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Disaster Management and Triage
Full text linkClarifying the Disaster Triage Plan for Volunteer Nursing Faculty and Students at a Private University Campus
This project provides a brief overview of the collaboration between campus security, the campus health clinic, and the nursing department at a private university in a disaster requiring medical triage. The partnership between campus security and senior nursing students aims to amplify the original plans of the current disaster preparedness and clarify volunteer roles for nursing students and faculty. Both agencies have emphasized the importance of disaster preparedness and the support role the nursing department can play in these plans. The main goal of this project was to create a protocol and education recommendations for nursing faculty and students willing to volunteer in case of a mass casualty event such as an earthquake. This intervention will allow all departments to coordinate well and have streamlined communication.
Background
According to the United States Geological Survey (USGS, 2024), around 37 states in the United States, including Washington, have experienced earthquakes of a magnitude 5 over the last 200 years. The Seattle Office of Emergency Management (SOEM, 2014) states that earthquakes are the most dangerous hazard in Seattle, Washington, due to the city being on a major faultline.
During the initial assessment stage of this project, it was discussed that the nursing department had a specified role to play in the case of a disaster such as an earthquake. Specific protocols for volunteers from the nursing faculty and students needed to be developed. There was a knowledge deficit in the nursing department regarding how they could help in a mass casualty event. Without specified volunteer roles and responsibilities, confusion and inefficiency would impair the assistance and human resources the nursing department can provide. Therefore, we started our planning and based our intervention on education.
Activities
The main goal of this project was to address the nursing department’s knowledge deficit regarding disaster triage procedures in collaboration with campus security and the campus health clinic. With this in mind, we planned and implemented realistic interventions for the nursing department. The university has emergency and evacuation protocols in place, and the health clinic has specific plans for a triage tent in the case of a disaster. Drawing from these resources, we created educational tools to assist in the understanding of triage and disaster preparedness to nursing students and faculty.
Hung et al. (2021) demonstrated the effectiveness of disaster preparedness education related to increased knowledge and perceived ability of nursing students in case of disaster. With this knowledge, we developed recommendations for integrating university-specific disaster preparedness education into the nursing program curriculum. Recommendations include a fifteen-minute presentation on the triage and health clinic disaster response plan incorporated into nursing school orientation and an in-depth disaster simulation training later in the program. Simulation training would count for required nursing student clinical hours. We also held an educational session for the first year nursing students. The educational sessions contained nursing students’ and faculty’s expectations and clear volunteer roles in evacuation and triage care. This activity was done in a nursing class with 35 students, which lasted 45 minutes. This presentation may be supplementary to the presentation that the faculty can use during orientation.
Arslan et al. (2024) examined nursing students\u27 experiences during an earthquake and found that while several students participated in search and rescue efforts, there was a significant need for improved organization and coordination in earthquake response protocols. These instructions were designed to be stated succinctly on a badge card to be attached to students’ identification cards for easy access and in resource pages accessible to students and faculty.
Triage is an important component of medical disaster response, so we incorporated triage basics into our project. SALT (sort, assess, life-saving interventions, treatment and/or transport) triage effectively provides the most help to the most people with the available resources (Mehralian et al., 2023). Basic triage instructions were included on the badge cards and within the volunteer roles document to be included in course resources. Additionally, we included a recommendation for SALT triage training to be integrated into the curriculum. While our basic triage instructions were not equivalent to SALT as we had no grey category, we emulated it as much as possible while following the triage instructions already in place by health services.
Given the ongoing nature of our project, we also created documents to ensure sustainability. The first document summarized the role of campus security, the campus health clinic, and the nursing department in case of disaster to ensure that each entity involved had the same information. The second document summarized our assessment, project, and recommendations for future projects to be given to a future leadership group.
Outcomes
We generated three goals for the outcome of the project, and we met each of these to some extent. Our first goal was that campus security and the nursing department would have clear communication on how to collaborate should a disaster occur. This goal has been met by creating our document that details the roles of campus security, the health clinic, and nursing volunteers in the case of a disaster. This document has been shared with the head of campus security and the Dean of Nursing.
