Abstract Nurses constitute the largest group in the healthcare workforce and are called on to assist in emergencies such as disasters. Research has shown that professionals with higher levels of knowledge are more likely to respond to actual emergencies. Yet most hospital based nurses do not possess the skills needed for disaster response. The Basic Disaster Life Support (BDLS) course, with its comprehensive content, represents the gold standard for disaster education. Since confidence also plays a role in response, a tool to measure this variable could be useful. There were five purposes of this study: determine whether one teaching method (computer or classroom instructor-led) is superior over another for disaster education; evaluate how knowledge retention varies between instructional models; examine whether a correlation exists between self-efficacy and disaster knowledge; pilot a new instrument, Disaster Self-Efficacy Scale (DSES); complete psychometrics on the Basic Disaster Life Support exam. The study was an experimental pretest/posttest/follow-up with a single between-group factor (type of training with three levels) and three within-group factors measured at three intervals. The sample included 82 hospital-based nurses randomly assigned to a computer-based, instructor-led, or control group. A MANOVA and MANCOVA were conducted to evaluate group differences at three time intervals. Psychometric evaluation was conducted on both the BDLS and the piloted Disaster Self-Efficacy measures. The BDLS test was shown to be in need of revisions and updating. The DSES measure shows promise for determining disaster self-efficacy and may be useful to target training though it needs further validation. Learning results showed that when controlling for pretest differences, experimental groups had higher posttest BDLS and DSES scores than the control group but there was no difference between experimental groups. There was no difference between experimental groups for BDLS scores at follow-up. Conclusions were that training, regardless of how it was delivered, led to a dramatic increase in disaster knowledge and disaster self-efficacy; computer-based education is a feasible alternative to teaching BDLS; retention still poses a challenge for disaster education. Implications for nursing education and practice were identified. Future research should focus on further development and validation of the DSES and BDLS instruments.

The thesis deals with the issue of emergency preparedness of Nestlé Česko, s.r.o, Zora Olomouc. According to the Act. No. 224/2015 Coll., concerning prevention of major accidents caused by selected dangerous chemical substances or chemical preparations and concerning amendment there is underlimit amount of hazardous chemical ammonia in the area and we cannot classify this as group A or B. On these not-classified resources there are not subject to some duties under this Act, especially the obligation to prepare an emergency documentation. There are a lot of factories like this in the Czech republic (and in the world) and there is certain danger for employees of this companies and for civilian population who is in the danger area. There is more than 6700kg of ammonia in the factory Zora and it is quite a lot. We have to look at special precautions. Ammonia is taken as moderately toxic substance that irritates the eyes, mucous membranes, and in high concentrations can cause death. Another dangerous effect, except the toxicity is its explosiveness and flammability. Impacts of hazardous concentrations are not threat only for people but also for animals and the environment.

Population evacuation plan is one of the plans of specific operations, which are covered within the region's emergency plan according to Decree No. 328/2001 Coll.Evacuation belongs among the basic methods of population protection, being a summary of principles and organisation measures to ensure moving the persons, animals and material assets from the area endangered by an extraordinary event to other area. In the case of an extraordinary event endangering larger territorial unit, not only the populated agglomerations and industrial facilities may be included in the area evacuation, but also the inpatient healthcare facilities, where the situation difficulty is amplified by the patients depending on care by medical personnel and provision of healthcare services. Presently, there is no clear legal standard imposing an obligation on organisations to elaborate a complete evacuation plan. This issue is covered only partially in the sphere of legislation concerning fire protection. Nevertheless within the region's emergency plan elaborated for solution of extraordinary events requiring declaration of the third level (in the case of endangering more than 100 and less than 1,000 persons) and special level of alarm (when more than 1,000, a part of a municipality or enterprise grounds are endangered), all organisations with more than 100 persons should have the evacuation plans prepared. In the case of inpatient healthcare facilities, elaboration of evacuation plans is absolutely inevitable. The theoretical part of the dissertation describes the general principles and methods of performing the population evacuation. Attention was paid also to professional coverage, evacuation authorities and organisations and their structure according to the scope of the taken measures. In the chapter called "Application of the evacuation plan to inpatient healthcare facilities", the general principles and procedures concerning evacuation were applied to the inpatient healthcare facilities. In the practical part of the dissertation, an analysis of preparedness of the inpatient healthcare facilities for possible area evacuation to all-nation extent was made and the hitherto experience of the personnel of the inpatient healthcare facilities with any type of evacuation and their preparedness for possible complete evacuation were examined. Such examinations were made by questionnaire surveys. The collected data have been processed by statistical methods. The evaluation of results is presented in the "Results" chapter. On the basis of the acquired knowledge, a proposal of evacuation plan was drafted for the inpatient healthcare facilities. At the end of the dissertation, the procedures are suggested that may help manage perfectly the potential complete evacuation. Expected utilisation of the dissertation results was directed to definition of the optimum procedures and measures leading to successful management of evacuation of an inpatient health care facility. The dissertation conclusions may be used not only as the document for creating evacuation plans for other health care facilities, but they may contribute to considerable extent to elaboration of uniform evacuation preparation methodology within the emergency preparedness of the healthcare services.

