Preparing for Burn Disasters: Predictors of Improved Perceptions of Competency after Mass Burn Care Training

Abstract

Introduction:Prehospital and community hospital healthcare providers in the United States must be prepared to respond to burn disasters. Continuing education is the most frequently utilized method of updating knowledge, skills, and competence among healthcare professionals. Since preparedness training must meet multiple educational demands, it is vital to understand how participants'work and educational experience and the program's content and delivery methods impact knowledge acquisition, and how learning influences confidence and competence to perform new skills.Purpose:The purpose of this exploratory, convenience sample study was to identify healthcare provider characteristics and continuing education training content areas that were predictive of self-reported improvement in competence after attending a mass-casualty burn disaster continuing education program.Methods:Logistic regression analysis of data from a post-training evaluation from nine, one-day continuing education conferences on mass burn care was used to identify factors associated with improved self-reported competency to respond to mass burn casualties.Results:The following factors were associated most closely with increased self-reported competency: (1) prehospital work setting (odds ratio (OR) = 3.06, confidence interval (CI) = 0.83–11.30, p = 0.09); (2) 11 or more years of practice (OR = 0.31, CI = 0.09–1.08, p = 0.07); and (3) practice in an urban setting (OR = 0.01, CI = 0.18–0.82, p >0.01). Confidence items included: (1) ability to implement appropriate airway management modalities (OR = 2.31, CI = 1.03–5.17, p >0.04); (2) manage patients with electrical injuries (OR = 4.86, CI = 1.84–12.85, p >0.001); (3) identify non-survivable injuries (OR = 2.24, CI = 0.93–5.43, p = 0.07); and (4) recognize special problems associated with burns in young children or older adults (OR = 2.14, CI = 0.87–5.23, p = 0.10). The final model explained 89.9% of the variability in self-reported competence.Conclusions:Interventions used to train healthcare providers for burn disasters must cover a broad range of topics. However, learning needs may vary by practice setting, work experience, and previous exposure to disaster events. This evaluation research provides three-fold information for continuing education research: (1) to identify content areas that should be emphasized in future burn care training; (2) to be used as a model for CE evaluation in other domains; and (3) to provide support that many factors must be considered when designing a CE program. Results may be useful to others who are planning CE training programs.

Measures of Intervention in Burn Disasters: Preparedness and Crisis Management

“…Results of recently published studies, suggested that a continuing education training course of pre-hospital and community hospital healthcare providers could be effective in improving the participants' knowledge and their abilities and confidence toward burn disaster management. More importantly, the changes in knowledge, abilities, and confidence appear to be translated to an enhanced sense of competence to perform during a burn disaster [7,27]. Facing a burn disaster, any given facility can handle a limited workload at one time [28].…”

“…Instead, in a major burn accident, a field triage protocol for rapid evaluation of burn injuries may be all what is needed. Detailed assessment of injuries of burn casualties is practical only in a specialized clinical setting [27]. It must be acknowledged though that every rapid triage protocol has inherent significant limitations [44,45].…”

Advanced Burn Life Support for Day-to-Day Burn Injury Management and Disaster Preparedness

“…However, several states reported finding it difficult to convey a coherent message of managing multiple burn-injured patients, when the general audience felt uncomfortable managing even the first burn-injured patient. 1,[26][27][28][29][30][31] (The BTHPP is now located in the U.S. DHHS Office of the Assistant Secretary for Preparedness and Response [ASPR] and referred to as the Hospital Preparedness Program [HPP].) 32 The first year this program included offering a wide-reaching series of presentations regarding the aims for the burn surge disaster program and focused on historical burn disasters that wreaked havoc for first responders, first receivers, trauma, and burn centers alike.…”

“…Critical partners include EMS agencies as well as hospitals with and without burn centers. 30,31,33,34 To meet the educational need, those involved with the burn surge disaster program evaluated national standardized educational programs. Key criteria for selection included; current science validated by a national stakeholder organization for the care of a burn-injured patient, 35 a core component involving the management of a surge of burn-injured patients, and was approved to offer the relevant educational credits recognized by the various professional organizations to include physicians, nurses, and paramedical personnel.…”

Could the Kornati Islands Firefighting Tragedy have been Avoided with Better Occupational Medicine and Safety?

“…Frequent education training courses for such staff have to be carried out [9]. Experience and preparedness are preconditions for alleviating disaster events [10].…”