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Canadian Journal of Public Health = Revue Canadienne de Santé Publique logoLink to Canadian Journal of Public Health = Revue Canadienne de Santé Publique
. 2007 Sep 1;98(5):358–363. doi: 10.1007/BF03405419

Are We Ready? Evidence of Support Mechanisms for Canadian Health Care Workers in Multi-jurisdictional Emergency Planning

Tracey L O’sullivan 12,22, Carol A Amaratunga 12,32,✉, Jill Hardt 12, Darcie Dow 12, Karen P Phillips 12,42,✉, Wayne Corneil 12,42
PMCID: PMC6975624  PMID: 17985675

Abstract

Background

Federal, provincial and municipal leaders in Canada have adopted a culture of preparedness with the development and update of emergency plans in anticipation of different types of disasters. As evident during the 2003 global outbreak of Severe Acute Respiratory Syndrome (SARS), it is important to provide support for health care workers (HCWs) who are vulnerable during infectious outbreak scenarios. Here we focus on the identification and evaluation of existing support mechanisms incorporated within emergency plans across various jurisdictional levels.

Methods

Qualitative content analysis of 12 emergency plans from national, provincial and municipal levels were conducted using NVIVOTM software. The plans were scanned and coded according to 1) informational, 2) instrumental, and 3) emotional support mechanisms for HCWs and other first responders.

Results

Emergency plans were comprised of a predominance of informational and instrumental supports, yet few emotional or social support mechanisms. All the plans lacked gender-based analysis of how infectious disease outbreaks impact male and female HCWs differently. Acknowledgement of the need for emotional supports was evident at higher jurisdictional levels, but recommended for implementation locally.

Conclusions

While support mechanisms for HCWs are included in this sample of emergency plans, content analysis revealed few emotional or social supports planned for critical personnel; particularly for those who will be required to work in extremely stressful conditions under significant personal risk. The implications of transferring responsibilities for support to local and institutional jurisdictions are discussed.

MeSH terms: Communicable diseases, occupational health, public health, health personnel, health services administration, disease outbreaks, health policy

Footnotes

Acknowledgements: The authors gratefully acknowledge the funding support of the Canadian Chemical, Biological, Radiological and Nuclear Research Technology Initiative (CRTI), Defence Research and Development Canada. Special thanks to our colleagues Lynn McCrann, Heather Smith Fowler, Bob Clarke, Daniel Krewski, Louise Lemyre, and Eileen O’Connor, from the research team for the project titled: Caring About Healthcare Workers As First Responders. Thank you also to several project partners, including the Bureau for Women’s Health and Gender Analysis, Health Canada; the Canadian Federation of Nurses Unions; Victorian Order of Nurses; and the Canadian Women’s Health Network.

