NCM 0120 Disaster Nursing RLE - Loanzon, Patricia O.

NCM 0120 - DISASTER
NURSING RLE
PORTFOLIO
PATRICIA O. LOANZON
BSN 4-D
TABLE OF
CONTENTS
MODULE 1: THE PHILIPPINE DISASTER AND RISK PROFILE:
PHASES OF A DISASTER
PHILLIPS 66.......................................................................................................4
MODULE 2: DISASTER MANAGEMENT CONTINUUM (PRE-IMPACT:

PREVENTION/MITIGATION)
INFOGRAPHICS................................................................................................5
VIDEO BLOG.....................................................................................................6
MODULE 3: ETHICAL AND LEGAL PRACTICE AND ACCOUNTABILITY

IN DISASTER PREPAREDNESS
CASE REPORT ANALYSIS..............................................................................7
MODULE 4: DISASTER MANAGEMENT CONTINUUM (IMPACT

RESPONSE: DISASTER TRIAGING)
CASE BASED LEARNING................................................................................8
MODULE 5: RESEARCH STUDY ON DISASTER PREPAREDNESS

AND RISK REDUCTION MANAGEMENT
EVIDENCE BASED JOURNAL REVIEW.........................................................9
MODULE 7: OPPORTUNITIES FOR ENTREPRENEURIAL NURSING

PRACTICE
ENTREPRENEURIAL PLAN...........................................................................10
NCM 0120 | DISASTER NURSING RLE PORTFOLIO
INTRODUCTION
I am a proud student nurse of Angeles University Foundation under the
College of Nursing. I decided to pursue nursing because it includes all
of life’s facets, not just the end. I believe that Nursing is a way of life
that is constantly changing and creating different opportunities to mold
and strengthen the structure of the nursing field.
Nursing is a fulfilling profession that will allow me to make a difference

in the lives of many people while also observing and appreciating their
progression. Consequently, nursing is the embodiment of my beliefs, a
vessel for me to exude my character of love and care on a population
that needs it the most. I want to make a difference in people's lives as
well as improve the healthcare system's practices, standards, services,
and treatment.
This learning portfolio will be a collection and compilation of my work

and reflections which demonstrates a nursing student's effort,
development, accomplishments, and skills earned throughout the course
at university. This will allow me to reflect on my overall performance,
determine my strengths and weaknesses domains, monitor my
development throughout the learning process, and inspires me to take
ownership of my own learning. This portfolio will be used for academic
purposes only. Feel free to browse and explore wherein you can see my
different activities, skills, and reflections in NCM 0120 Disaster Nursing
RLE. Thank you and God Bless!
NCM 0120 | DISASTER NURSING RLE PAGE 04
PHILLIPS 66
INFOGRAPHICS
VIDEO BLOG
https://drive.google.com/file/d/1CoFK9D9XD7byQ7Xy
9Q3TP9JSCQS-oRxq/view?usp=drive_link
CASE REPORT ANALYSIS

CASE BASED LEARNING

EBJ REVIEW
ENTREPRENEURIAL
PLAN
APPENDICES
Resume | Actual Outputs | Screenshots of Graded Outputs
Resume | Documentation | Actual Activities
RESUME
APPENDICES
PATRICIA O. LOANZON
Mobile: (+63) 995 932 8893 | Email: loanzonpatty@gmail.com | https://www.facebook.com/patloanzon
SUMMARY AND OBJECTIVE

Strong team player with excellent communication and problem-solving abilities who can handle
pressure and make critical decisions. A transformational leader with experience, developing
compelling presentations, and identifying and seizing chances to advance an institution's
mission. To bring my strong sense of dedication, motivation, responsibility, and to utilize my
knowledge and skills. To obtain an employment with a hospital that offers a positive atmosphere
to learn and implement new skills and technologies for the betterment of the institution. To build
a long-term career in the hospital with opportunities for career growth.
EDUCATION
Angeles University Foundation Angeles City
Bachelor of Science in Nursing 2019 - 2023
Guagua, Pampanga
St. Mary's Academy of Guagua

2013 - 2019
With Honors
St. Nicholas Academy Guagua, Pampanga

With Honors 2010 - 2012
Psalms Academy Guagua, Pampanga

With Honors and Special Awards 2006 - 2010
PROFESSIONAL EXPERIENCE
St. Raphael Foundation and Medical Center Mabalacat, Pampanga

Ward Nurse Intern 2022
Assessed and monitored patients
Organized and maintained daily worksheets, current forms, and proper tab filing in medical charts
Administered medications and maintained storage procedures and regulations
Performed procedures such as inserting intravenous lines, bed making, tepid sponge bath, and
changing of diapers
Provided psychological, emotional, and educational support to patients and family members
Assisted post-surgery patients
Rafael Lazatin Memorial Medical Center (RLMMC) Angeles City, Pampanga

Delivery Room Nurse Intern 2022
Met with expectant mothers for prenatal visits and provided care for normal and problematic
pregnancies
Assessed and monitored vital signs for both mother and newborn
Provided information, guidance, and hands-on clinical care to pregnant women
Performed procedures such as leopold maneuver, inserting intravenous lines
Monitored fetal heartbeat and length and strength of contractions during labor
Assisted with any complications and assisted in administering medications during birth
Cleaned the equipments in the delivery room and gave newborn care
Angeles University Foundation Medical Center Angeles City, Pampanga

Ward Nurse Intern 2022
Assessed and monitored patients
Maintained daily worksheets, current forms, and proper tab filing in medical charts
Administered medications and maintained storage procedures and regulations
Observed and assisted in procedures such as 2D echocardiography and electrocardiogram
Performed procedures such as inserting intravenous lines, bed making, tepid sponge bath, and
changing of diapers
LEADERSHIP AND INVOLVEMENT
AUF CON Honor Society 2021- 2022
Class Representative
WEBINARS, WORKSHOP, AND TRAININGS
February 2022
Developing an Entrepreneurial Mindset
January 2022
Liver Cancer and Viral Hepatitis Prevention Awareness
National Health Emergency Preparedness December 2021