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Scholars from various disciplines have long attempted to identify the variables most closely associated with individual preparedness. Therefore, we now have much more knowledge regarding these factors and their association with individual preparedness behaviors. However, it has not been sufficiently discussed how decisive many of these factors are in encouraging preparedness. In this article, we seek to examine what factors, among the many examined in previous studies, are most central to engendering emergency preparedness in individuals particularly for tornadoes by utilizing a relatively uncommon machine learning technique in disaster management literature. Using unique survey data, we find that in the case of tornado preparedness the most decisive variables are related to personal experiences and economic circumstances rather than basic demographics. Our findings contribute to scholarly endeavors to understand and promote individual tornado preparedness behaviors by highlighting the variables most likely to shape tornado preparedness at an individual level.

There are currently many emergencies that may affect the security environment of the Czech Republic. No extraordinary event chooses time or place to intervene. Among the most vulnerable people we can rank people in social facilities or health facilities because these people are dependent on the help of others. Healthcare facilities have their own specificities, which need to be given increased attention, especially in the event of emergencies. Currently, patients' entitlement to health care is high. Care should be provided in its entirety and at a high level. The aim of this thesis is to increase the readiness of Jihlava Hospital for selected emergency events. A research question has been set for this work: What is the readiness of Jihlava Hospital for selected emergencies? Data acquisition will take several forms. The research and analysis of legal norms and documents related to the issue will be crucial. Analysis of synthesis, document induction and environmental observation will be used. Subsequent interviews with employees of Jihlava Hospital and other relevant people will also play an important role. To evaluate the readiness of Jihlava Hospital, a risk analysis will be performed using the KARS method. The result will be a Plan of Emergency Preparedness, which will be given to the hospital. Thesis can also serve research purposes for hospitals to increase their preparedness for emergency situations.

National healthcare as executed through the Patient Protection and Affordable Care Act (ACA) was introduced in 2010, but was discussed for several decades prior to its enactment. Section 5210 of the ACA established funding for a Regular and Ready Reserve Corps (RRRC) to provide support to local healthcare entities with emergency preparedness. It is unknown what impact Section 5210 of the ACA has had on local emergency preparedness, as well as what obstacles are encountered with implementing this piece of legislation at the local level. The purpose of this case study was to understand the obstacles encountered at a local level by healthcare entities by combining rational choice theory and complex adaptive systems through Ostrom's institutional analysis and development theory. Data for this case study were obtained through interviews with 6 hospital emergency coordinators of hospitals in the Tennessee Highland Rim Region. These data were coded and analyzed following Moustakas' modified Van Kaam procedure. Findings from this study concluded that participants perceived that Section 5210 of the ACA did not impact hospital operations at the local level. However, other obstacles including employee turnover, communication, and process standardization and education are perceived to exist in terms of planning and emergency preparedness. The results of this study may impact social change by enhancing state and local policy makers' ability to identify and create a future roadmap for health care policy implementation at local and regional levels.

