Preparing Long-Term Care Facilities for Natural and Man-Made Disasters

描述（由申请人提供）：脆弱的老年人是灾害事件中风险最高的人群之一。长期护理中的老年人的特征，包括身体活动能力受损、认知功能下降、感官意识减弱和慢性健康状况，造成了独特的应急规划挑战。什么时候应该疏散设施？居民将在哪里避难？他们将如何运输？这些都是长期护理设施所有者和运营商面临的难题。尽管州和联邦要求制定应急计划，但越来越多的证据表明，长期护理机构对灾难准备不足。拟议研究的目的是减少长期护理中老年人与灾害有关的死亡和受伤的风险。这一目标将通过制定和评价一个全面的应急准备课程来实现。从本课程开发的基于计算机的培训材料将提供长期护理业主，管理员和设施应急计划团队的知识，技能和工具，他们需要制定，实施和实践应急行动计划。在第一阶段，研究人员召集了一个多学科专家咨询小组，讨论长期护理机构在制定和实施应急计划以及应对实际灾害事件时面临的挑战。咨询小组制定了详细的应急准备课程。研究人员在一项试点测试中对该课程进行了评估，该测试有43名业主，运营商和来自辅助生活设施和熟练护理设施的设施灾难协调员。后测结果表明，所提出的课程，提高了参与者的知识，态度，并打算与应急准备的做法。从测试前到测试后的平均进步为31.71%，在0.0005的水平上具有显著性。参与者对每个模块的六项标准（清晰度，有用性，重要性，兴趣，全面性和长度）的评估表明课程的强烈认可。在第二阶段，该课程将成为制定一个互动的、基于计算机的培训方案的基础。模块将结合联合收割机文本，图形，动画，声音和高分辨率视频，创造一个完全互动的媒体丰富，学习者控制的环境。该计划将在全国实地测试中进行评估，小型，中型和大型长期护理设施，采用随机前测/后测实验设计与对照组。实地测试还将包括在培训前和培训后一个月对参加者的应急行动计划进行评价。这个提议的项目支持国家老龄化研究所的使命“改善美国老年人的健康和福祉”。“考虑到与灾害有关的死亡和受伤的风险，这项研究对居民、设施所有者、工作人员和家庭成员至关重要。公共卫生相关性：脆弱的老年人是灾害事件中风险最高的人群之一。长期护理中老年人的特点为工作人员带来了独特的应急规划挑战。该项目将通过编制和分发全面和有效的应急准备课程，力求减少与灾害有关的伤亡事件。

DESCRIPTION (provided by applicant): Frail older adults represent one of the highest risk populations in disaster events. Characteristics of older adults in long-term care, including impaired physical mobility, reduced cognitive functioning, diminished sensory awareness, and chronic health conditions, create unique emergency planning challenges. When should a facility evacuate? Where will residents take shelter? How will they be transported? These are all difficult questions that long-term care facility owners and operators face. Despite state and federal requirements for emergency planning, there is growing evidence that suggests long-term care facilities are ill-prepared for a disaster. The purpose of the proposed research is to reduce the risk of disaster-related deaths and injuries to older adults in long-term care. This goal will be accomplished through the development and evaluation of a comprehensive emergency preparedness curriculum. The computer-based training materials developed from this curriculum will provide long-term care owners, administrators, and facility emergency planning teams with the knowledge, skills, and tools they need to develop, implement, and practice an emergency operations plan. During Phase I, researchers convened a multidisciplinary advisory group of experts to discuss the challenges long-term care facilities face when developing and implementing an emergency plan and responding to an actual disaster event. The advisory group developed a detailed emergency preparedness curriculum. Researchers evaluated the curriculum in a pilot test with 43 owners, operators, and facility disaster coordinators from assisted living facilities and skilled nursing facilities. Posttest results suggest that the curriculum as presented improved the participants' knowledge, attitudes, and intended practices related to emergency preparedness. The average improvement from pre to posttest was 31.71%, which was significant at the .0005 level. Participant evaluation of each module on six criteria (clarity, usefulness, importance, interest, comprehensiveness, and length) suggests a strong approval of the curriculum. During Phase II, the curriculum will be the basis for the development of an interactive, computer-based training program. Modules will combine text, graphics, animation, sound, and high-resolution video to create a fully-interactive media-rich, learner-controlled environment. The program will be evaluated in a national field test with small, medium, and large long-term care facilities, using a randomized pretest/posttest experimental design with a control group. The field test will also include an evaluation of participants' emergency operations plans prior to the training and one month after the training. This proposed project supports the National Institute on Aging's mission "to improve the health and well- being of older Americans." Considering the risk of disaster-related death and injury, the research is critically important to residents, facility owners, staff, and family members. PUBLIC HEALTH RELEVANCE: Frail older adults represent one of the highest risk populations in disaster events. Characteristics of older adults in long-term care create unique emergency planning challenges for staff. This project will seek to reduce the incidence of disaster-related deaths and injuries through the development and distribution of a comprehensive and validated emergency preparedness curriculum.