Communication in the Workplace October 2021
12th Nursing Research Colloquium October 2021

The SDG Webinar Series: Tobacco and Alcohol Control and

their Implications on Public Health in the ASEAN Region
NSRC Webinar on Leadership October 2021

MaTBay Ba ang Kaalaman mo sa TB? September 2021
#EndingThrowbackTuberculosis
Cultural Competency: Attributes of Professional Nurses August 2021

towards Patient Care August 2021

Delivery of a Newborn Baby “Baby on Board! You’re going
to be a great mother! July 2021

Essential Intrapartum Newborn Care: Breastfeeding/Unang
Yakap Continues Amidst the COVID-19 Pandemic
Introduction to COVID-19: Methods for Detection,

July 2021
Prevention, Response, and Control
AUF-NSTP: Basic Life Support Training September 2019
SKILLS
Therapeutic Communication Health Education
Patient Assessment Efficiency Under Pressure
Active Listening Critical Thinking and Decision Making
TRAITS
Amiable Fast learner
Adaptable Passionate
Willing to learn Flexible
PROFESSIONAL REFERENCES
Cherry Sangcap, RN, MN
Delma Joie Magtubo, RN, MN
AUF - Clinical Instructor
sangcap.cherry@auf.edu.ph
Warlito Penullar Reyes, RN, MN

reyes.warlito@auf.edu.ph
APPENDICES
NCM 0120 RLE
ACTUAL ACTIVITIES
PAG IWAS MGA KARANIWANG
Upos ng SANHI NG SUNOG O
SA SUNOG sigarilyo
PINAGMULAN
Mga kemikal na
PINAGMULAN NG
flammable o madaling
masunog
APOY
Iniwang niluluto o
ISTATISTIKA NG
nakasinding kandila
SUNOG SA PILIPINAS
13,029 insidente ng apoy
mula Enero 1 hanggang

Overloading ng
Disyembre 26, 2022 (BFP) mga appliances/
Koneksyon ng
kuryente
ALAM MO BA?
Ang buwan ng Marso ang
itinalagang “Fire Prevention Month”
(Presidential Proclamation No. 115-A)
ANO ANG MGA DAPAT GAWIN?

Planuhin kung paano lilikas.
Maghanap ng dalawang labasan sa inyong
BAGO DAGDAG KAALAMAN!
bahay na malayo sa apoy o usok. Paano ang tamang paggamit ng fire extuingisher?
Turuan ang mga bata na hindi dapat magtago

Tandaan ang akronim na PASS.
o paglaruan ang apoy kapag may sunog.
Ilayo ang mga bata sa mga posporo at lighter, at mga
madaling masunog na bagay.

Inspeksyunin ang mga maaaring nakaharang sa pinto
o bintana.
Siguraduhin na madaling maaalis ang mga bintana.
Maglagay ng smoke alarm sa loob ng bahay.
Ilagay sa iisang bag ang lahat ng importanteng
dokumento o kaya ay magkaroon ng digital copy ng
mga ito.
Maglagay ng fire extinguisher sa loob ng bahay.
Umalis sa lugar na nasusunog.

Siguraduhin na nakasarado ang mga
HABANG MGA DAPAT TAWAGAN
pintuan upang mapigilan ang pagkalat ng
sunog.
Gamitin ang fire alarm kung mayroon man upang
maalerto ang lahat. ANGELES CITY FIRE STATION

Tumawag kaagad ng bumbero at ng tulong. Address: Rizal St, San. Nicolas,
Ituring na mapanganib ang lahat ng uri ng sunog Angeles, 2009 Pampanga

Kung mayroong magagamit na fire extinguisher kunin
ito at gamitin, sundan ang hakbang na PASS. Central Fire Station, City Hall
Kung may usok at apoy sa inyong pangunahing ruta sa

Compund
paglabas, gamitin ang sumunod na ruta. (045) 322-2333
Kung kinakailangan lumabas sa lagusan na puno ng
usok, gumapang sa baba patungo sa labasan. San Nicolas Fire Sub-station

Kapag mainit ang pinto, wag itong buksan at gumamit
ng pangalawang ruta palabas. (045) 322-6758

Kumuha ng malaking tuwalya at basain ito, gawin itong
pang taklob sa paglabas ng bahay Cellphone Numbers:

Maging mabilis ang kilos at manatiling kalmado. 0995-822-3620 (Globe)
0925-451-3550 (Sun)
Magbigay ng first aid kung kinakailangan.

Ipaalam sa iba na ikaw ay ligtas, tawagan
PAGTAPOS
o i-text sila.
Isugod kaagad sa propesyonal na doktor o
beterinaryo ang tao o hayop na naapektuhan sa

sunog.
Magpatuloy nang pag-iingat: magpanatili ng “fire
watch”. SUNOG AY IWASAN,

Manatili sa labas ng bahay nang napinsala ng sunog
hanggat hindi pa sinasabi ng mga opisyal na ligtas BAWAT BUHAY AY
nang pumasok muli. PAHALAGAHAN,

Huwag na munang gamitin ang tubig hanggang sa
PAG-IINGAT ANG
masabi ng mga opisyal na ligtas ang pinagmumulan ng
nito. KAILANGAN, TARA NA’T

ISULONG ANG
REFERENCES:
Dimaandal, G. (2020, January 21). Mga Hakbang Para Makaiwas sa Sunog. Mediko.ph.
NALALAMAN
Retrieved February 21, 2023, from https://mediko.ph/mga-hakbang-para-makaiwas-sa-sunog/
FIRE PREVENTION - TOP CAUSE OF FIRES IN THE PHILIPPINES - FAULTY
ELECTRICAL CONNECTIONS - ELECTRICAL SAFETY. (n.d.).
https://www.phelpsdodge.com.ph/updates/article/top-cause-of-fires-in-the-philippines
Judy. (n.d.). Wildfire Prep 101: What to do Before, During and After a Fire. Retrieved on February 20,
2023 from https://judy.co/blogs/content/wildfire-prep-101-what-to-do-before-during-and-after-
a-fire
Marciano, M. (2021, February 22). Mga Dapat Gawin Kapag may sunog: Mahalagang Dapat
Tandaan: Theasianparent Philippines. theAsianparent. Retrieved February 21, 2023, from
https://ph.theasianparent.com/mga-dapat-gawin-kapag-may-sunog
ANGELES UNIVERSITY FOUNDATION
Angeles City
College of Nursing
Second Semester, Academic Year 2022-2023

NCM 0120: Disaster Nursing Related Learning Experience
Case Report Analysis:

Disaster Ethics and Healthcare Personnel: A Model
Case Study to Facilitate the Decision Making Process
Submitted by:
Advincula, Kyla Sophia Nicole B. Loanzon, Patricia O.

