Aim: This study aimed to evaluate the use of the “Natural Disaster Preparedness Scale for Hospital Nursing Departments” tool, before applying it in real health settings.

Methods: The study subjects were representatives of nursing departments in hospitals across Japan and nursing managers in charge of disaster prevention and response within these hospitals. In this two-phased study, 5,093 hospitals were informed about the development of the Scale and invited to test it. Five months later, a questionnaire was sent to these hospitals by postal mail, to seek feedback on their use of the Scale. In the second phase, participants were invited to use an online version of the Scale and provide feedback about it.

Results: Survey responses for Phase 1 were obtained from 1,366 hospitals (26.8%). The uptake of the Scale was extremely limited, with only 5.3% (n = 72) of the hospitals reporting having used it. Sixty-two out of 72 hospitals (86.1%) that had used the Scale answered they would like to use the Scale again. In Phase 2, the Scale was provided online. It was used 214 times by 186 hospitals, and the evaluation items were completed by 29 hospitals that used it frequently.

Conclusions: Implementing systems in Japanese hospitals to measure how nurses prepare for disasters is a complex process. The majority of nurses in Japan remain to be convinced that their disaster preparedness can be measured by a validated Scale. Further education in Japan’s hospitals will be necessary to change these perspectives, given that nurses’ preparation for such emergencies is mandated by law in their role as nurses in disaster base hospitals.

Aim: To strengthen disaster risk-reduction capacities of a community, a combination of self-help, mutual assistance and government aid is crucial. Government aid is limited for the large-scale disaster due to many reasons, and not all people can protect their own lives themselves. Thus, mutual assistance could enhance their capacities in response to a disaster. This paper aimed to explore mutual assistance activities during disasters at communities in Japan, Indonesia and Nepal, in order to understand its value in nursing for disaster risk reduction. This study was needed to get the database for further research focusing on nursing contribution to disaster risk reduction.

Methods: Case analysis was conducted based on authors’ experiences, government documents, news articles, and personal communications with affected community peoples who experienced disasters in Soma, Japan; Jakarta, Indonesia; and Bhaktapur, Nepal.

Results: Mutual assistance was performed in the community in each of the three countries despite differences in regional, socio-cultural, economic, and types of disaster. Until the arrival of government aid, community people helped each other to evacuate, provide first aid, distribute food, maintain sanitation in shelters, and so on. Nurses provided routine care before the disaster and during the response activities following the disaster.

Conclusion: Mutual assistance helps the community people to minimize the disaster effects before the disaster, and to recover better in the post-disaster period. Nurses should expand their roles in improving mutual assistance in the community for disaster risk reduction. This study suggests the needs of study in identifying nursing activities for strengthening mutual assistance.

Aim: This project investigates the effect of subjective sleepiness on critical skills performance of National Guard (NG) medical personnel during highly realistic and immersive disaster-training exercises.

Methods: This study used a longitudinal, observational design in a sample (n=77) of NG medical personnel over three high-intensity disaster-training exercises. During three separate 3- to 5-day disaster response training exercises, participants completed a critical skills test four times per day. At the same time, their subjective sleepiness was measured using the Karolinska Sleepiness Scale (KSS). The effect of subjective sleepiness on: (1) reaction time to complete critical skills questions; and (2) accuracy in completing critical skills questions were analyzed using generalized linear mixed models.

Results: With changing disaster response duties and assignments, 91% of participants responded to 2,228 critical skills questions over two to three different disaster exercises. When levels of sleepiness (KSS self-reported scores) were rated as ‘Extremely alert’, response accuracy averaged 91%; however, when self-reported sleepiness was scored as “Extremely sleepy”, accuracy dropped to 60%.

Conclusions: Increasing sleepiness correlated significantly with decreasing accuracy on critical skills questions. Participant professional licensure was also significantly correlated with accuracy of responses to critical skills questions. Military deployments and disaster-training exercises designed to replicate real-world events require prolonged periods of sleep insufficiency or sleep interruptions. Adjustments to shift work for nurses, attention to pre-deployment screening and education, and a change in cultural attitudes may be needed to make a positive difference in morale, mission completion, and casualty reductions.

