A Comparison of the Nursing Home Evacuation Experience Between Hurricanes Katrina (2005) and Gustav (2008)
A Comparison of the Nursing Home Evacuation Experience Between Hurricanes Katrina (2005) and Gustav (2008)
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DOI：
10.1016/j.jamda.2009.06.010
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发表时间：
2009-11-01
影响因子：
7.6
通讯作者：
Dosa, David
中科院分区：
文献类型：
--
作者：
Blanchard, Gary;Dosa, David
背景：卡特里娜飓风的悲惨遗产之一是路易斯安那州（LA）养老院（NH）居民的生命损失。卡特里娜飓风揭示了对如何安全疏散脆弱人群的应急准备和理解的惊人缺乏。三年后，洛杉矶为古斯塔夫飓风做好了准备，这场风暴预示着可以与卡特里娜飓风相媲美。虽然它的破坏程度最终与卡特里娜相比相形见绌，但古斯塔夫之前的警告和预测路径产生了一个类似于卡特里娜的NH疏散过程。本文的目的是确定是否NH行政主管（ADS）觉得更准备在Gustav.Methods之前撤离：在2006年，Dosa等（5）（J Am Med Dir Asphalt，3/07），采访了20个NH ADS定性电话调查，以评估他们从卡特里娜飓风中吸取的教训。与这20家参与养老院的管理人员进行了联系，并要求他们参加一项后续调查，以比较2005年和2008年之间的飓风准备情况。具体而言，ADS被问及他们是否在古斯塔夫之前撤离，他们的目的地，以及撤离的后勤问题（例如，运输，受伤）。ADS被要求评价他们的信心与国家援助，飓风运输，和疏散准备的10分制（10 =最有信心），并比较他们的准备卡特里娜飓风。结果：16的20个国家卫生署参加了2006年同意接受调查-其中11人在卡特里娜飓风前举行了相同的位置。与卡特里娜飓风不同的是，风暴前只有45%的人撤离，所有16个国家卫生机构都在古斯塔夫之前撤离（56%到另一个国家卫生机构，46%到教堂，健身房，大学或其他设施）。总体而言，ADS将他们对古斯塔夫的准备程度的信心平均为8.3（范围5至10），而卡特里娜的平均值为5.4（范围3至8），提高了54%。在卡特里娜飓风前雇用的11名ADS中，73%的人报告说与州政府的合作有所改善，55%的人指出交通有所改善。尽管如此，7个ADS指出，在撤离期间存在严重的后勤问题（主要是交通）; 4名居民受伤（2例髋部骨折，1例创伤性跌倒，1例脑血管意外）; 2例住院患者出现创伤后应激障碍（posttraumatic stress.Conclusions）：NH ADS感觉更有准备为古斯塔夫疏散居民，部分原因是改善了与州政府机构的沟通和协作;然而，在飓风来临之前疏散脆弱的新罕布什尔州居民仍然存在严重的发病率和后勤问题。（《美国医学博士杂志》2009年; 10：639-643）
Background: One of the tragic legacies of Hurricane Katrina was the loss of life among Louisiana (LA) nursing home (NH) residents. Katrina revealed a staggering lack of emergency preparation and understanding of how to safely evacuate frail populations. Three years later, LA braced for Hurricane Gustav, a storm heralded to rival Katrina's power. Although its magnitude of destruction ultimately paled to Katrina, the warnings and predicted path preceding Gustav yielded a process of NH evacuations similar to Katrina. The goal of this article was to ascertain whether NH administrative directors (ADS) felt more prepared to evacuate before Gustav.Methods: In 2006, Dosa et al(5) (J Am Med Dir Assoc, 3/07), interviewed 20 NH ADS by qualitative telephone survey to evaluate their lessons learned from Katrina. Administrators at these 20 participating nursing homes were contacted and asked to participate in a follow-up survey to compare hurricane preparedness between 2005 and 2008. Specifically, ADS were asked if they evacuated before Gustav, their destination, and about logistical issues with evacuation (eg, transportation, injuries). ADS were asked to rate their confidence with state assistance, hurricane transportation, and evacuation preparedness on a 10-point scale (10 = most confident) and compare their preparedness to Katrina.Results: Sixteen of the 20 NHs that participated in 2006 agreed to be surveyed-11 of whom held the same position before Katrina. Unlike Katrina, when only 45% evacuated before the storm, all 16 NHs evacuated before Gustav (56% to another NH and 46% to a church, gym, college, or other facility). Overall, ADS rated their confidence in preparedness for Gustav as a mean of 8.3 (range 5 to 10) compared with a mean of 5.4 (range 3 to 8) for Katrina, a 54% improvement. Of the 11 ADS employed pre-Katrina, 73% reported improved collaboration with the state and 55% noted improved transportation. Nevertheless, 7 ADS noted significant logistical problems during evacuation (mostly transportation); 4 noted resident injuries (2 hip fractures, 1 traumatic fall, and 1 cerebrovascular accident); and 2 noted resident posttraumatic stress.Conclusions: NH ADS felt more prepared to evacuate their residents for Gustav, owing partly to improved communication and collaboration with state agencies; however, significant morbidity and logistical problems remain with evacuating frail NH residents before hurricanes. (J Am Med Dir Assoc 2009; 10: 639-643)