Agustin, Christine P. Mangalino, Joshua Renz D.
Cabiling, Gerna Maie Anne S. Reynolds, Bianca Rachel Bonnie D.
David, Alyssa Mae D. Sitson, Kelly Gale D.
Espinoza, Lindsay Olive D. Sunga, Gabriella Mari P.
Lacson, Clarence Denise R. Group 14, BSN 4D
Submitted to:
Rudena Madayag, RN, MN
March 9, 2023
Case Report:
David is employed as a staff nurse at a 300-bed tertiary care facility in uptown
New Orleans. The hospital’s staffing solution for its hurricane response plan was the
creation of a three (3) tier nursing response team. The nurses assigned to tiers 1 and 2
were considered essential and would be expected to report to the hospital to provide
patient care during the hours before (usually 24 hours), during, and after (usually 12
hours) the hurricane’s arrival and departure. During this time, the hospital would go into
a “lock-in” mode where no employee was allowed to enter or leave the premises
regardless of their shift assignment. Once the “lock-in” phase of the hurricane plan has
ended, it is the responsibility of the members on tier 3 to provide a recovery and relief
period for those persons on tiers 1 and 2.
David and his wife are preparing to evacuate New Orleans for Hurricane Katrina.
He receives a phone call from a friend who is a tier 1 member requesting that David
stop by the pharmacy, pick up some toiletries, and drop them off on his way out of town.
David arrives at the hospital and is greeted with the news that the first mandatory
evacuation call has caused a mass exodus from the city and over 75% of the members
of tiers 1 and 2 are evacuating the city. David’s wife is an insulin dependent diabetic
who is on a strict dietary, medication, and exercise regime. As a result, David has never
accepted a position that would designate him as essential personnel. David has,
however, never failed to report to work as a tier 3 relief member. The nursing
administrator pleads with David to stay and assist and is assured that he and his wife
will have suitable lodging and that her medical and dietary needs will be attended to
accordingly.
There are more than 2000 employees, family members, and pets sheltered in the
hospital. Eight hours post Katrina, there is only essential electricity and water and food
has begun to be rationed. There will be no tier 3 nursing personnel relief because
entrance into the city has been halted as a result of the devastation. David has just
completed a 12-hour shift tour when his wife informed him that her blood glucose is 276.
Unknown to David, her diabetic meals have been altered as a result of food and water
rationing. In addition, the diversion of electricity has left her insulin in an uncontrolled
environment. David locates the nursing administrator and gives notification that he is
leaving due to his wife’s condition. David is informed that if his wife’s condition worsens
she will be cared for, but leaving the hospital at this time will constitute job abandonment
and will be reported to the Louisiana State Board of Nursing.
Introduction
Hurricane Katrina, a large and extremely powerful hurricane leaves a historic
mark on the Northern Gulf Coast which caused enormous destruction and significant
loss of life. Hurricane Katrina is the costliest hurricane to ever hit the United States and
is considered to be one of the five deadliest hurricanes to ever strike in the U.S. leaving
1,833 fatalities and approximately $108 billion of damage. This was a storm that
captivated the public and media with most coverage occurring in the New Orleans area.
Considering the scope of its impacts, Katrina was one of the most devastating natural
disasters in United States history. A fulcrum of viable questions and concerns were
aroused by images of stranded, desperate, dying, and dead citizens. The justification of
physician-propagated euthanasia for the sick and elderly, as well as medical genocide
of hospitalized patients, was sustained by perceptions of despair and imminent doom.
These actions initiated a discordance of outrage, indignation, and criticisms. In

an effort to maintain the appearance of orderliness and normalcy in an area ruled by
chaos and deviancy and to provide an amount of psychological tranquility for the people
who are living in fear, assurances, pacifications, and pledges of investigation and
retribution were commonly seen being done due to the situation. However, the concrete
utilization of this methodology does not take into account the degree of abstraction
inherent in the complex determination of resolutions and implications generated as a
result of the personal, professional, and employer-employee dilemmas created by a
catastrophe of this magnitude for not only the healthcare recipients but for the
healthcare providers as well.
Registered nurses are considered to be the largest group of healthcare
personnel according to the U.S. Department of Labor. Three out of five nurses are
employed as clinicians in hospitals wherein they provide direct care to physiologically
and psychologically compromised individuals. In this kind of setting, the prevailing
ethical dilemmas are mostly client-driven and are frequently associated with problems of
well-being, choice, privacy, and cost/insurance reimbursement. The proximity of the
client-nurse relationship facilitates the involvement of nurses in various stages of the
ethics procedural process. Therefore professionals within these facilities such as nurse
clinicians, administrators, educators, and researchers often find themselves involved in
or affected by the ethics inherent to the delivery of healthcare services. Additionally,
federal and state regulatory organizations frequently demand that certain ethical
breaches and suspected ethical violations be recorded, tracked, then, a corrective
action plan must be developed and implemented.
Although professional associations and national healthcare organizations support

