背景:最近的灾害强调卫生部门需要减轻灾害风险。缺乏评估医院灾难准备的标准化工具阻碍了医院应急/灾难准备的改进。关于医院备灾评估工具的研究非常有限。
目的:本研究旨在确定世界各地医院准备工具的存在和可用性,并确定这些研究仪器的重要组成部分。
方法:使用三个数据库进行了系统评价,也就是OvidMedline,Embase,和CINAHL,以及谷歌提供的灰色文献,相关网站,以及精选文章的参考列表。这些研究发表在2011-2020年世界各地的医院备灾,用英语写的,由两名独立审稿人选出。根据世界卫生组织(WHO)的六个地理区域分析了研究的全球分布,根据联合国人类发展指数(UNHDI)的四个类别。根据4S概念框架确定和分类准备主题:空间,东西,工作人员,和系统。
结果:在总共1,568篇文章中,53符合纳入标准,并被选中进行数据提取和综合。很少有发表的研究使用研究工具来评估医院的灾难准备。东地中海区域记录的此类出版物数量最多。发现联合国人类发展指数较低的国家的出版物数量较少。发展中国家更多地关注自然灾害的备灾,而较少关注化学品,生物,放射学,核准备(CBRN)。基础设施,物流,能力建设,交流是空间下的优先主题,东西,工作人员,和4S框架的系统域,分别。大多数研究忽略了医院备灾的一些关键方面,比如运输,备用电源,停尸房设施和尸体处理,疫苗接种,奖励/激励,和志愿者。
结论:在4S框架的每个领域下确定了重要的准备主题。应适当解决被忽视的方面,以确保医院做好充分的准备。这次审查的结果可用于规划全面的备灾工具。
BACKGROUND: Recent disasters emphasize the need for disaster risk mitigation in the health sector. A lack of standardized tools to assess hospital disaster preparedness hinders the improvement of emergency/disaster preparedness in hospitals. There is very limited research on evaluation of hospital disaster preparedness tools.
OBJECTIVE: This study aimed to determine the presence and availability of hospital preparedness tools across the world, and to identify the important components of those study instruments.
METHODS: A systematic
review was performed using three databases, namely Ovid Medline, Embase, and CINAHL, as well as available grey literature sourced by Google, relevant websites, and also from the reference lists of selected articles. The studies published on hospital disaster preparedness across the world from 2011-2020, written in English language, were selected by two independent reviewers. The global distribution of studies was analyzed according to the World Health Organization\'s (WHO) six geographical regions, and also according to the four categories of the United Nations Human Development Index (UNHDI). The preparedness themes were identified and categorized according to the 4S conceptual framework: space, stuff, staff, and systems.
RESULTS: From a total of 1,568 articles, 53 met inclusion criteria and were selected for data extraction and synthesis. Few published studies had used a study instrument to assess hospital disaster preparedness. The Eastern Mediterranean region recorded the highest number of such publications. The countries with a low UNHDI were found to have a smaller number of publications. Developing countries had more focus on preparedness for natural disasters and less focus on chemical, biological, radiological, and nuclear (CBRN) preparedness. Infrastructure, logistics, capacity building, and communication were the priority themes under the space, stuff, staff, and system domains of the 4S framework, respectively. The majority of studies had neglected some crucial aspects of hospital disaster preparedness, such as transport, back-up power, morgue facilities and dead body handling, vaccination, rewards/incentive, and volunteers.
CONCLUSIONS: Important preparedness themes were identified under each domain of the 4S framework. The neglected aspects should be properly addressed in order to ensure adequate preparedness of hospitals. The results of this
review can be used for planning a comprehensive disaster preparedness tool.