NUR 113: DISASTER NURSING

STUDENT ACTIVITY SHEET BS NURSING / FOURTH YEAR

Session # 2

Materials:
LESSON TITLE: I. Disaster Preparedness: Leadership and
Book, pen and notebook
Coordination in Disaster Healthcare System: DRRM in the
Philippine Perspective References:

LEARNING OUTCOMES: Veenema, T.G. (2019) Disaster Nursing and

Emergency Preparedness for Chemical,
Upon completion of this lesson, the nursing student can: Biological, and Radiological Terrorism and
other Hazards 4th Edition
1. Describe DRRM.
2. Familiarize the goals of NDDRM.
3. Describe the Incident management system and its
http://www.ndrrmc.gov.ph/attachments/artic
elements and their relationships with the Health Sector.
4. Discuss the various types of command structures; Incident le/3031/NDRP_Consequence_Management_f
Command Post, Emergency Operations Center, or_Terrorism_related_Incidents.pdf
Emergency Coordination Center.
5. Identify the command structures that could be applicable to
the Health Sector. https://www.slideshare.net/irpex/disaster-risk-
6. Discuss the role of the HEM (Health Emergency reduction-and-management-28415360
Management) developing incident command system
integrating health component.

LESSON PREVIEW/REVIEW (5 minutes)

Instruction: Differentiate Natural Disasters from Anthropogenic Disasters and give an example for each.

MAIN LESSON (30 minutes)

DISASTER RISK REDUCTION and MANAGEMENT (DRRM)

It is a systematic process of using administrative decisions, organization and operational skills and capacities to
implement strategies, policies and improved coping capacities of the society and community in order to lessen the
adverse impacts of hazards and the possibility of a disaster.

2 ASSUMPTIONS: disaster risk is endemic & it is within the power of the state to reduce disaster risk (Source: IRR of
RA10121)

DRRMC ORGANIZATIONAL NETWORK

❖ National Disaster Risk Reduction & Management Council

❖ 12 Regional Disaster Risk Reduction & Management Councils
❖ 80 Provincial Disaster Risk Reduction and Management Councils
❖ 122 City Disaster Risk Reduction and Management Councils
❖ 1,512 Municipal Disaster Risk Reduction and Management Councils
❖ 42,026 Barangay Disaster Risk Reduction and Management Committees

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THE NATIONAL DISASTER RISK REDUCTION MANAGEMENT COUNCIL (NDRRMC)

The National Disaster Risk Reduction and Management Council (NDRRMC), formerly known as the National Disaster
Coordinating Council (NDCC), is a working group of various government, non-government, civil sector and private sector
organizations of the Government of the Republic of the Philippines established by Republic Act 10121 of 2010.

THE NATIONAL DISASTER RESPONSE PLAN

The NDRP is the Government of the Philippines’ “multi-hazard” response plan. Emergency management as defined in the
NDRRM Act of 2010 (RA10121), is the organization and management of resources to address all aspects or phases of
the emergency, mitigation of, preparedness for, response to and recovery from a disaster or emergency

The NDRP is also built on the following understanding:

• All government agencies and instrumentalities have their own respective Disaster Preparedness Plans for
Terrorism related incidents;
• All Local Government Units (LGUs) have prepared their Contingency Plans for Terrorism related incidents and
implemented their Local Disaster Risk Reduction and Management Plans (LDRRMPs) within the DRRM
Framework of Prevention/Mitigation, Preparedness, programs and activities that are directly connected to
response like prepositioning of key assets and resources; and
• The Cluster Approach System and Incident Command System in response operations have been cascaded to all
levels of government both national and local.

National Disaster Risk Reduction and Management Plan 2011-2028.

The NDRRMP sets down the expected outcomes, outputs, key activities, indicators, lead agencies, implementing partners
and timelines under each of the four distinct yet mutually reinforcing thematic areas. The goals of each thematic area lead
to the attainment of the country’s overall DRRM vision, as graphically shown below.

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The NDDRMP goals are to be achieved by 2028 through 14 objectives, 24 outcomes, 56 outputs, and 93 activities. The
24 outcomes, with their respective overall responsible agencies, are summarized below.