The goal of this thesis was to find out the current state of the operation of the risk management in selected health service providers. For this purpose, there was a questionnaire survey conducted together with a form of interview. There was created a questionnaire for selected health service providers (Annex 1). It was necessary to set certain criteria for the selection of the health services providers. The first criterion was to cover health service providers in the whole Czech Republic. The second criterion set that it should be a inpatient facility. The third criterion definded that only hospitals should be covered. The forth criterion excluded University Hospitals from the selected sample. The fifth criterion required that there will be hospitals with more than 400 medical beds in their facilities. Reviews of annual reports of hospitals were drawn up to implement all the criterions for selecting the sample of health services providers and there were excluded facilities with less than 400 medical beds. The theoretical part deals with health care in the Czech Republic defining the providers of health services and health care system. Furthermore, it deals with crisis management in health care including crisis preparedness of health care, crisis documentation and exercises. There was specified a health risk management and risk analysis methods. There was a questionnaire containing 13 closed and 12 opened questions created for selected providers of health services used in the practical part. The questionnaire was divided into five categories related to the definition of Act No. 240/2000 Coll., crisis management, namely analysis and evaluation of security risks, planning, organization, implementation, control of activities (Annex 1). The questionnaire was distributed via the Click4Survey internet portal, it was an online questionnaire and the interviewed persons were also contacted by telephone. The interviewees were persons engaged in risk management at a particular selected health service providers. There were 18 hospitals out of a total of 33 hospitals surveyed participated in the survey. The results were processed into graphs, tables and interpreted in the discussion section of the thesis. The goal of the thesis was "To find out the current state of the operation of the risk management in selected health service providers." The results show that, risk management in the hospitals surveyed does not reach sufficient knowledge and experience in some cases.

A societal crisis is an emergency that affects many people and large parts of society, threatening life, health, safety and basic values. In a societal crisis, there is a need for coordination between various bodies in the society. Coordination in societal crises has previously been studied mainly from a management perspective. Learning perspectives have been studied to a lesser extent. The main purpose of this thesis is to increase knowledge about the conditions for developing consensus and establish a common understanding of synergy-effects, a surplus value, for knowledge meetings between individuals from different organizations when they cooperate in the emergency management system. The study seeks to understand to the following questions: 1) What images and ideas do participants bring into the coordination group about societal crisis, how have they developed and changed? 2) How do the participants act when they have different pictures and meet? 3) Can the basic ideas of the research circle be used for knowledge building at knowledge meetings in the emergency management-system? 4) Can the basic ideas of the research circle be used to develop consensus and establish a common understanding of synergy-effects before societal crises happen? The main study consists of three case studies in three different-sized municipalities. It is based on 36 semi-structured interviews with participants in local crisis management coordination groups, observations during exercises and meetings, document studies and an experiment with the so-called knowledge meeting. The results are compared with complementary studies from two knowledge meetings and two coordination exercises based on observation, questionnaires and evaluations. The individuals, organizations, and structures have been identified as frame factors for coordination groups. The results show that the participants have different images of societal crisis and that coordination is a time-consuming approach requiring cross-perspective learning, interaction, as well as dialogue and reflection skills. The participants eventually develop their crisis learning, i.e. conflict-filled adaptation. A system's opened nature is important for individual learning.

The Strategic National Stockpile (SNS) is a program that provides medical countermeasures during a public health emergency. A public health emergency can be a natural or man-made disaster, an act of terrorism, or a pandemic. The Cities Readiness Initiative (CRI) was created to help the nation’s largest metropolitan regions develop the ability to provide SNS life-saving medications in the event of a large-scale bioterrorist attack or naturally occurring disease outbreak. To address the risks associated with a public health emergency the Center for Disease Control and Prevention (CDC) requires a comprehensive emergency response plan for distributing SNS/CRI materials quickly and efficiently. The Fulton County Department of Health and Wellness (FCDHW) is tasked with responsibility for distributing and dispensing of SNS/CRI medical assets delivered during a public health emergency. FCDHW is also tasked with the development of a comprehensive response plan. Past TAR scores revealed that passing SNS/CRI audits has been a challenge for FCDHW. A case study was conducted to note if the development of an information management system could facilitate successful future SNS/CRI audits. A needs assessment revealed that an information management system for emergency preparedness and response compliance was needed. Microsoft SharePoint 2007 was used to develop the information management system. SharePoint contains a secure document repository that linked the work products of all relevant internal and external stakeholders and revealed compliance deficiencies early enough to allow for corrective actions. The result was a passing TAR score that was a 59 point increase from the last published score.