title: Survey of factors affecting health care workers' perception towards institutional and individual disaster preparedness.
abstract: BACKGROUND
  Health care institutions constantly must be prepared for disaster response. However, there are deficiencies in the current level of preparedness. The aim of this study was to investigate the factors affecting the perception of health care workers (HCWs) towards individual and institutional preparedness for a disaster.
  
  
  METHODS
  A survey on disaster incident preparedness was conducted among doctors, nurses, and allied health workers over a period of two months in 2010. The survey investigated perceptions of disaster preparedness at the individual and institutional level. Responses were measured using a five-point Likert scale. The primary outcomes were factors affecting HCWs' perception of institution and individual preparedness. Secondary outcomes were the proportions of staff willing to participate and to place importance on disaster response training and their knowledge of access to such training. Data was analyzed using descriptive statistics. Logistic regression was performed to determine the factors that influenced the HCWs' perception of their individual and institutional readiness. Odd ratios (ORs) of such factors were reported with their 95% confidence intervals (CIs).
  
  
  RESULTS
  Of 1700 HCWs, 1534 (90.2%) completed the survey. 75.3% (1155/1534) felt that the institution was ready for a disaster incident, but only 36.4% (558/1534) felt that they (as individuals) were prepared. Some important factors associated with a positive perception of institution preparedness were leadership preparedness (OR = 13.19; 95% CI, 9.93-17.51), peer preparedness (OR = 6.11; 95% CI, 4.27-8.73) and availability of training opportunities (OR = 4.76; 95% CI, 3.65-6.22). Some important factors associated with a positive perception of individual preparedness were prior experience in disaster response (OR = 2.80; 95% CI, 1.99-3.93), institution preparedness (OR = 3.71; 95% CI, 2.68-5.14), peer preparedness (OR = 3.49; 95% CI, 2.75-4.26), previous training in disaster response (OR = 3.48; 95% CI, 2.76-4.39) and family support (OR = 3.22; 95% CI, 2.54-4.07). Most (80.7%, 1238/1534) were willing to participate in future disaster incident response training, while 74.5% (1143/1534) felt that being able to respond to a disaster incident constitutes part of their professional competency. However, only 27.8% (426/1534) knew how to access these training opportunities.
  
  
  CONCLUSIONS
  This study demonstrated that HCWs fare poorly in their perception of their individual preparedness. Important factors that might contribute to improving this perception at the individual and institution level have been identified. These factors could guide the review and implementation of future disaster incident response training in health care institutions.
authors: Department of Emergency Medicine, Tan Tock Seng Hospital, Singapore. gheehianlim@gmail.com
authors: Ghee Hian
authors: GH
authors: Lim
authors: Beng Leong
authors: BL
authors: Lim
authors: Alicia
authors: A
authors: Vasu
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards*; D003430:Cross-Sectional Studies; D003625:Data Collection; D004189:Disaster Planning; D005260:Female; D006801:Humans; D007318:Inservice Training; D007857:Leadership; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010564:Personnel, Hospital / Q000193:education* / Q000523:psychology; D020377:Self Efficacy; D012846:Singapore; D062606:Tertiary Care Centers / Q000458:organization & administration* / Q000592:standards; D000078329:Workforce; D055815:Young Adult