating Adaptive Grieving Styles: A Delphi Study. Death Studies, 1091–7683, vol. 33, no. 5, 2009, pp. 462– 480. <http://www.informaworld.com/smpp/content~db=all ~content=a910570528> (accessed 22.08.09). Health Care Commission, 2007. Information for healthcare providers. NHS Acute, 06–07, Meeting Core Standards, Public Health, Emergency Planning (accessed 23.07.08). Heptonstall, J., Gent, N., 2008. CRBN Incidents: Clinical Management & Health Protection. Health Protection Agency, London. Version 4, September 2008. <http://www.hpa.org.uk/web/ HPAwebFile/HPAweb_C/1194947377166> (accessed 17.05.09). Home Office, 2004. The Decontamination of People Exposed to Chemical, Biological, Radiological or Nuclear (CBRN) Substances or Material: Strategic National Guidance. Home Office. second ed., May 2004. HPA, 2006a. Emergency Planning College. Emergency Preparedness – A Foundation. Module 1. Morning Lecture: ‘‘Integrated Emergency Management’’ Course: 2006/21/DOS. 23rd May 2006. Central City Training Venue. London. HPA, 2006b. Emergency Planning College. Emergency Preparedness – A Foundation. Module 1. Afternoon Lecture: ‘‘The Bigger Picture. Lines of Communication within and beyond the Health Service Community.’’ Course: 2006/21/DOS. 23rd May 2006. Central City Training Venue, London. HPA, 2006c. Emergency Planning College. Emergency Planning Liaison Officer Training. Module 2 – Hazard Mapping, Risk Identification & Mitigation. Course: 2006/30/DOS. 25th July 2006. Central City Training Venue, London. HPA, 2009. Reports of Swine Flu in Mexico and US. HPA Press Release, 24th April, 2009. <http://www.hpa.org.uk/web/HPAweb& HPAwebStandard/HPAweb_C/1240530351364> (accessed 25.05.09). Lachance, D., Plante, E´., Bouchard-Thomassin, A.-A., Champetier, S., Roussel, E´., Drolet, M.-C., Couet, J., Arsenault, M., 2009. Moderate Exercise Training Improves Survival and Ventricular Remodelling in an Animal Model of Left Ventricular Volume Overload Circ Heart Fail in American Heart Association. Published June 15, 2009. doi:10.1161/CIRCHEARTFAILURE.108.845487. <http://circheartfailure.ahajournals.org/cgi/content/abstract/ CIRCHEARTFAILURE.108.845487v1> (accessed 22.08.09). NEPEC, 2003. Educational Competencies for Registered Nurses Responding to Mass Casualty Incidents. Nursing Emergency Preparedness Education Coalition. Vanderbilt University, Nashville, Tennessee, USA. <http://www.nursing.vanderbilt.edu/ incmce/competencies.html> (accessed 29.10.09). NVivo8, 2008. Qualitative Data Analysis Software; QSR International Pty., Ltd., Version 8, 2008. <http://www.qsrinternational.com/ support_faqs_detail.aspx?view=11> (accessed 23.10.09). Oren, M., 2009. Medical Complications. CBRNe World. Falcon Communications Ltd., Autumn 2009, pp. 94–95. Powell, C., 2002. The Delphi technique: myths and realities. Journal of Advanced Nursing 41 (4), 376–382. Rosatto, C., 2009. Crystal Ball. CBRNe World. Falcon Communications Ltd., Autumn 2009, pp. 110–111. Ru¨ter, A., 2006. Disaster Medicine – Performance Indicators. Information Support and Documentation: A Study of an Evaluation Tool. Linko¨ping University Medical Dissertations No. 972, Sweden. <http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva- 7990> (accessed 08.07.08). Sundnes, K., Birnbaum, M., 2003. Health disaster management: guidelines for evaluation and research in the Utstein style. Prehospital and Disaster Medicine 17 (Suppl. 3). UK Resilience, 2009. Civil Contingencies Act, 2004. Cabinet Office, London. <http://www.cabinetoffice.gov.uk/ukresilience/preparedness/ ccact.aspx#part1> (accessed 30.05.09). WADEM, 2009. World Association for Disaster and Emergency Medicine. <http://www.wadem.org/mission.html> (accessed 30.08.09).

PY - 2010/4/5

Y1 - 2010/4/5

N2 - Emergency planning is a new science and there is a lack of UK standardisation in regard to NHSemergency planning. A first step to achieving standardisation within emergency planning is elucidationof national training competencies.Aim: This study was designed to find consensus amongst multi-agency chemical, biological,radiological, nuclear and explosive (CBRNe) experts on the factors that must be included infuture NHS CBRNe competencies.Methods: Data was collected using an anonymised online Delphi study. Two rounds of studywere completed. Experts were selected through a combination of purposive and snowball sampling.In total 43 experts agreed to take part in this study. Twenty-one experts responded to thefirst round’s single open-ended question. Fourteen experts responded to the second which contained64 Likert-scored questions. Consensus was achieved in 46 questions.Results: The consensus of expert opinion generated 10 suggested core training competencies.Conclusion: There is an urgent need to standardise national planning, training and evaluationof NHS staff who are expected to respond to CRBNe and other emergencies. Further research isneeded to identify training and response templates so that lessons can be learned from theseexperiences and fed back to improve future response.

AB - Emergency planning is a new science and there is a lack of UK standardisation in regard to NHSemergency planning. A first step to achieving standardisation within emergency planning is elucidationof national training competencies.Aim: This study was designed to find consensus amongst multi-agency chemical, biological,radiological, nuclear and explosive (CBRNe) experts on the factors that must be included infuture NHS CBRNe competencies.Methods: Data was collected using an anonymised online Delphi study. Two rounds of studywere completed. Experts were selected through a combination of purposive and snowball sampling.In total 43 experts agreed to take part in this study. Twenty-one experts responded to thefirst round’s single open-ended question. Fourteen experts responded to the second which contained64 Likert-scored questions. Consensus was achieved in 46 questions.Results: The consensus of expert opinion generated 10 suggested core training competencies.Conclusion: There is an urgent need to standardise national planning, training and evaluationof NHS staff who are expected to respond to CRBNe and other emergencies. Further research isneeded to identify training and response templates so that lessons can be learned from theseexperiences and fed back to improve future response.

KW - CBRNe

KW - Delphi study

KW - Emergency department

KW - Major incident

U2 - 10.1016/j.ienj.2010.04.001

DO - 10.1016/j.ienj.2010.04.001

M3 - Article

VL - 19

SP - 96

EP - 105

JO - International Emergency Nursing

T2 - International Emergency Nursing

JF - International Emergency Nursing

SN - 1755-599X

ER -