References

  • 1.Naylor D, Basrur S, Bergeron M, Brunham R, Butler-Jones D, Dafoe G, et al. Learning from SARS: Renewal of Public Health in Canada. Ottawa, ON: Health Canada; 2003. [Google Scholar]
  • 2.ONA/OPSEU. Final Recommendations to Justice Campbell Regarding: Occupational Health and Safety Matters Arising from SARS. 2004. [Google Scholar]
  • 3.Wisniewski R, Dennik-Champion G, Peltier JW. Emergency preparedness competencies: Assessing nurses’ educational needs. J Nurs Admin. 2004;34(10):475–80. doi: 10.1097/00005110-200410000-00009. [DOI] [PubMed] [Google Scholar]
  • 4.Ruef C. A new influenza pandemic — Unprepared for a big threat? Infection. 2004;32(6):313–14. doi: 10.1007/s15010-004-7604-x. [DOI] [PubMed] [Google Scholar]
  • 5.Public Health Agency of Canada. Canadian Pandemic Influenza Plan. Ottawa: Public Health Agency of Canada; 2004. [Google Scholar]
  • 6.WHO Global Influenza Preparedness Plan [homepage on the Internet]. World Health Organization. 2005. [Google Scholar]
  • 7.Emergency Program Act [homepage on the Internet]. Victoria, BC: Queen’s Printer, 2004. Available online at: https://doi.org/www.qp.gov.bc.ca/ statreg/stat/E/96111_01.htm#section6 (Accessed February 9, 2006).
  • 8.The Emergency Measures Act [homepage on the Internet]. Winnipeg, MB: Queen’s Printer, January 2006. Available online at: https://doi.org/web2.gov.mb.ca/laws/statutes/ccsm/e080e. php#8 (Accessed February 9, 2006).
  • 9.Civil Protection Act [homepage on the Internet]. Quebec, QC: Quebec, December 1, 2005. Available online at: https://doi.org/www.canlii.org/qc/ laws/sta/s-2.3/20060614/whole.html (Accessed February 9, 2006).
  • 10.Emergency Measures Act [homepage on the Internet]. New Brunswick: Queen’s Printer, July 15, 2005. Available online at: https://doi.org/www.gnb.ca/ acts/acts/e-07-1.htm (Accessed February 9, 2006).
  • 11.An Abridged Guide to Emergency Response Roles [homepage on the Internet]. Whitehorse, YK: EMO, March 2004. Available online at: https://doi.org/www.community.gov.yk.ca/pdf/abridged guide2004.pdf (Accessed February 9, 2006).
  • 12.Emergency Preparedness and Planning [homepage on the Internet]. Edmonton, AB: Queen’s Printer, 2003. Available online at: https://doi.org/www.ocipep.gc.ca/ep/legisla/ep_ab/e_p_p_ e.asp#local (Accessed November 2, 2005).
  • 13.The Emergency Planning Act [homepage on the Internet]. Regina, SK: Queen’s Printer, 2003. Available online at: https://doi.org/www.qp.gov.sk.ca/ documents/English/Statutes/Statutes/E8-1.pdf (Accessed February 9, 2006).
  • 14.Emergency Management Act [homepage on the Internet]. Toronto, ON: Queen’s Printer, 2003. Available online at: https://doi.org/www.elaws.gov.on.ca/DBLaws/Statutes/English/90e09_ e.htm (Accessed February 9, 2006).
  • 15.Emergency Measures Act [homepage on the Internet]. Charlottetown, PEI: Queen’s Printer, March 31, 2000. Available online at: https://doi.org/www.gov.pe.ca/law/statutes/pdf/ e-06_1.pdf (Accessed February 9, 2006).
  • 16.Emergency Measures Act [homepage on the Internet]. Nova Scotia: Office of the Legislative Counsel, House of Assembly, June 5, 1998. Available online at: https://doi.org/www.gov.ns.ca/ legislature/legc/statutes/emergmsr.htm (Accessed February 9, 2006).
  • 17.Civil Emergency Measures Act [homepage on the Internet]. Yellowknife, NT: Canarctic Graphics, December 19, 1998. Available online at: https://doi.org/www.justice.gov.nt.ca/Legislation/..%5CP DF%5CACTS%5CCivil_Emerg_Measures.pdf (Accessed February 9, 2006).
  • 18.Civil Emergency Measures Act [homepage on the Internet]. Nunavut: December 19, 1998. Available online at: https://doi.org/action.attavik.ca/ home/justice-gn/attach-en_conlaw_prediv/ Type0281.pdf (Accessed February 9, 2006).
  • 19.Emergency Preparedness [homepage on the Internet]. Newfoundland: Queen’s Printer. Available online at: https://doi.org/www.ocipepbpiepc.gc.ca/ep/legisla/ep_nfld/levels_a_e.asp# munici (Accessed November 2, 2006).
  • 20.Ontario Ministry of HealthLong-Term Care, Emergency Management Unit. Ontario Health Pandemic Influenza Plan. Toronto: June; 2005. [Google Scholar]
  • 21.Amaratunga CA, O’Sullivan TL, In: Walter U, Neumann B (Eds.), Double Jeopardy of Health Professionals in Crisis Situations: Experiences of SARS and Consequences for Gender Strategies, Gender in Health Promotion and Prevention. Vienna: Springer, In press.
