In the last eleven years we have seen more disasters that have impacted our healthcare system in numerous ways.  Some of these disasters have had an indirect impact with an influx of patients into the system, while others have directly affected the ability to deliver healthcare.  The lessons learned from all of this led to the very comprehensive “Emergency Preparedness and Disaster Response: Competency Based Educational Objectives for Perinatal and Neonatal Nurses”. 

Proposed change: In this age of continually evolving healthcare, our staff nurses have an overwhelming amount of information to process and learn on an on-going basis, in addition to working in a busy Women’s Hospital that performs around 7,000 births per year. Our approach to meeting these competencies is to provide hands-on training addressing one area of need at a time.

Implementation, outcomes and evaluation:   We started by having all clinical mother-baby team members actually wear our baby evacuation vests carrying four one-gallon water jugs to simulate what it would feel like to physically evacuate four babies, coupled with a review of our fire evacuation plan and location of emergency evacuation routes.  Six months later, we added adult evacuation using the paraslyde and had teams of two to four staff members evacuate a real person from a bed to the floor and down a flight of stairs.  This was paired with additional training on initial fire response, our Hospital Emergency Response Team, and recognizing fire compartments and when to evacuate a fire compartment.  

The feedback from team members was overwhelmingly favorable that they enjoyed being able to actually do hands-on practice for the vests and paraslyde.

Implications for nursing practice:

 We plan to address the following topics including hands on training in the next one to two years: active shooter scenario requiring lock down of the facility, recognition of chemical, biological, radiological, nuclear and explosive agents and how to respond, use of disaster supply carts that have some obstetric specific supplies on them, lecture and practice of triage system, and practice/review of caring for patients in low-tech environments.

Keywords: Disaster preparedness, evacuation, training