Improving Emergency Nurse Preparedness for Mass Casualty Incidents: A Quality Improvement Project

Disasters and mass casualty incidents are increasing owing to natural hazards, violence, and public health crises. A disaster-prepared emergency nurse workforce is essential for patient safety and system resilience. At a high-volume level 1 trauma center, a recent mass casualty incident revealed significant gaps in nurse preparedness, including limited knowledge of the emergency operations plan, insufficient training, and low confidence.

Guided by Rogers' 5-stage change theory and the knowledge-to-action framework, this quality improvement project targeted 31 emergency nurse leaders. Pre- and postintervention outcomes were measured using the emergency preparedness information questionnaire, a disaster preparedness skills questionnaire, and the nursing attitudes regarding disaster preparedness scale. The program included didactic education, hands-on training, tabletop exercises, and the development of an "MCI Playbook." Nurse leaders as "Super Users" and a microlearning series called "Trauma Tuesdays" supported sustainability.

Nurse knowledge increased by 71.6%, confidence by 38.8%, and perceived skills by 9.5%. Post-training scores between experienced and inexperienced nurses were nearly identical, demonstrating the program's effectiveness in closing the knowledge gap.

A structured, evidence-based disaster preparedness program improved emergency nurse readiness for mass casualty incidents and provided a replicable model for other health systems. Sustainability was strengthened through institutional backing, nurse leaders as "Super Users," and integration of an "MCI Playbook."