COORDINATION AND EMERGENCY AND DISASTER

Challenges in Managing Emergencies related to Coordination and Communication

• No identifiable leader or incident manager

• No basic organizational structure for chain of command and span of control
• No common terminology
• No unified communications system
• No system for allocating resources
• Lack of integration, due to competition
• Lack or loss of resources, due to failures in planning and lack of resource allocation
• Lack of planning, due to absence of commitment
• failures in risk and crisis communications

INCIDENT MANAGEMENT SYSTEM (IMS)

❑ Is a standardized, all hazards incident management concept.
❑ It can be composed of several levels
• ICP (INCIDENT COMMAND POST)
• EOC (EMERGENCY OPERATIONS CENTER)
• ECC (EMERGENCY COORDINATION CENTER)
❑ Allows its users to adopt an integrated organization structure to match the complexities and demands of single
or multiple incidents without hindered by jurisdictional boundaries

Emergency Response Management Systems: Core Principles

• Based on an all-hazards approach
• Modular, scalable or adaptable organization

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 • Support for joint engagement of multiple institutions / organizations in management decisions
• Clear lines of accountability and authority
• Clearly defined roles and responsibilities, consistent with normal roles and supported by training
• Clearly articulated procedures for activation, escalation, and demobilization of emergency capacities.
• Common functional groupings and consistent terminology
• Integrated with stakeholder agencies
• Mechanisms for the involvement of all stakeholders and users of the EOC in its design, operational planning and
evaluation.
• Provision of capacity to manage public communications opportunities as part of the response to emergencies
Core Components of the System
• integrated communications
• modular organization
• unified command structure
• manageable span of control
• consolidated incident action plans
• comprehensive resource management
• pre-designated incident facilities

The essence of the system 5 functions (in many countries)

1. Incident management (manager who coordinates)
2. Operations
3. Planning
4. Logistics
5. Administration and finance

Management: provides overall direction of the response through the establishment of objectives for the system. This
functional area usually includes other activities that are critical to providing adequate management:
– Public Information manages information released to media and public;
– Safety assesses hazardous and unsafe conditions and develops measures to ensure responder safety; and
– Liaison provides coordination with agencies outside the response system. For the purposes of this discussion, the
terms Operations: achieves management’s objectives through directed strategies and developed tactics.
Logistics: supports management and operations with personnel, supplies, communications equipment, and facilities.
Plans/Information: supports management and operations with information processing and the documentation of
prospective plans of actions (also known as action plans, or APs). Critical components include:
Administration/Finance: supports management and operations through tracking of such issues as reimbursement and
regulatory compliance.

Incident Management System (IMS)

The IMS (or Incident Command System) refers to the combination of facilities, equipment, personnel, procedures, and
communications operating within a common organizational structure and designed to aid in the management of
resources during incident response. The MCM Management System emphasizes management rather than command
because no inherent “line authority” exists in a multidisciplinary response by which assets can be commanded.

Levels of command
Level 1: using emergency response plans of the hospitals; developing operational plans to respond to a crisis
Level 2: information sharing; systems: mutual aid

Level 3: there are several command and coordination mechanisms: at the site (Incident Command Post); the Emergency
Operations Centre (EOC) at the local authority level (multi-sectoral). Depending upon the organization of the country (it
size; level of development, resources available) the EOC can be at District level or even at Provincial level

Level 4: in some countries level 3 is assumed by level 4 in this diagram. The notion of Emergency Coordination Centre is
important when the size of the incident justify the activation of national (or provincial in some countries) plans. In some

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particular circumstances the national level has not only a coordination function but also a “managerial function of the
response” (it can be in the case of a pandemic; for managing the international donations, etc.)
Incident Command Post (ICP)
• Site
• tactical resources directly applied to address emergency problems
• responders may come from one agency, or many
• the on-site response is directed by one agency by jurisdiction or agreement
• operates from an ad-hoc site command post
• utilizes standard functions
• Advise incoming units of what’s going on. What does it contain?
• Be part of solution, not the problem. May have to wait for special resources to arrive. Does a problem still exist?
• Do not rush to a scene. Gather info before entering a scene. Is the area safe to be in? If not, make it safe with
your capabilities or wait for trained resource to arrive
• Expect chaos & confusion
• Careless heroics can injure or kill you
• First priority is personal safety, then team safety, then by standers safety and last is patient safety

EOP (Emergency Operation Center) requires much preparatory work, especially a plan describing the core
elements: The plan usually is composed of:
• purpose of the plan
• concept of operations, management structure, roles of personnel and how the components work together
• Activation procedures and levels, and who has authority
• Escalation and de-escalation plan
• Call-out list and notification procedures
• Checklists of the roles and responsibilities of EOC functions
• Checklists of standard operating procedures
• floor plan, with inventory and locations of equipment and supplies
• Electronic information management processes (including a layout plan of phone, fax, data lines, cables, switches
and outlets)
• Communication resources and procedures, especially mobile phones and radios
• Public information and warning processes
• Procedures for engaging levels of government and/or a superior authority/ jurisdiction
• Standard forms and instructions for documenting EOC activities
• Maps of the area of the event
• Guidelines for worker care and safety
• agency and position responsible for maintaining and updating the plan
• Training and exercise schedule to ensure staff and procedures are up-to-date.