  • 22.Hupcey JE. J Adv Nurs. 1998. Clarifying the social support theoryresearch linkage; p. 27. [DOI] [PubMed] [Google Scholar]
  • 23.Heaney CA, Israel B. Social networks and social support. In: Glanz K, Rimer BK, Lewis FM, editors. Health Behavior and Health Education: Theory, Research, and Practice. 3rd ed. San Francisco, CA: Jossey-Bass, Inc.; 2002. [Google Scholar]
  • 24.Yassi A, Bryce E, Moore D. Protecting the face of health care workers: Knowledge gaps and research priorities for effective protection against occupationally-acquired respiratory infectious diseases. Vancouver: Occupational Health and Safety Agency for Healthcare in BC; 2004. [Google Scholar]
  • 25.BC Centre for Disease Control. BC Pandemic Influenza Preparedness Plan. 2005. [Google Scholar]
  • 26.Manitoba Health. Preparing for Pandemic Influenza in Manitoba. 2006. [Google Scholar]
  • 27.Alberta Government. Alberta’s Plan for Pandemic Influenza. 2003. [Google Scholar]
  • 28.New Brunswick Department of Health. New Brunswick Pandemic Influenza Plan: For the Health Sector. 2005. [Google Scholar]
  • 29.Gouvernement du Quéebec. Quebec Pandemic Influenza Plan: Health Mission. 2006. [Google Scholar]
  • 30.Am J Infect Control. 2005.
  • 31.Yassi A, Moore D, Fitzgerald JM, Bigelow P, Hon CY, Bryce E, et al. Research gaps in protecting healthcare workers from SARS and other respiratory pathogens: An interdisciplinary, multi-stakeholder, evidence-based approach. J Occup Environ Med. 2005;47(1):41–50. doi: 10.1097/01.jom.0000150207.18085.41. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 32.Taylor-Clark K, Blendon R, Zaslavsky A, Benson J. Confidence in crisis? Understanding trust in government and public attitudes toward mandatory state health powers. Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Science. 2005;3(2):138–47. doi: 10.1089/bsp.2005.3.138. [DOI] [PubMed] [Google Scholar]
  • 33.Hobbs J, Kittler A, Fox S, Middleton B, Bates D. J Health Commun. 2004. Communicating health information to an alarmed public facing a threat such as a bioterrorist attack; pp. 67–75. [DOI] [PubMed] [Google Scholar]
  • 34.Reynolds B, Seeger M. Crisis and emergency risk communication as an integrative model. J Health Commun. 2005;10(1):43–55. doi: 10.1080/10810730590904571. [DOI] [PubMed] [Google Scholar]
  • 35.Rosen P. Coping with bioterrorism is difficult, but may help us respond to new epidemics. BMJ. 2000;320(7227):71–72. doi: 10.1136/bmj.320.7227.71. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 36.Office of Emergency Management. City of Toronto Emergency Plan. Toronto: City of Toronto; 2004. [Google Scholar]
  • 37.Wynn F, Peter E. Editorial: Nurses and quarantine: Reflections upon the SARS crisis in Toronto. Nursing Inquiry. 2003;10(4):207–8. doi: 10.1046/j.1440-1800.2003.00194.x. [DOI] [PubMed] [Google Scholar]
  • 38.Cava M, Fay K, Beanlands H, McCay E, Wignall R. The experience of quarantine for individuals affected by SARS in Toronto. Public Health Nursing. 2005;22(5):398–406. doi: 10.1111/j.0737-1209.2005.220504.x. [DOI] [PubMed] [Google Scholar]
  • 39.Ohara R. ‘Interminable hell’: Hiroshima’s nurses remember the atomic bomb. Nursing Inquiry. 2005;12(4):303–5. doi: 10.1111/j.1440-1800.2005.00294.x. [DOI] [PubMed] [Google Scholar]
  • 40.Barbera J, Macintyre A, Gostin L, Ingelsby T, O’Toole T, De Atley C, et al. Large-scale quarantine following biological terrorism in the United States: Scientific examination, logistic and legal limits, and possible consequences. JAMA. 2001;286(21):2711–17. doi: 10.1001/jama.286.21.2711. [DOI] [PubMed] [Google Scholar]
  • 41.Enarson E, Morrow B. The Gendered Terrain of Disaster: Through Women’s Eyes. Westport, CT: Praeger Publishers; 1998. [Google Scholar]
  • 42.Amaratunga CA, O’Sullivan TL. In the path of disasters: Psychosocial issues for preparedness, response and recovery. Prehospital and Disaster Medicine. 2006;21(3):139–44. doi: 10.1017/S1049023X00003605. [DOI] [PubMed] [Google Scholar]
  • 43.Chunkath S, Sherratt D, Chotani R, Smyth I, Burns K, Hidayat M. Panel 2.3: Gender dimensions and human rights aspects to responses and recovery. Prehospital and Disaster Medicine. 2005;20(6):404–7. doi: 10.1017/S1049023X00002983. [DOI] [PubMed] [Google Scholar]

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