Our next goal was that nursing faculty and students would clearly understand their opportunities to volunteer and what steps to take during a mass casualty disaster. This goal has not yet been met. While we created educational and informational materials, we were only able to share these with one class, evaluating their learning with a Kahoot. The created materials will be reviewed by leaders in the nursing department and will be implemented in the future after they are approved.
Our last goal was that we would execute a solid plan and outline further steps regarding the collaboration between campus security and the campus health clinic for future nursing students to utilize. We have met this goal by creating documents to share with future nursing leaders to ensure sustainability of our project.
A key limitation of the project was the limited time available to provide educational sessions to other cohorts within the nursing program. We propose incorporating a training session during orientation for incoming cohorts to ensure continuity. This session could be simulation hours, reinforcing disaster preparedness and emphasizing its importance. Additionally, we recommend a brief yet impactful disaster planning and role-specific training for staff, lasting approximately 15 to 30 minutes, to be included in the back-to-school meeting.
Conclusion
This project addressed a knowledge deficit within the nursing department with regard to how they can volunteer in the case of a mass casualty disaster. The impact of this education and policy recommendation prepares the nursing department to volunteer effectively. This project greatly improves the outcomes of the private university in the event of a mass casualty disaster by equipping the nursing department to help the security office and health clinic effectively save lives with available resources.
References
Arslan, N., Topan, A., & Kurtuncu, M. (2024). Earthquake experiences of nursing students residing in earthquake zone, the disaster of the century: A qualitative study. Omega, 302228241231013. Advance online publication. https://doi.org/10.1177/00302228241231013
Hung, M. S. Y., Lam, S. K. K., Chow, M. C. M., Ng, W. W. M., & Pau, O. K. (2021). The effectiveness of disaster education for undergraduate nursing students\u27 knowledge, willingness, and perceived ability: An evaluation study. International Journal of Environmental Research and Public Health, 18(19), 10545. https://doi.org/10.3390/ijerph181910545
Mehralian, G., Pazokian, M., Akbari Shahrestanaki, Y., Salari, A., Saberinia, A., & Soltani, S. (2023). Development and validation of SALT triage method to facilitate the identification and classification of patients in mass casualty incidents. Journal of Injury & Violence Research, 15(2), 137–146. https://doi.org/10.5249/jivr.v15i2.1681
Seattle Office of Emergency Management. (2014). Earthquakes: A Seattle hazard identification & vulnerability analysis (SHIVA). Retrieved January 22, 2025, from https://www.seattle.gov/documents/Departments/Emergency/PlansOEM/SHIVA/2014-04-23_Earthquakes(0).pdf
U.S.G.S. (2024). New USGS map shows where damaging earthquakes are most likely to occur in the U.S. Retrieved January 22, 2025, from https://www.usgs.gov/news/national-news-release/new-usgs-map-shows-where-damaging-earthquakes-are-most-likely-occur-u
The power of disconnecting: The moderating effect of decompression on safety culture and organizational commitment in nurses
Full text linkThis dissertation examines the role of decompression in moderating and mediating the relationship between safety culture and affective organizational commitment among nurses in a pediatric healthcare organization. Data from 908 nurses were analyzed to test two primary hypotheses. The first hypothesis proposed that safety culture would positively predict organizational commitment, and the results supported this, showing that stronger safety cultures were associated with greater organizational commitment (b = 0.55, p \u3c .001). The second hypothesis suggested that decompression would moderate the relationship between safety culture and organizational commitment. However, decompression did not significantly moderate this relationship across the overall sample (b = 0.03, p = .258). Post hoc mediation analysis, however, revealed that decompression acted as a significant mediator (b = 0.071, p = .05), highlighting that decompression enhances the effect of safety culture on organizational commitment. These findings underscore the importance of fostering a strong safety culture and implementing decompression strategies, such as mindfulness practices and structured breaks, to improve nurse well-being and retention. Implications for healthcare organizations aiming to enhance workforce resilience and commitment are discussed, alongside suggestions for future research exploring departmental variations in decompression\u27s effectiveness
