This section covers Public Health Preparedness.

Transcription

1 This section covers Public Health Preparedness. The primary goal of this section is to identify the role of the PHN in Wisconsin for emergency preparedness and identify available resources. 1

2 Since September 11, 2001, and the anthrax incidents that followed, public health and hospitals have been thrust to the forefront of terrorism and emergency planning. Great strides have been made in Wisconsin's public health preparedness efforts, and Wisconsin s public health system is more prepared now than it has ever been before. Public health is better equipped, has improved its response plans, is training staff, and now routinely drills and exercises coordinated public health emergency response plans across the state. The terms on this slide and the following are specific to the area of Public Health Preparedness. Refer to the resource page for more information if you are not familiar with these terms. 2

3 The public health preparedness response to disasters and emergencies is based on the four phases of disasters as defined by the CDC to be mitigation, preparedness, response and recovery. Public health nurses bring critical expertise to each phase of disaster. An example of the mitigation phase would be the PHN response to a heat advisory. The PHN applies the nursing process at the individual and community levels to develop a mitigation response. 3

4 In this example of how the PHN is involved in the preparedness phase of disaster planning, the nurse brings a focus on the needs of special populations living in the community. PHN s are also involved in responding to disasters and collaborates with other agencies in providing an appropriate community response. 4

5 The PHN uses their knowledge of the nursing process to work with populations over time to assure individual, community and system needs are met to alleviate the impact of disasters. The purpose of the Wisconsin Public Health Emergency Plan, or PHEP, is to enable participating institutions and agencies to meet local, regional and state needs in a collaborative and organized manner during public health events that may involve large numbers of affected individuals. The Public Health Emergency Plan uses the National Incident Management System, or NIMS, to ensure that state and local agencies have a standardized approach to prepare, prevent, respond to, and recover from an event. The plan identifies the structure to allow public health agencies to call upon outside resources as well as details the process for activation of the response plan, coordinating response between other local, state, and federal agencies and other partners. The plan also includes protection of health care workers, providers, first responders, and the public. The Wisconsin Public Health Emergency Plan is designed for use by the public health sector in response to local outbreaks, larger multi-jurisdictional regional outbreaks, or in a coordinated response to a statewide or national outbreak. Some examples might be a local outbreak of pertussis, a regional outbreak of monkey pox, or a national response to pandemic Avian Influenza. 5

6 The Wisconsin Public Health Emergency Plan is organized into six major sections: - Quick Activation Checklist - Administration, including - Public Health Legal Authority - Purpose, Member Agencies, Update Cycle - Operations, including - 10 sections - Related Documents, and a - Glossary & Acronyms The Operations Sections of the Public Health Emergency Plan provides direction for how activities take place and is focused on the coordinated local public health and state public health response. It is organized into ten sections. 1. PHEP Activation response starts at the local level and expands to the national level. 2. Surveillance & Epidemiological Investigation includes reporting, evaluating, investigating, monitoring and follow-up. 3. Resource Management includes Mutual Aid, and management of human resources, staff and volunteers, equipment, and supplies. 4. Containment Measures includes infection control, and public health practices of social distancing, isolation and quarantine. 5. Laboratory includes notification, specimen submission, and dissemination of results. 6. Medicine Distribution addresses mass clinics, and response to large scale emergencies by accessing the Interim Pharmaceutical Stockpile (IPS) and Strategic National Stockpile (SNS), and the SNS Receiving, Storing and Staging (RSS) Warehouses. 7. Waste Disposal directs how to separate, store, secure and monitor biological waste. 8. Risk Communication is on how the Public Information Officer coordination of messages to the public and media, use of hotlines and services. 9. Tactical Communication focuses on use of redundant communication such as satellite phones and radios and a designated communication hub. 10. Demobilization and Evaluation is the last section on the demobilization process, recovery and evaluation. 6