Aim: This study describes the practices and challenges of disaster nursing experienced by Japanese nurses who were sent to Nepal soon after the 2015 earthquake.

Methods: Semi-structured interviews were conducted with 12 nurses (eight women), with a mean age of 38.6 years (SD 7.3 years). The interview content was analyzed qualitatively and descriptively using content analysis.

Results: Disaster nursing in Nepal included special content due to differences in the disaster sites, environment, and languages. The targets for nursing practices were victims, team members, local medical institutions and support groups, and the local staff in Nepal. Nurses experienced challenges in providing appropriate care related to the local background, communicating with local patients and staff from other countries, and collaborating as a team. Nurses lacked information about local infections; the knowledge level and educational background of local midwives and nurses; the literacy rate; and social characteristics including the caste system, culture, and rules related to health care. Participants also experienced challenges using certain materials due to the high temperature and humid climate (e.g., wound dressings); however, they developed suitable substitutes. Some nurses had difficulty using Fahrenheit thermometers, as they were unfamiliar with the measurement system. Further, the management of heat stroke, infection, and food allergies was necessary.

Conclusions: Major challenges for the Japanese nurses were the shortage of knowledge and skills related to the local background, communication, and team collaboration. These skills should be emphasized in training before deployment, and in basic disaster nursing education.

Aim: Disaster preparedness education is one approach to improving the preparedness of the health and public sector work force. The purpose of this report is to describe one approach to improving disaster preparedness for nurses and other health professionals through the unique opportunities available through academic study abroad. This report will describe the process of developing, approving, and implementing a disaster preparedness course in Saint Kitts and Nevis as a model for other programs.

Methods: This case report was written based on the experiences of the authors who have together developed and implemented an interdisciplinary study abroad program in disaster preparedness and global health at three different institutions. Common strategies and barriers are described to model and encourage others to produce similar programs in other locations.

Results: The major steps involved in creating a disaster preparedness study abroad program are selecting an international partner, developing course curriculum, writing a course program proposal, recruiting students, and maintaining international partnerships. As an example, the program in Saint Kitts and Nevis is described and incorporates learning strategies, including guest lectures, applied activities, service learning, cultural experiences, and simulation activities.

Conclusion: This case report provides an example of how to propose, develop, and implement a study abroad course in disaster preparedness. As disaster preparedness, response, and management is a multidisciplinary field, early exposure to diverse training and knowledge in a new environment can prepare nurses and professionals from other disciplines to contribute to a culture of disaster preparedness both in their chosen communities and across the globe.

Aim: This article describes processes and lessons learned from volunteer activities following the 2016 Kumamoto earthquake by graduate nursing students from the Japanese Red Cross College of Nursing. The aim is to provide suggestions about support activities for nurses in future disasters.

Method: The students planned the activities using a management process.

Result: Activities were undertaken in a medical and welfare facility. Facility equipment was damaged as a result of the earthquake, which caused an increased workload for those already caring for patients. This resulted in little rest for healthcare workers, causing them fatigue and exhaustion. To assist in maintaining pre-disaster activities with as little disruption to the patients as possible, the students supported both patients and healthcare workers. The students spent the majority of their time on day shift, which provided them the opportunity to listen to the healthcare workers as they expressed their concerns and experience of having survived the earthquake. A follow-up evaluation was undertaken 2 years post-earthquake to seek feedback on the activities and results in published articles relating to the disaster.

Conclusion: Necessary lessons learned included using pre-disaster networks, identifying needs in the disaster areas through assessment, and ensuring safety preparation before the activities. At the time of activity, the attitude of respecting the healthcare workers led to the establishment of good relationships, and listening to the healthcare workers contributed to care of their mental health. In addition, it is necessary to build a system for all the affected medical and welfare facilities to receive impartial supports.