Assessment of factors influencing nurses and the casualty department's preparedness for incidents of mass casualty at Nyangabwe referal hospital in Francistown, Botswana.
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Date
2025
Authors
Lekesi, Gaoduelwe
Journal Title
Journal ISSN
Volume Title
Publisher
The University of Zambia
Abstract
The increasing incidence of mass casualties globally has resulted in higher fatalities, financial losses, and disruptions in health institutions' service delivery. Health facilities are often overwhelmed by a surge of critically injured or ill patients, compromising their ability to provide timely and effective medical care. Emergency preparedness strategies enhance institutional capacity to ensure high-qualitycare and improved patient outcomes. The study assessed emergency preparedness for mass casualty incidents among nurses and the casualty department at Nyangabwe Referral Hospital in Francistown. A quantitative descriptive cross-sectional study adapted the World Health Organization(WHO) hospital emergency response checklist and the tool used by Amaitari et al (2020) in a study inNigeria. Through a survey of nurses, the study examined protocols, medical equipment, staff training, andtrauma support services. These factors shaped the preparedness strategy for major crises, enabling the institution to respond effectively during mass casualty incidents. The results were presented in frequency tables and summarized in percentage form. Chi-square and binary logistic regression analyses were conducted to assess factors influencing emergency preparedness and those associated with good practices in emergency preparedness, respectively. The study results revealed that multiple factors influenced the emergency preparedness of nurses and the casualty department. Overall emergency preparedness awareness (n=184) distribution among respondents was categorized into low, moderate, and high awareness. The majority, 71 respondents, were categorized under moderate awareness while the low awareness category had 68 respondents. The high preparedness awareness category had 45 respondents who fell under high emergency preparedness awareness. Similarly, the overall attitude towards emergency preparedness showed that 55% exhibited a poor attitude, while 45% demonstrated a good attitude. Furthermore, nearly half of the participants (50.5%) exhibited poor knowledge, while 49.5% had good knowledge of the primary survey. The chi-square analysis revealed significant associations between emergency preparedness and job title (p = 0.015), gender (p=0.025), work experience (p = 0.029), knowledge level (p = 0.001), and knowledge of the primary survey(p=0.043). However, the binary logistic regression found no significant association between gender and emergency preparedness. Lastly, the results indicate that while NRH has the basic structure and processes required for handling mass casualty incidents, certain deficiencies hinder optimal response. These include a lack of a dedicated trauma team, structured activation protocols, and sufficient ICU and emergency surgical capacity, compromising its ability to manage patient influx during disasters. Additionally, limited access to advanced diagnostic tools and a shortage of specialists delay life-saving interventions.
Keywords: Hospital emergency preparedness, mass casualty incidents, and Nurses.
Description
Thesis of Master of Science in Emergency and Trauma Nursing.