the use of codes of ethics at all institutional levels, it seems that less stringent
regulations apply to institutional policies and practices that have an impact on the
psychological and personal well-being of nursing staff. In addition, despite the
abundance of studies linking stress and ethical ramifications among other factors, as
growing concerns for nurses, initiatives that are promoted to advance policies devoted
to their well-being are confined to the area of workplace advocacy and continue to
concentrate on client-driven safety and outcomes measures. A widespread
disengagement regarding the emphasis that healthcare workers place on personal and
familial interests as well as how these problems create an impact on policy development
and implementation. This is significant in geographically susceptible areas of the gulf
coast wherein inclement weather poses the threat of catastrophic destruction, therefore,
there is an increased probability of ethics-driven situations that require solutions derived
from reliable decision-making models.
Background and Textual Evidence
Geography
The US state of Louisiana is located in the southern part of the USA. It has an
area of 52,377 square miles or 135,655 square km. This state is said to be the country’s
33rd largest state in terms of area and the 25th most populous housing approximately
4.649 million people. The state is subdivided into 64 parishes, which are similar to
counties, and contains 303 incorporated municipalities. The municipalities in Louisiana
are classified according to their population. Those that have a population that is less
than a thousand are classified as villages, those that have greater than 1,000 but less
than 5,000 people are classified as towns, and those that have a minimum population of
5,000 are classified as cities.
The greater New Orleans Metropolitan area comprises eight parishes namely
Jefferson, Orleans, Plaquemines, St. Bernard, St. Charles, St. John, St. James, and St.
Tammany. According to the U.S Census Bureau (2020), New Orleans is the largest city
in Louisiana housing approximately 383,997 residents but during the pre-Katrina
incident, New Orleans had approximately 500,000 residents living in a 500 square mile
radius. New Orleans is located in a somewhat peninsular location with a waterfront on
three sides. The core of the city expands around a curve of the Mississippi River which
lends it the moniker "Crescent City". Lake Pontchartrain links to Lake Borgne, a large
entrance to the Gulf of Mexico, near the Mississippi River. Lakes, marshlands, and
bayous spread in all directions from the city. New Orleans is the third lowest elevation
point in the United States with approximately 50% of the city sitting 1-10 feet below sea
level. The Mississippi River has natural levees, making the region less vulnerable to
hurricanes. Yet, as a result of human intervention, the land is already displaying
symptoms of subsidence. The results of erosion and wetland loss have created an
unstable delta basement.
Meteorology
Due to the surrounding waters, and lakes of the city, adding the fact that its
weather in the New Orleans area is hot, and humid, watersprouts–a tornado over a
body of water, hurricanes, storm surges, and flooding are a common and sometimes
dangerous phenomenon that can happen in the said city. Even with today's flood control
measures, New Orleans' low-lying terrain remains vulnerable to flooding during
hurricanes and/or storms. Levees and floodwalls, according to a research conducted by
the National Academy of Engineering and the National Research Council, no matter
how big or strong, the walls that encircle New Orleans cannot provide perfect protection
against overtopping or failure in catastrophic situations. According to the National
Hurricane Center 2005 statistics, pre-Katrina catastrophic incident, from 1851-2004,
Louisiana state has been striked by 49 hurricanes. One-third of which are categorized
as major, five of which are among the costliest in U.S. history, and 11 are said to be
among the most violent storms to ever make landfall in the United States. Despite these
hurricane trend indicators and a plethora of predictions and theories (Fischetti, 2001)
raised by meteorological experts regarding New Orleans' fate in the event of a direct
attack from a major hurricane, it has become abundantly clear that no one in the
government or industrial communities had satisfactory evacuation and or emergency
plans developed, analyzed, and ready for implementation.
Hurricane Katrina
On August 23, 2005, the tropical depression that became Hurricane Katrina
developed over the Bahamas, and meteorologists were quickly able to warn residents of
the Gulf Coast states that a significant storm was on its way. By August 28, evacuations
had begun throughout the region. That day, the National Weather Service projected that
once the storm hit, "much of the Gulf Coast region will be uninhabitable for weeks…
perhaps longer". New Orleans was at particular risk due to its geographical location.
New Orleans mayor during that time, Mayor Ray Nagin issued the city's first-ever
mandatory evacuation order the day before Katrina struck. He also proclaimed that the
Superdome, a stadium on relatively high ground near downtown, would serve as a "last
resort sanctuary" for individuals unable to flee the city. By evening, over 80% of the
city's population had left. Tens of thousands of people sought shelter at the Superdome,
but tens of thousands more decided to stay at home. The hurricane killed an estimated
1,200 people and caused an estimated $108 billion in property damage, making it the
most expensive storm on record.
The devastation caused by Hurricane Katrina exposed a number of deep-seated

issues, such as disputes over the federal government's response, difficulties in
search-and-rescue efforts, and a lack of preparedness for the storm, particularly with
regard to the city's aging series of levees, 50 of which failed during the storm,
significantly flooding the low-lying city and causing much of the damage. Katrina's
victims were disproportionately low-income and African American, and many of those
who lost their houses experienced years of hardship.
Healthcare Demographics
Before Hurricane Katrina happened in 2005, there were roughly 34 acute care
hospitals with a total bed capacity of 5,707 and a workforce of approximately 10,000
licensed nurses in the New Orleans metropolitan region. A major VA medical center, the
largest state-funded health sciences/level 1 trauma center, a regional children's
acute/ambulatory care hospital, and numerous smaller nonprofit and for-profit medical
centers with bed capacity larger than 400 were among these facilities. Within the city, all
of the hospitals that had nursing staff and staff family members were stranded in the
aftermath of Hurricane Katrina that required evacuation. The length of stay in the
hospitals before being evacuated ranged from 48 to 160 hours. All of the hospitals in
New Orleans were eventually closed. Only Touro Infirmary and Children's Hospital were
working at pre-Katrina capacity during that period. Nonetheless, more than half of the
licensed nurses working in these healthcare institutions are contract or per diem agency
staff.
Ethical Decision Making

