An exploratory study to shape a disaster nurse practitioner scope of practice
Dr. Frances Dunniway, DNP, is a certified nurse practitioner and critical care nurse with a passion for emergency response. A nurse over 35 years, she has served 25 years on the Federal Disaster Medical Assistance Team where she has deployed to many National disaster and special events including 911 at Ground Zero, Kosovo Refugee-Operation Freedom, Presidential inaugurations and funerals, Olympics and COVID pandemic. Currently she practices in Home Based Primary Care serving Veterans who are homebound.
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The impact and devastation from national disasters pose imminent risk to large populations. If trained in disaster response and following evidence-based practice standards, the Nurse Practitioner (NP) could be prepared to adapt to any setting or surrounding, utilizing their full educational and health care training. Currently there are no written guidelines during disasters to manage the various clinical conditions. Using a Delphi technique, this exploratory study investigated the multidisciplinary understanding about the disaster NP role. Key findings included: 1. Across four groups of disaster responders, there was confusion about the disaster NP role, indicating a need for role clarity. 2. Among NP respondents, there was agreement that practice was limited in a disaster compared to everyday practice, identifying no scope of practice and lack of role knowledge as causes. 3. To help understand the disaster NP role, simulated field training was the most highly valued and the least was individual training. 4. Regarding services delivered, the most valued were the disaster NPs ability to perform urgent services with competence and skill, NPs ability to recognize need to triage to higher level of care and NPs acknowledging emergent skill limitations. Having one defined scope of practice could establish guidelines for practice, reducing legal risk and eliminating role confusion, and improve victim access to care. Furthermore, standardized guidelines could be disseminated to other disaster responders and victims, which could eliminate duplicity of resources and practice barriers across local, state, tribal, and federal boundaries.
This dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 3631359; ProQuest document ID: 1566173448. The author still retains copyright.
This item has not gone through this repository's peer-review process, but has been accepted by the indicated university or college in partial fulfillment of the requirements for the specified degree.
|Review Type||None: Degree-based Submission|
|Research Approach||Pilot/Exploratory Study|
Guidelines for Practice
|Grantor||Western University of Health Sciences|
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