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PROTECTING OUR MOST VULNERABLE
CITIZENS: LESSONS LEARNED FROM KATRINA TO IMPROVE
READINESS IN NURSING HOMES
Research by Dr. Sarah B. Laditka
Health Services Policy and Management
About 3 million of America’s most vulnerable
citizens reside in nearly 17,000 nursing homes, many
located in high-risk areas. Although nursing homes have
disaster plans in place, these plans might not
adequately prepare them for a major disaster. The
University of South Carolina’s Department of Health
Services Policy and Management researchers set out to
evaluate how administrators, staff, volunteers, and
families responded to Hurricane Katrina. Researchers
also investigated the effects of the disaster on
administrators, staff, and residents in sheltering
facilities in the short- and medium-term aftermath of
Katrina. Their goal was to develop recommendations to
improve preparedness to respond to complex disasters
such as Katrina.
 USC
researchers targeted a mix of rural and urban nursing
homes that sheltered Katrina nursing home evacuees in
Mississippi for their study. They gathered this
information through telephone interviews with 14 hosting
nursing homes in Mississippi in October of 2005. They
also conducted site visits with four selected host
nursing homes in early November, during which they
discussed administrators’ and staff experiences with the
Katrina disaster. In late January and early February,
researchers conducted follow-up telephone surveys with
the 14 host nursing homes. They also interviewed several
Mississippi public officials.
The outcome of the research revealed several valuable
lessons. As far as systems-related lessons, they learned
that administrators should establish close working
relationships with community leaders because they are
vital to securing assistance during an emergency. In
terms of staff- and resident-related lessons, they
learned that teamwork and conducting regular disaster
drills is essential. There were also many supply, power,
and communication-related lessons. In one example, the
researchers discovered that nursing homes must establish
redundant communication systems that do not rely on cell
phones, landlines, or the Internet. Few hosting nursing
homes have revised their disaster plans. However, a
number have developed closer ties to the emergency
management system in their communities.
Researchers also concluded that nursing homes should
cross-train employees to serve as certified nursing
assistants (CNA). This would help nursing homes to
provide residents with personal care in emergencies,
when CNA needs are likely to be understaffed. Further,
they recommended that the staff should include
individuals certified to operate a commercial motor
vehicle to transfer residents during the evacuation.
Researchers also determined that emergency preparations
should include adequate supplies for at least seven
days, including food and water for residents and
evacuated residents, staff that may be unable to return
home, evacuated staff, and family members. Medicine,
medical/personal supplies, and disposable eating
utensils for use when water availability is limited
should also be on hand.
Researchers concluded that nursing homes should consider
levels of planning for disaster preparedness.
Specifically, they should prepare for localized and
widespread disasters by defining and arranging for
resources in the immediate area, in a second radius
farther out, and a third radius. In widespread
disasters, supplies such as water and food are needed.
Finally, researchers concluded that mental health
services should be available to staff and residents to
assist them in coping with disasters, including their
personal losses and aftereffects. These services should
ideally be in place immediately following the disaster.
This project will make new knowledge available to
improve preparedness plans for frail populations.
Through continued research and training of health care
professionals to prepare for potential disasters,
researchers are convinced that the nation’s ability to
have preparedness procedures in place to protect our
society’s most vulnerable members can be improved. The
project has also expanded the team’s extensive network
of partners with South Carolina nursing homes to include
nursing homes in Mississippi, providing a solid
foundation for research extensions in the areas of
preparedness, organizational management, and elder
abuse.
USC researchers developed two experiential
student-learning experiences, in part based on this
research project. These experiences were incorporated
into two health administration courses in the fall of
2005, Long Term Care Administration and Approaches and
Concepts in Healthcare Administration. Pre- and
post-tests showed significant improvements in students’
preparedness knowledge. The results of this research
were disseminated to the policymaking, practice, and
academic communities.
Biography
Dr. Sarah B. Laditka is an associate professor and
the director of the Master of Health Administration
Program in the Department of Health Services Policy and
Management at the Arnold School of Public Health at the
University of South Carolina. Dr. Laditka is also a
senior research affiliate in the Office for the Study of
Aging and in the South Carolina Rural Health Research
Center at the Arnold School of Public Health. Her
research has been published in more than 20 journals,
including Archives of Internal Medicine, Health
Services Research, Journal of the American Geriatrics
Society, Journal of Applied Gerontology, Journal of
Gerontology: Social Sciences, Social Sciences and
Medicine, and Women and Health. The Federal Office
of Rural Health Policy, Health Resources and Services
Administration and the Centers for Disease Control and
Prevention have funded her research.
Research Team/Collaborators:
All members of the project team are affiliated with
the Arnold School of Public Health, the University of
South Carolina. Principal Investigator: Sarah B. Laditka,
Ph.D., Associate Professor, Health Services Policy and
Management (HSPM). Co-Investigators: (alphabetical
order) Carol B. Cornman B.S., RN, PA, Director, Office
for the Study of Aging (OSA); Courtney B. Davis, MHA,
Research Associate, OSA; James N. Laditka, D.A., Ph.D.,
Research Assistant Professor and Graduate Director of
Epidemiology, and Director of Research, OSA, ASPH; Jane
V.E. Richter, Dr.PH., RN, CHES, Director, Center for
Public Health Preparedness; Sudha Xirasagar, MBBS,
Ph.D., Research Assistant Professor, HSPM. |