Autonomy
According to the Internet Encyclopedia of Philosophy (n.d.), autonomy is
an individual’s capacity for self-determination or self-governance. It is one’s
freedom from any controlling interferences and personal limitations that may
prevent their meaningful choices. Autonomy is not solely for patient use only, but
also the healthcare practitioners can also practice autonomous decisions. Nurses
can refuse a work given to him/her if it is not part of their role, and they know that
it is beyond their skills, and abilities. However, if a nurse accepts an assignment
delegated to him/her, then the nurse is responsible and accountable for his/her
nursing actions and care delivered thereafter.
Non-maleficence
Non-maleficence states that a medical practitioner must do no harm
intentionally to his/her patients. Nurses must provide a standard of care that will
avoid or minimize risk to the patients. This ethical principle requires four things:
1) an act is not intrinsically wrong, 2) a good effect is intended, 3) the good effect
isn’t a by-product of bad effect, and 4) the good outweighs the bad. An example
of which is nurses demonstrating this principle by avoiding negligent care to their
patient. As nurses, we should always make sure that every action and decision
we make will always be good and will not harm our patients.
Beneficence
Beneficence is defined as an act of charity, mercy, and kindness with a
strong connotation of doing good to others including moral obligation. This ethical
principle wants us to do actions that will contribute to the welfare of others. It
requires positives and negatives to be balanced. As nurses, we must always use
our clinical judgment to act in the best interest of our patients. In every
circumstance, the nurse must act in a way that promotes human dignity and
protects the patient's rights.
Justice
Justice is an ethical principle where its meaning ranges from the fair
treatment of individuals to the equitable allocations of resources. Justice is
concerned with the equal allocation of advantages and obligations to individuals
in social institutions, as well as how different people's rights are honored.
Review of Relevant Concepts to the Case

Ethical Theory
Deontology
Deontology is a combination of the Greek terms meaning duty (deon) and
the science (or study) of (logos). Deontology is one of the normative theories
used to determine what actions are ethically obligatory, prohibited, or permissible
in current moral philosophy. Deontology, then, is an ethical philosophy that uses
rules to discern between good and bad. This ethical theory also requires that
everyone must adhere to the law and perform their duties. In this case,
deontology doesn’t require weighing the costs and benefits of a situation,
whether the result is good or bad, as long as one follows the laws, performs their
duties and avoids violating rules. In the case of David, he still did his job and
worked as a tier 3 nurse even though members of tier 1 and 2 nurses have not
reported to their duties.
Utilitarianism
A kind of consequentialism known as utilitarianism holds that actions (or
particular categories of actions) should be judged according to their effects.
Because the utilitarian holds that it is conceivable for the right thing to be done
from a bad motive, utilitarianism differs from ethical theories that depend the
rightness or wrongness of an action on the agent's motivation. Utilitarianism,
then, is an ethical philosophy that distinguishes between good and wrong by
emphasizing results. According to this argument, the morally best course of
action is the one that benefits the majority of the population. It also means that,
whether the action is good or bad, as long as the effects or the results are good,
it doesn't matter and it is the right thing to do. Lastly, it is considered an ethical
choice once the action or decision would produce the greatest good for the
greatest number of people. In the case of David, he still reported to his work
knowing that he could provide care to a lot of patients, while leaving his wife
considering her condition, to fulfill his duty.
Concept or Principle, Relevant Facts, and Most Important Issues

ANA Code of Ethics Provision 5
The American Nurses Association Code of Ethics was created as a
manual for performing nursing duties in a way that is consistent with the ethical
requirements of the profession and the quality of nursing care. Provision 5 states
that “The nurse owes the same duties to self as to others, including the
responsibility to promote health and safety, preserve wholeness of character and
integrity, maintain competence, and continue personal and professional growth.”
The case specifically mentioned the first part of the fifth provision which is the
statement “the nurse owes the same duties to self as to others”. This shows that
ANA understands how closely a nurse's personal and professional lives are
connected and that duty to oneself is a significant indication for character
integrity. The Code of Ethics for Nurses states that moral respect recognizes the
value and dignity of every individual, regardless of their characteristics or
circumstances in life. As a result, respect includes oneself, and we owe
ourselves the same duties as we do to others. This still applies to maintaining
competence, advancing health and safety, preserving integrity and wholeness of
character, and continuing one's own and one's career's growth.
Issues involving the rights, responsibilities, and deployment of registered

