Emergency nurse disaster preparedness during mass gatherings: a cross-sectional survey of emergency nurses' perceptions in hospitals in Mecca, Saudi Arabia

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Abstract

Objectives

To assess hospital emergency nurses' self-reported knowledge, role awareness and skills in disaster response with respect to the Hajj mass gathering in Mecca.

Design

Cross-sectional online survey with primary data collection and non-probabilistic purposive sample conducted in late 2014.

Setting

All 4 public hospitals in Mecca, Saudi Arabia.

Participants

106 registered nurses in hospital emergency departments.

Main outcome measure

Awareness, knowledge, skills and perceptions of emergency nurses in Mecca with regard to mass gathering disaster preparedness.

Results

Although emergency nurses' clinical role awareness in disaster response was reported to be high, nurses reported limited knowledge and awareness of the wider emergency and disaster preparedness plans, including key elements of their hospital strategies for managing a mass gathering disaster. Over half of the emergency nurses in Mecca's public hospitals had not thoroughly read the plan, and almost 1 in 10 were not even aware of its existence. Emergency nurses reported seeing their main role as providing timely general clinical assessment and care; however, fewer emergency nurses saw their role as providing surveillance, prevention, leadership or psychological care in a mass gathering disaster, despite all these broader roles being described in the hospitals' emergency disaster response plans. Emergency nurses' responses to topics where there are often misconceptions on appropriate disaster management indicated a significant knowledge deficit with only 1 in 3 nurses at best or 1 in 6 at worst giving correct answers. Respondents identified 3 key training initiatives as opportunities to further develop their professional skills in this area: (1) hospital education sessions, (2) the Emergency Management Saudi Course, (3) bespoke short courses in disaster management.

Conclusions

Recommendations are suggested to help enhance clinical and educational efforts in disaster preparedness.

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Most cited references 23

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Health risks at the Hajj

Qanta Ahmed, Yaseen M. Arabi, Ziad Memish (2006)

Summary Annually, millions of Muslims embark on a religious pilgrimage called the “Hajj” to Mecca in Saudi Arabia. The mass migration during the Hajj is unparalleled in scale, and pilgrims face numerous health hazards. The extreme congestion of people and vehicles during this time amplifies health risks, such as those from infectious diseases, that vary each year. Since the Hajj is dictated by the lunar calendar, which is shorter than the Gregorian calendar, it presents public-health policy planners with a moving target, demanding constant preparedness. We review the communicable and non-communicable hazards that pilgrims face. With the rise in global travel, preventing disease transmission has become paramount to avoid the spread of infectious diseases, including SARS (severe acute respiratory syndrome), avian influenza, and haemorrhagic fever. We examine the response of clinicians, the Saudi Ministry of Health, and Hajj authorities to these unique problems, and list health recommendations for prospective pilgrims.

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Emergence of medicine for mass gatherings: lessons from the Hajj

Ziad Memish, Gwen Stephens, Robert Steffen … (2011)

Summary Although definitions of mass gatherings (MG) vary greatly, they consist of large numbers of people attending an event at a specific site for a finite time. Examples of MGs include World Youth Day, the summer and winter Olympics, rock concerts, and political rallies. Some of the largest MGs are spiritual in nature. Among all MGs, the public health issues, associated with the Hajj (an annual pilgrimage to Mecca, Saudi Arabia) is clearly the best reported—probably because of its international or even intercontinental implications in terms of the spread of infectious disease. Hajj routinely attracts 2·5 million Muslims for worship. WHO's global health initiatives have converged with Saudi Arabia's efforts to ensure the wellbeing of pilgrims, contain infectious diseases, and reinforce global health security through the management of the Hajj. Both initiatives emphasise the importance of MG health policies guided by sound evidence and based on experience and the timeliness of calls for a new academic science-based specialty of MG medicine.

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Hajj: health lessons for mass gatherings.

Shuja Shafi, Robert Booy, Elizabeth Haworth … (2008)

The potential for spread of infectious diseases associated with mass gatherings is well recognised. Hajj, the unique annual mass gathering of over 2 million Muslims from all over the world, presents enormous challenges to the authorities in Saudi Arabia. They have a comprehensive programme updated annually, to ensure that all aspects of Hajj rituals are conducted safely and without major incident. The inevitable overcrowding in a confined area of such large numbers increases the risk of respiratory infections. Of these 'Hajj cough' is the most frequently reported complaint and is caused by a variety of viruses and bacteria. The outbreaks of meningococcal W135 strains in 2000 and 2001 with the associated high mortality showed the potential for international spread at mass gatherings. Collaboration between health policy makers and community leaders in the UK resulted in a rapid and impressive reduction of these infections. On-going disease surveillance and data analysis is necessary to better understand health risks and strengthen evidence base for health policy and prevention. The battle against spread of travel-related infections is a shared responsibility. Countries sending pilgrims should co-ordinate preventive measures by healthcare professionals and community groups. A multi-pronged approach involving awareness programme for pilgrims and their health advisers, supported by rapid diagnosis, timely treatment, prevention by vaccine, community measures, infection prevention and control practices are necessary. The benefits from such measures go beyond the Hajj to protect health and reduce inequalities. Establishing an international centre for public health relating to the Hajj will enable co-ordinating international health action and appropriate intervention.

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Author and article information

Journal

Journal ID (nlm-ta): BMJ Open

Journal ID (iso-abbrev): BMJ Open

Journal ID (hwp): bmjopen

Journal ID (publisher-id): bmjopen

Title: BMJ Open

Publisher: BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )

ISSN (Electronic): 2044-6055

Publication date Collection: 2017

Publication date (Electronic): 25 April 2017

Volume: 7

Issue: 4

Electronic Location Identifier: e013563

Affiliations

[1 ]Ministry of Health Saudi Arabia, King Fisal Hospital , Mecca, Saudi Arabia

[2 ]School of Health Sciences, City, University of London , London, UK

Author notes

[Correspondence to ] Fuad Alzahrani; alnbhan_fm@ 123456hotmail.com

Article

Publisher ID: bmjopen-2016-013563

DOI: 10.1136/bmjopen-2016-013563

PMC ID: 5477837

PubMed ID: 28400457

SO-VID: d1046fc0-45fc-4beb-ab5a-f2d7a5c89307

Copyright © Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

License:

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

History

Date received : 20 July 2016

Date revision received : 21 November 2016

Date accepted : 20 December 2016

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Emergency nurse disaster preparedness during mass gatherings: a cross-sectional survey of emergency nurses' perceptions in hospitals in Mecca, Saudi Arabia

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Abstract

Objectives

Design

Setting

Participants

Main outcome measure

Results

Conclusions

Related collections

Preventive and Emergency Medicine Insights

Most cited references 23

Health risks at the Hajj

Emergence of medicine for mass gatherings: lessons from the Hajj

Hajj: health lessons for mass gatherings.

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Cited by 23

Most referenced authors 187