Examining the Impact of Depression and Anxiety on the Trajectory of Executive Functioning and Processing Speed in Mild Cognitive Impairment (MCI)
Full text linkMild cognitive impairment (MCI) is an intermediary state between normal aging and dementia which is growing in prevalence in the older adult population. Trajectories for MCI are variable and can result in a variety of outcomes including a rescinding of the MCI diagnosis, progression to dementia, or a new state of cognition. The current study examined the impact of depression and anxiety on the cognitive domains of executive functioning and processing speed in MCI trajectories. Data was used from the National Alzheimer’s Coordinating Center’s Uniform Data Set and included a sample of 2886 participants with and MCI diagnosis. Hierarchical linear modeling procedures were conducted to examine the impact of depression and anxiety over time on executive functioning and processing speed over a 3 year period. Results indicated that increasing depression over time was significantly associated with declining executive functioning over time (t = 6.20, p \u3c .001) and poorer processing speeds over time (t = -7.06, p\u3c .001). Increasing anxiety over time was significantly associated with declining executive functioning over time (t = 3.06, p = .002) but was not associated with changes in processing speed over time (t = -1.15, p = .250). Additionally, individuals with greater increases in depression (B = 0.10, p = .010) and/or anxiety (B = 1.04, p = \u3c .001) demonstrated a higher chance of progressing from MCI to dementia within the 3 years of the study. Results suggest that mental health factors including depression and anxiety may serve as unique predictors of cognitive decline and trajectories in MCI. Clinical implications, limitations, and future directions are discussed
The Role of Somatization in Predicting Health-Related Quality of Life among Racial and Ethnic Minorities: Examining the Mediating Effects of Perceived Injustice and Symptom Catastrophizing
Full text linkThere is a pressing need to address the significant health disparities of underrepresented groups such as racial and ethnic minorities (Mills et al., 2020). As of 2019, individuals identifying as a racial or ethnic minority make up 40% of the U.S population as of 2019, yet they fare significantly worse across many health-related measures (Hill et al., 2022). Given these disparities in healthcare and health outcomes, racial and ethnic minorities represent an important group to investigate somatization and health-related quality of life (HRQOL). Cognitive appraisals, such as perceived injustice and symptom catastrophizing, may mediate this relationship, influencing how somatization translates into reduced HRQOL given the association between maladaptive cognitive appraisals and physical and mental health outcomes (Seto & Nakao, 2017; Trost et al., 2018). Additionally, structural racism, discrimination, and lack of culturally competent care and resources perpetuates perceived injustice and the significant gap in healthcare outcomes among racial-ethnic minorities (Trost et al., 2018; van Ryn & Fu., 2003). Despite the large representation of racial-ethnic minorities within the U.S population, relatively little is known how somatization impacts HRQOL in racial-ethnic minorities and there remains a gap in understanding the processes occurring in the individual that impacts the relationship between somatization and HRQOL. This study sought to expand on the current understanding of somatization and healthcare disparities by investigating the mediating effects of symptom catastrophizing and perceived injustice on the relationship between somatization and HRQOL in racial-ethnic minorities.