nurses to disaster areas
Ballantyne and Achour (2022) state that previous studies have shown that
healthcare worker redeployment has been routinely used to increase capacity,
with minimal emphasis on nurses. Their study findings revealed that nurses in
redeployed roles were prone to stress and anxiety and sought committed
leadership despite the additional obstacle of working with unfamiliar coworkers
and surroundings. Nurses are crucial to the healthcare system's resilience, which
is impossible to achieve without a thorough resilience strategy. As a result,
healthcare organizations must create strategies, rules, and enforcement methods
to guarantee that their workforce is adequately empowered and protected
throughout both potential redeployments and regular operations.
Abandonment
Abandonment was described as "leaving a nursing assignment without
properly notifying the appropriate personnel" by the Louisiana Board of Nursing
(LSBN). Two things must have occurred for a situation to qualify as patient
abandonment: 1) the nurse must have accepted the assignment, establishing a
nurse-patient relationship; and 2) the nurse must have terminated the
relationship without giving notice to the proper person so that another nurse can
continue to care for the patients. The distinction between patient abandonment
and employee abandonment is the problem that the nursing board faces. While
job abandonment refers to an action when an individual leaves their employment
without giving notice and has no intention of returning, patient abandonment
refers to an action when a healthcare provider incorrectly ends the nurse-patient
relationship. Nurses and leaders need to understand the distinction. To effectively
delegate, leaders need to be familiar with their team members' skills. On the
other hand, nurses must not accept a task that they are unqualified to
accomplish, whether it be because they are worn out or because they are
unfamiliar with the location. If a nurse accepts a job, they have a responsibility to
deliver competent, safe care until they appropriately hand over responsibility to
another licensed provider. It must also be noted that while turning down an
assignment, nurses must do it with objectivity and professionalism.
Case Presentation
A. Outline of Parts
1. In an uptown New Orleans tertiary care institution with 300 beds, David
works as a staff nurse. The hospital's storm reaction strategy included the
formation of a three (3) layer nursing response team.
2. The nurses assigned to tiers 1 and 2 were deemed critical and were
required to report to the hospital to provide patient care in the hours
preceding, during, and following the arrival and departure of the hurricane.
3. At this period, the hospital would adopt a "lock-in" mode, in which no staff,
regardless of shift assignment, was permitted to enter or leave the
grounds. Once the "lock-in" phase of the storm plan has concluded, it is the
obligation of tier 3 members to offer a time of recovery and respite for
those on tiers 1 and 2.
4. David and his wife are planning to evacuate New Orleans in preparation
for Hurricane Katrina. He receives a phone call from a tier 1 member
buddy who requests that David swing by the drugstore, pick up some
toiletries, and drop them over on his way out of town.
5. As David arrives at the hospital, he is informed that the first evacuation
orders call has resulted in a widespread evacuation from the city, with
over 75% of tier 1 and 2 members evacuating.
6. David's wife is a diabetic who requires insulin and follows a strict diet,
medicine, and exercise regimen. As a consequence, David has never
accepted a role in which he would be considered vital staff. David, on the
other hand, has never missed a day of work as a tier 3 relief member.
7. The nursing administrator begs David to remain and help, assuring him
that he and his wife would have enough accommodation and that her
medical and food requirements will be met.
8. The hospital is home to around 2000 staff, family members, and pets. Only
necessary electricity and water are available eight hours post-Katrina, and
food is being rationed. Because of the destruction, entry into the city has
been blocked, hence there will be no tier 3 nursing personnel relief.
9. David had just finished a 12-hour shift when his wife notified him that her
blood glucose level was 276. David was unaware that her diabetes meals
had been adjusted due to food and water shortages. Furthermore, the
loss of power has placed her insulin in an unregulated environment.
10. David finds the nursing administrator and informs her of his impending
departure owing to his wife's illness.
11. David is told that if his wife's condition worsened, she would be cared
for, but that deciding to leave the hospital at this time will be considered
job abandonment and will be reported to the Louisiana State Board of
Nursing.
B. Detected Problems
1. Was David’s decision the most appropriate decision?
● David's decision to leave the hospital in order to attend to his wife's
medical needs may not be the most appropriate thing to do
because he is considered an essential tier 3 relief member and
leaving during a time of crisis could put the hospital's response plan
at risk. Additionally, leaving without proper authorization may be
considered job abandonment and could have legal and professional
consequences for David. The nursing administrator has assured
David that suitable lodging and care will be provided for his wife,
which should alleviate some of his concerns. It may have been
more appropriate for David to communicate his wife's medical
needs to the nursing administrator and work with them to find a
solution that would allow him to attend to his wife's needs while still
fulfilling his responsibilities as an essential member of the hospital's
hurricane response team. David should have discussed his
situation with the nursing administrator and explored alternative
options before making a decision to leave.
2. If placed in the same position, what would your decision have been?
● Leaving a job during a time of crisis, especially in healthcare, is a
serious matter and could have legal and professional
consequences. David should have communicated his concerns
about his wife's health to his supervisors and attempted to find a
solution that would allow him to stay at work while also ensuring his
wife's needs are met. It is also important to note that healthcare
workers have a duty to provide care during times of crisis, and
being a member of a tiered response team means that David has a
responsibility to fulfill his role in the hospital's hurricane response
plan. If possible, he should have tried to fulfill his duties while also
ensuring his wife's safety and well-being. If I were in David's
position, my decision would depend on several factors. Firstly, I
would consider the hospital's response to my situation. If the
nursing administrator can guarantee that my wife's medical and
dietary needs will be attended to and suitable lodging will be
provided, I would be more likely to stay and continue to provide
assistance as a tier 3 relief member. However, if the hospital is
unable to provide the necessary care for my wife and ensure her
safety, I would feel justified in leaving to take care of her. Secondly,
I would weigh the potential consequences of leaving the hospital
against the potential consequences of staying. If leaving the
hospital could result in job abandonment charges and negatively
impact my nursing license, I would consider staying and fulfilling my
obligations as a tier 3 relief member. However, if my wife's health is
at risk and I feel that staying in the hospital could compromise her
safety, I would prioritize her wellbeing over the potential
consequences of leaving. Overall, my decision would prioritize the
health and safety of my loved one while also considering my
professional obligations and the potential consequences of my
actions.
3. Were there any other ethically sound options that David could have
employed?
● Yes, there were other ethically sound options that David could have
employed. One option would have been to notify the nursing
administrator of his wife's condition and ask for permission to bring
her to the hospital so that she could receive appropriate medical
care. Another option would have been to ask for assistance in
finding suitable lodging for his wife that could meet her medical and
dietary needs while he continued to work at the hospital. David
could also have tried to negotiate with the nursing administrator for
a solution that would allow him to attend to his wife's needs while
still fulfilling his duties as a relief member. However, it is important
to note that the situation was complex and there may not have
been a perfect solution. Ultimately, the decision David made was
based on his personal values and priorities, and he had to weigh
the potential consequences of his actions. These options would
have ensured that David fulfilled his job obligations while also
taking care of his wife's medical needs.
4. Should professional and governing organizations for nursing declare

a position? Regarding nurses who live and or work in high-risk areas
of the country?
● Yes, professional and governing organizations for nursing must
declare a position which caters to nurses who live and work in
high-risk areas of the country. The professional and governing
organizations may declare a position like a disaster management
nurse. The nursing practice speciality known as professional
development is established by standards, is grounded in research,
and is an essential component of producing excellent results for
patients and organizations. Professional development, a
specialization of nursing practice that is governed by standards and
supported on research, is crucial in achieving outstanding
outcomes for patients and organizations and especially to nurses
who live and work in high risk areas. A disaster management nurse
is a licensed nurse who provides emergency management
services. Mostly, this entails caring for people affected by natural
catastrophes, automobile accidents, and disease outbreaks. The
safety and security of nurses who live and work in high-risk areas
must also be ensured. They must have an organized plan not only
for patients, but also for nurses who live and work in high risk
areas. Encourage governments to make plans for how they will
respond to the fundamental requirements of nurses in the event of
a disaster. This includes putting a system in place that aims to
provide nurses with food, water, and shelter, as well as continuing
to provide the normal compensation and incentives that are
provided for the amount of time they work. Ensure that nurse input
is received by actively participating in both the strategic formulation
and the implementation of disaster plans.
5. Was the nursing administrator’s decision ethically sound?

