Using tabletop exercises to evaluate nurses' clinical performance of hazardous materials disaster management: A...

Hazardous materials (Hazmat) disaster is a specific event with low probability but may be a heavy burden on public health. Competence in Hazmat disaster emergency management is necessary for nurses who care about mass casualties in the first line, especially for nurses in military hospitals. However, less attention has been paid to evaluation of competence of Hazmat disaster emergency responses using tabletop exercises.

To identify competence in Hazmat disaster emergency response and factors influencing performance on tabletop exercises.

A cross-sectional design was employed in this study. Competence of nurses responding to a hazardous materials invasion was evaluated by a tabletop exercise. In each case the "Task Based Checklist" was used for evaluation. Multivariate analysis of covariance was conducted to detect the effects of traditional training on performance in Hazmat disaster tabletop exercises.

A total of 161 nurses were recruited for this study. A checklist with 12 items comprised of two dimensions of disaster management was created and validated (CVI = 0.90). Inter-rater reliability for the evaluators ranged from 0.88 to 1. Performance on Hazmat site control, debris management and individual skills in decontamination were found to be suboptimal. Traditional disaster nursing training had no significant influence either on performance on Hazmat site control or patient care after controlling for differences in education level, age and gender.

The tabletop exercise is an innovative method for disaster nursing educators seeking to evaluate response competence in Hazmat disaster simulation exercises. It is necessary to consider the characteristics of the participants when designing the training program and educational strategies. Participants from the military hospital were shown to have limited competence in Hazmat disaster emergency management.