title: Disaster Preparedness among Health Professionals and Support Staff: What is Effective? An Integrative Literature Review.
abstract: Introduction It is important that health professionals and support staff are prepared for disasters to safeguard themselves and the community during disasters. There has been a significantly heightened focus on disasters since the terrorist attacks of September 11, 2001 in New York (USA); however, despite this, it is evident that health professionals and support staff may not be adequately prepared for disasters. Report An integrative literature review was performed based on a keyword search of the major health databases for primary research evaluating preparedness of health professionals and support staff. The literature was quality appraised using a mixed-methods appraisal tool (MMAT), and a thematic analysis was completed to identify current knowledge and gaps. Discussion The main themes identified were: health professionals and support staff may not be fully prepared for disasters; the most effective content and methods for disaster preparedness is unknown; and the willingness of health professionals and support staff to attend work and perform during disasters needs further evaluation. Gaps were identified to guide further research and the creation of new knowledge to best prepare for disasters. These included the need for: high-quality research to evaluate the best content and methods of disaster preparedness; inclusion of the multi-disciplinary health care team as participants; preparation for internal disasters; the development of validated competencies for preparedness; validated tools for measurement; and the importance of performance in actual disasters to evaluate preparation.
  
  
  CONCLUSIONS
  The literature identified that all types of disaster preparedness activities lead to improvements in knowledge, skills, or attitude preparedness for disasters. Most studies focused on external disasters and the preparedness of medical, nursing, public health, or paramedic professionals. There needs to be a greater focus on the whole health care team, including allied health professionals and support staff, for both internal and external disasters. Evaluation during real disasters and the use of validated competencies and tools to deliver and evaluate disaster preparedness will enhance knowledge of best practice preparedness. However, of the 36 research articles included in this review, only five were rated at 100% using the MMAT. Due to methodological weakness of the research reviewed, the findings cannot be generalized, nor can the most effective method be determined. Gowing JR , Walker KN , Elmer SL , Cummings EA . Disaster preparedness among health professionals and support staff: what is effective? An integrative literature review. Prehosp Disaster Med. 2017;32(3):321-328.
authors.affiliation: 1St Vincent's Private Hospital Sydney,New South Wales,Australia.
authors.forename: Jeremy R
authors.identifier: http://orcid.org/0000-0002-2055-5236
authors.initials: JR
authors.lastname: Gowing
authors.affiliation: 1St Vincent's Private Hospital Sydney,New South Wales,Australia.
authors.forename: Kim N
authors.initials: KN
authors.lastname: Walker
authors.affiliation: 2University of Tasmania,School of Health Science,Tasmania,Australia.
authors.forename: Shandell L
authors.identifier: http://orcid.org/0000-0001-9757-9976
authors.initials: SL
authors.lastname: Elmer
authors.affiliation: 2University of Tasmania,School of Health Science,Tasmania,Australia.
authors.forename: Elizabeth A
authors.identifier: http://orcid.org/0000-0001-6501-7450
authors.initials: EA
authors.lastname: Cummings
mesh_terms: D004189:Disaster Planning; D006282:Health Personnel; D006801:Humans; D007318:Inservice Training; D011361:Professional Competence
keywords:  EMT emergency medical technician;  EPIQ Emergency Preparedness Information Questionnaire;  MMAT mixed-method appraisal tool;  PPE personal protective equipment;  RN Registered Nurse;  START Simple Triage and Rapid Treatment System;  hospital; disaster planning; disasters; health personnel; learning; personnel