● The nursing administrator's decision was not ethically sound. David
agreed to stay in the hospital even though he is a member of the
tier 3 relief because he was assured that his insulin-dependent,
diabetic wife will be well taken care of. The administrator failed to
keep his word as it was later revealed that David's wife had
hyperglycemia and her insulin was in an uncontrolled environment.
Given that both parties were in the middle of a calamity and the
circumstances have left the hospital in manpower shortage,
threatening to report David for job abandonment was unethical
because he was, in fact, present and reported to work even when
he was not designated to be there during that time. Using threats of
possible reprimand to make David stay at the hospital creates a
hostile work environment. The nursing administrator also used their
position as a leader to pressure David into working despite having
completed a 12-hour shift, which makes him vulnerable to errors
due to exhaustion.
6. Should David receive a state board reprimanded for his actions?

● Yes, David should be reprimanded by the state board for his
actions. Even if he does not want to accept the job, he has chosen
to do so, which has ramifications for his responsibilities and
accountability as a nurse. A reprimand is a type of disciplinary
action being used by healthcare providers such as nurses. It is
frequently issued to those who have committed minor offenses of
the Healthcare Practice Act or the Nursing Practice Act. In David’s
case, a verbal warning is appropriate in the situation but if he fails
to comply with it, a written warning will be given. As nurses, it is a
must to maintain responsibility and accountability when working. It
is the responsibility of David to fulfill responsibilities, tasks, or
functions with sound professional judgment and to accept
accountability for the judgments made in the course of doing so as
he accepted the job from the nursing administrator. David must
have the accountability or the capacity to account for his decisions,
actions, and omissions. It involves maintaining competency,
ensuring excellent patient care outcomes and professional
standards, and being responsible to people/patients.
7. Should the nursing members of tiers 1 and 2 receive a state board

reprimand for not reporting to work?
● No, the nursing members of tiers 1 and 2 who were unable to report
for work should not be reprimanded. According to The Code of
Ethics, nurses have a duty to respond in times of disasters under
extreme conditions. There are current position statements that
address issues involving rights, responsibilities, and deployment of
registered nurses to disaster areas. Having said this, nurses also
have the professional right to refuse any patient assignment –
based on their professional and ethical responsibilities – if it puts
themselves at serious risk for harm. Provision 5 of The American
Nurses Association code of ethics also states that "nurses owe the
same duties to self as to others". Stated in California Health and
Safety Code Section 1317, immunity from liability is provided for
health facilities and their members who may be at risk for loss of
life. A law in Louisiana, specifically La. R.S. 29:735.5 states that a
health care provider who provides services during a disaster will not
be held legally responsible for acting or failing to act. They will only
be held responsible if there was an intent to cause harm. In the
case scenario, team members from tier 1 and 2 who were unable to
come into their shift did not intend any harm on others. Rather, they
were included in the population that was mandatorily evacuated for
their safety. They acted upon the interest of keeping themselves
safe, not on the intent of neglecting patient care.
C. Reasons why the problem emerged and persist

The problem emerged when news came in that 75% of the members of
tiers 1 and 2 are evacuating the city. This created the problem of the hospital
being short-staffed during a time where manpower was needed the most due to
the possible casualties brought by Hurricane Katrina and to the current patients
receiving care. David decided that he would stay under the conditions that his
wife's medical needs would be taken care of during the entirety of the disaster.
Because these conditions were not met, the problem persisted. Due to the
worsening condition of his wife, David felt that being in the comfort of their own
home where he would be able to take care of his wife's needs was the best
decision. This action recognizes that nurses' professional and personal lives are
entwined and that duty to self is symbolic of wholeness of character. However,
this would mean that the hospital would have one less nurse. The nursing
administrator, acting on the best interest of the hospital and the patients in it,
found this situation to be unethical. This prompted them to insinuate that David's
actions constitute job abandonment and will be reported to the state's board of
nursing. This only fuels the problem further as they have not found common
ground to have a fruitful conversation and come to an agreement that will be
beneficial for both parties.
Conclusion/Recommendations
In conclusion, being a nurse is more than a job or a profession; when you
selected this route, you decided to help those in need. David's decision is not the best
one, however based on the situation, David's wife's blood glucose level has reached
276, necessitating immediate care. Hence, according to David's decision, as long as he
properly endorsed his job, he has the freedom to decide. But, as nurses, it is our
responsibility to cater to our patients' needs. He might address this topic with the
nursing administration before making a decision.
Indeed, it is quite challenging to choose between your responsibilities as a nurse
and your family. Being a nurse entails adhering to the ethical standards of the nursing
profession, thus having the ability to make important decisions in this situation is
essential. The group can see why David made the choice he did, but if the group had
been in his shoes, the group might have looked into other options first. The group could
have first discussed this issue with the nursing administration and then devised a
strategy that wouldn't jeopardize the health of my patients and my wife. Before making a
decision, a nurse must exhaust all other options. There are a lot of individuals that
depend their life on us, thus assessing all the probable repercussions of our actions is a
requirement in our decision making.
Additionally, David could have utilized alternative methods that were ethically
appropriate. The ICN, which is recognized as the global representative of nursing,
suggests that disaster management plans should prioritize the resilience of nurses,
including their physical and mental well-being. In addition, the ICN suggests that
support should be given to nurses' families and dependents during the recovery phase.
In David's situation, it is crucial to address his wife's health needs urgently, as he cannot
leave the hospital due to his duty. The ICN also advocates for strategies that promote
social justice and equitable access to healthcare and social services, and calls on
governments and disaster management organizations to provide the necessary support
systems to address the health needs of those impacted by disasters. Both patients and
nurses, including their families, should be given equal justice and equity. David has the
right to express his concerns to his colleagues to promote fairness, justice, and equality
within the healthcare team. The Sendai Framework provides guiding principles and
action priorities for disaster risk management that prioritize the protection of individuals
and their health, livelihoods, property, and cultural and environmental assets, while also
safeguarding human rights. Despite disastrous events that may occur within a hospital,
the principle of autonomy should apply to all healthcare workers, including David,
particularly if a relative or significant other is affected. Finally, nurses should work
together with their governments to encourage the planning for responding to the basic
needs of nurses in the event of a disaster, including providing food, water, shelter, and
continued compensation and incentives for their work.
In light of this, professional and governing nursing organizations must declare a