7 Every public health agency in Wisconsin has Mutual Aid Agreements and Memorandums of Understanding as legal documents to authorize the sharing of agency personnel, materials, supplies and resources to assist other agencies in providing a public health emergency response. Wisconsin Act 186 provides the authority for local health departments to request mutual aid in a situation that warrants an increased capacity due to overextension or loss of resources. The purpose of this position paper from the Association of State and Territorial Directors of Nursing, is to provide national guidance to all public health nurses in the United States and itsterritories that describes the roles and actions public health nurses must take to protect the health and safety of communities, families, and individuals during emergencies. Reviewing this document is important to your orientation as a PHN. 7

8 There are five foundational principles to guide the practice of public health nursing in emergencies: 1. Public health nursing roles in emergency preparedness are generally consistent with the scope of public health nursing practice. 2. The components of the nursing process are in alignment with the phases of all-hazards emergency preparedness. 3. Competencies provide a framework for defining public health nursing roles and actions in emergency preparedness. 4. Competencies are directly linked to education, training and practice events. 5. Public health nurses bring leadership, policy, planning and practice expertise to emergency preparedness and response. The related competencies are on the next two slides. All healthcare workers in public health emergency and disaster preparedness need skills that are covered in a set of core competencies. There are 12 emergency preparedness core 8

9 competencies identified by the Association of State and Territorial Directors of Nursing that apply specifically to public health nurses. These competencies are shown on this and the next slide. Developing these competencies in all public health nurses provides a substantial step toward the CDC s vision of every health department fully prepared: every community better protected. Initial orientation to these competencies can be done in a general way. Full training and measurement requires tailoring them to the structure and function of each agency and the anticipated individual functional roles of public health nurses during an emergency. TRAIN, or the TrainingFinder Real-Time Affiliate Integrated Network, is a source to find and register for public health related training sessions throughout Wisconsin and the nation. Each session includes the corresponding public health core competencies. TRAIN includes a Resource tab offering free use of training manuals, Powerpoint presentations, and other educational tools and materials. 9

10 TRAIN may also be used as an electronic database to maintain and track any related public health training you complete. The Wisconsin Health Alert Network (WI HAN) is a health alert and communications system developed for use by Wisconsin's Public Health departments, hospitals, clinics, emergency rooms, laboratories, law enforcement, fire service, EMS, volunteer and other health agencies. It is funded by a grant from the CDC with the goal of an improved communications infrastructure for all Wisconsin Public Health Agencies and their partners. The Wisconsin Pandemic Flu Resource website is a great source of information on many topics including seasonal influenza, avian influenza, and pandemic influenza. It also includes the WI Pandemic Toolkit for guidance on pandemic planning for communities, businesses, health care facilities, schools, and families. 10

11 Public health preparedness also provides opportunities to use public health interventions. The three most common and important are: 1. Surveillance: Public health nurses are instrumental in surveillance for unusual disease occurrence or patterns. In addition to monitoring the communicable disease trends in communities, the public health nurse often works with the schools to develop surveillance systems for influenza-like-illnesses. 2. Community Organizing: Community organizing helps community groups identify common problems or goals, mobilize resources and develop and implement strategies for reaching goals they collectively set. Public health nurses participate in community organizing with the schools, businesses, day care centers, and community members to help make plans in case of emergency or disaster. 3. Collaboration: The local consortiums are examples of local health departments collaborating to be prepared for emergencies to achieve a common goal by pooling their resources. This program was developed through a partnership between the Wisconsin Department of Health Services and the University of Wisconsin-Madison School of Nursing through the 11

12 Linking Education and Practice for Excellence in Public Health Nursing Project funded by DHHS/HRSA/#D11HP This module would not have been possible without the input of the many public health nurses in academia and practice across the State of Wisconsin who contributed to this program. We would like to give special thanks to those who provided content review of this module. Expert consultation for this module was provided by: Jackie Kowalski, RN, Regional Immunization Consultant, Bureau of Communicable Disease, Wisconsin Division of Public Health Susan Nelson, RN, MSN, Regional Immunization Consultant Bureau of Communicable Disease, Wisconsin Division of Public Health Tanya Oemig, WEDSS Manager, Bureau of Communicable Disease, Wisconsin Division of Public Health Lorna Will, RN, MA, Program Director, Respiratory Diseases and International Health Unit, Bureau of Communicable Disease, Wisconsin Division of Public Health 12