Role of Health Emergency Manager in IMS

• Protect response personnel and resources
• Minimize loss of life, disability and suffering
• Protect public health
• Protect civil infrastructure
• Protect environmental and economic assets, including property
• Reduce economic losses

Risk Communication
- purposeful exchange of information about the existence, nature and form severity or acceptability of health risks between
policymakers, health care providers and the public/media aimed at changing behavior and inducing action to
minimize/reduce risks.
- The process of bringing together various stakeholders to come to a common understanding aboutthe risks, their
acceptability, and actions needed to reduce the risks

Risk Communication Activities

Pre Crisis Crisis Post Crisis

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 ◼ Development of a ◼ Implementation of the ◼ Impact/summative evaluation
communication plan communication plan ◼ Documentation of lessons
◼ Fostering alliances/ ◼ Process evaluation/monitoring learned
networking ◼ Impact evaluation of ◼ Revision of plans
◼ Formative evaluation of the immediate effects
Plan ◼ Networking/advocacy
◼ Revision of plan based on
monitoring results

Nurses’ Responsibility in Risk Communication

• Identifying/ verifying sources of information
• Protecting patients’ rights to privacy and confidentiality
• Advocating for the public’s right to know
• Following institution’s chain of command or flow of communication
• Supporting institution’s official statements about public health risk and safety

CHECK FOR UNDERSTANDING (10 minutes)

You will answer and rationalize this by yourself. This will be recorded as your quiz. One (1) point will be given to correct
answer and another one (1) point for the correct ratio. Superimpositions or erasures in you answer/ratio is not allowed.
You are given 10 minutes for this activity:

Multiple Choice
1. It is a systematic approach to identifying, assessing and implementing strategies and plans that aims to reduce,
the probability of a hazard event.
a. Disaster risk reduction management
b. Rehabilitation and recovery
c. Disaster prevention
d. Nursing process
ANSWER: ________
RATIO:______________________________________________________________________________________
________________________________________________________________________________________
2. The leading agency for Disaster Prevention and Mitigation.
a. DOST
b. DILG
c. DOH
d. DSWD
ANSWER: ________
RATIO:____________________________________________________________________________________
__________________________________________________________________________________________
3. It is the Government of the Philippines’ “multi-hazard” response plan.
a. National Disaster Response Plan (NDRP)
b. National Disaster Risk Reduction Management Council (NDRRMC)
c. Philippine National Red Cross
d. Philippine Disaster Plan (PDP)
ANSWER: ________
RATIO:____________________________________________________________________________________
__________________________________________________________________________________________
4. It is the lead agency of Response.
A. DILG
B. DSWD
C. DOH
D. NEDA
ANSWER: ________
RATIO:____________________________________________________________________________________
__________________________________________________________________________________________

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 5. It is a purposeful exchange of information about the existence, nature and severity or acceptability of health risk
between policymakers, health care providers AND THE MEDIA.
a. Emergency response
b. Incident Action Plan
c. Incident management system
d. Risk Communication
ANSWER: ________
RATIO:____________________________________________________________________________________
__________________________________________________________________________________________

RATIONALIZATION ACTIVITY (THIS WILL BE DONE DURING THE FACE TO FACE INTERACTION)
The instructor will now rationalize the answers to the students. You can now ask questions and debate among yourselves.
Write the correct answer and correct/additional ratio in the space provided.
1. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
2. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
3. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
4. ANSWER: ________
RATIO:_______________________________________________________________________________________
____________________________________________________________________________________________
5. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________

LESSON WRAP-UP (5 minutes)

You will now mark (encircle) the session you have finished today in the tracker below. This is simply a visual to help you
track how much work you have accomplished and how much work there is left to do.

You are done with the session! Let’s track your progress.

AL Activity: CAT: 3-2-1

Instructions:
1. As an exit ticket at the end of the class period
2. After the lesson, have each student record three things he or she learned from the lesson.
3. Next, have them record two things that they found interesting and that they’d like to learn more about.
4. Then, have students record one question they still have about the material.
5. Review the students’ responses. You can use this information to help develop future lessons and
6. determine if some of the material needs to be taught again.

Three things you learned:

1. ______________________________________
2 ______________________________________
3. ______________________________________
Two things that you’d like to learn more about:
1. ______________________________________
2. ______________________________________
One question you still have:
1. ______________________________________

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