Results indicated that higher somatization scores significantly predicted worse HRQOL outcomes, both physically and emotionally. Parallel mediation analyses demonstrated that somatization significantly predicted symptom catastrophizing (b=0.50, p\u3c .001) and perceived injustice (b=1.48, p\u3c .001). The total indirect effect of somatization on physical health through both mediators was significant (b=-1.05, 95% CI [-1.68, -0.51]), although neither mediator independently reached statistical significance. However, perceived injustice independently mediated the relationship between somatization and emotional health significantly (b=-0.81, 95% CI [-1.49, -0.16]), while symptom catastrophizing did not significantly mediate this relationship. This suggests external attributions of injustice may intensify emotional distress more broadly than symptom catastrophizing and further suggests the need for further exploration of factors impacting the relationship between somatization and HRQOL in racial-ethnic minorities
Seattle Pacific College Chorus, Circa 1921
No full textThe Seattle Pacific College Chorus standing for a photo indoors.https://digitalcommons.spu.edu/archives_images_seminary/1115/thumbnail.jp
Cultural Contexts in Psychotherapy: Exploring Person-Centered Therapy Across Individualistic and Collectivistic Cultures
No full textPerson-centered therapy (PCT), a therapeutic approach emphasizing autonomy and self-expression, may not fully address the cultural needs of individuals from collectivistic backgrounds, where identity is shaped by interdependence, family roles, and group harmony. This proposed mixed-methods study investigates whether a culturally tailored version of PCT (CPCT), integrating collectivistic values and family dynamics, leads to more effective identity exploration than standard PCT. The study focuses on adults aged 18–25 in the United States seeking therapy for identity-related concerns. Participants (N = 140) will be randomly assigned to 12 sessions of either PCT or CPCT. Cultural orientation of the participants will be measured using the Auckland Individualism and Collectivism Scale. Effectiveness of therapy in identity exploration will be assessed through the Self-Concept Clarity Scale and semi-structured qualitative interviews. A linear regression model will examine main effects of therapy type, while moderation analysis will test whether cultural orientation influences therapy effectiveness. The study hypothesizes that CPCT will result in greater improvements in identity clarity, self-concept coherence, and alignment with cultural values, particularly for individuals with collectivistic cultural orientation. Study findings aim to advance culturally responsive clinical practice by empirically testing adapted therapeutic models, with implications for therapist training and improved treatment outcomes across diverse populations
Beers\u27 Home
No full textThe family home of the Beers family, photographed from the sidewalk.https://digitalcommons.spu.edu/archives_images_seminary/1047/thumbnail.jp
Free Methodist Church, Circa 1901
No full textNew and old buildings of the First Free Methodist Church shown, photo taken from the street corner. The new building was constructed in 1901.https://digitalcommons.spu.edu/archives_images_seminary/1105/thumbnail.jp
The Impact of Home and School Socialization on White Identity
No full textYoung White individuals often do not have answers to questions surrounding their culture, very few give out defining features of their White identity with confidence (Dottolo & Stewart, 2013). Instead of answering these questions with specific definitions, they respond with “I don’t know” or they deflect the question by shifting to another way to identify themselves either through religion or location. Following the grounded theory approach described by Strauss & Corbin (1990), we conducted semi-structured interviews at a college in the Southeastern region (n= 36) of the United States including topics such as their home and school experiences, their White cultural experiences, and defining White identity. The data was analyzed using an open coding process to identify thematic categories, utilizing the keywording function of the qualitative data analysis program, Transana. When asked about their first experiences recognizing their own White identity, the participants drew from their family background and school environment. Those who grew up in a more homogeneous environment tended to articulate their White identity in terms of their personal, American experience. Those who had more exposure to diversity during their schooling tended to describe their White identity in comparison to the “others”. This study demonstrates that there are multiple pathways of recognizing and defining one’s racial identity. Recognizing these different pathways will help researchers and educators to address different trajectories of development, meeting young White individuals where they are at, in order to facilitate their progression in White racial identity development
White Identity and its Inherent Ties to Americanism
No full textWhite individuals often experience negative emotions such as guilt and anger when talking about White identity and privilege (Dottolo & Stewart, 2013). Although these negative emotions can work as catalysts for social justice activism, the remorse and distress may be overwhelming and counterproductive (Pinterits et al., 2009). We conducted semi-structured interviews with 36 undergraduate college students from the southeastern area of the United States. The participants were asked open-ended questions about how they perceive their own White identity, white culture, and about white privilege and white guilt. We then organized the transcribed data into thematic categories utilizing the collection function of Transana, a qualitative data analysis program. We found that participants struggled to talk about their White identity and what white culture was. Instead, they articulated their White identity in terms of being American, as national identity could be seen as more value-neutral than racial identity. White identity in America may be intrinsically tied to white privilege and white guilt, so White individuals may describe their identity in terms of other intersectional identities