position for nurses who live and work in high-risk areas of the country. Professional
organizations promote workplace safety, health, and wellness for nurses. They
advocate for policy changes on critical health issues affecting nurses and the general
public. The International Council of Nurses (2019), strongly believes that nurses must
be included in the developing and application of policies for disaster risk reduction,
response, and recovery on a global scale as well as advocates for governments, the
private sector, and other stakeholders to adopt disaster risk reduction, response, and
recovery strategies in order to prevent the loss of lives, livelihoods, and health.
Moreover, nurses have consistently proven to be dependable responders, and their
compassionate nature usually compels them to help those in need even if it jeopardizes
their own safety and/or well-being. According to the American Nurses Association
(2017), the nurse has a strong relationship with the public, who expects nurses and
other health care providers to respond to their needs in the event of different types of
disaster resulting in mass injury or illness. As a result, society encourages professions
to self-regulate on the assumption that such a response will occur. Also, it is important
that nurses must participate actively in supporting and assisting institutions and
governments to foresee possible hazards and vulnerabilities and to improve their
capacity to predict, warn of, and respond to disasters, for instance through the
development of a national disaster plan and emergency funds in order to be prepared
when such disasters occur. However, during pandemics or natural disasters, nurses and
other health care providers must balance providing high-quality care for others while
taking care of themselves, especially those who are located or work in high-risk areas.
The Code of Ethics for Nurses with Interpretive Statements (the Code)
establishes the ethical standard for the profession and provides a guide for nurses to
use in ethical analysis and decision-making. Nursing duties must be assigned or
delegated by nurses, who are accountable and responsible for doing so. The
assignment or delegation must adhere to organizational policy, state practice statutes,
and professional nursing practice guidelines. In addition, nurses working in
management and administration must create a secure setting that promotes and
encourages proper delegation and assignment. David or any other member of the
nursing team cannot be purposefully given a task for which they are unprepared or
unqualified by the nursing administration. Decisions on delegation or assignments
cannot be made by a nurse without following employer policies or instructions. The
nurse administrator should encourage open communication with healthcare
professionals so they can voice concerns or even decline assignments they are
unqualified for something without fear of retaliation.
According to the emergency preparedness and emergency response plans

(2014), Nurses, assistive staff, and all other employees have distinct tasks in both
internal and external crises. It is extremely vital that the nurse administrator allows all
personnel know their duties and responsibilities before such a disaster happens since
there isn't much opportunity to review a policy and procedure when a disaster actually
does occur. Based on the presented case, David arrived at the hospital, and that the
nursing administrator pleads with him to stay and assist and is assured that he and his
wife will have suitable lodging and that her medical and dietary needs will be attended
to accordingly. It is clearly evident that the roles of nurses were not properly identified
prior the occurrence of the disaster.
As such, according to the first formal Code of Ethics, Provision 8, The nurse
collaborates with other healthcare providers and the general public to preserve human
rights, develop health diplomacy, and eliminate health inequities. Supporting the idea
that health is a right for every person will allow access to best practice prospects
through discipline-wide collaboration. The capacity of the nurse to work in different
healthcare environments may entail extraordinary cases that demand for ongoing
actions of advocacy and diplomacy. With the case presented, considering that David’s
wife is at home and is needing immediate help concerning her health status, David must
collaborate with other health professionals and have proper endorsement to his
co-worker in the hospital setting regarding the health care plan and progress of patients
affected by the disaster.
Consequently, Provision 5 of the ANA code of ethics (2001) states that “the
nurse owes the same duties to self as to others”. The ANA also acknowledges that the
nurse’s professional and individual lives are intertwined and that commitment to self is
in itself symbolic of the fullness of character. Regarding David’s position, he knows that
he has a duty to help and give supervision to his wife who is an insulin dependent
diabetic and while in the hospital, he was informed that her wife’s blood glucose is 276.
With this, he needs to leave the hospital premises to be of service to her sick wife. The
worth, and hence the initiation and advancement of disciplinary action of each request
are examined on a case-by-case rationale. Yet, there is no priority for consequences
that will put David and or his family in imminent danger. Without an accurate evaluative
tool to conduct the investigatory approach, findings acquired must sustain all competing
viewpoints and must accordingly be valid and reasonable.
Moreover, the nursing staff members from Tiers 1 and 2 who failed to report for
duty should not be reprimanded. Although the Louisiana State Board of Nursing (LSBN)
and American Nurses Association (ANA) have a declaratory statement regarding the
deployment of Louisiana nurses to disaster areas as well as endorsements of outside
nurses that volunteer to work in Louisiana post-disaster, Provision 5 of the ANA code
of ethics (2001) states that “the nurse owes the same duties to self as to others”.
Alongside this, nurses also have the professional right to refuse any patient assignment
if doing so would put them at a significant danger of harm due to their responsibilities as
both professionals and citizens. According to La RS 29:735.5, a Louisiana statute, a
healthcare provider who provides services during a disaster is not liable for their actions
or inaction. Only if there was a malicious intent, will they be held accountable. The tier 1
and tier 2 team members who were unable to report for their shift in this case scenario
had no malicious intent. They were otherwise a part of the public that was forcibly
evacuated in order to protect themselves.
Recommendations
In the hypothetical situation, Nurse David and his wife were trapped in a hospital
that was unable to meet their basic needs, along with the other nurses and their
families. When they report to work during a storm or other disaster, nurses are advised
to make early plans and put in place measures to address their personal requirements.
A nurse must have enough food and drink to last for at least five days, as well as
comfortable, insulated clothing, flashlights, personal toiletry items, and a five- to
seven-day supply of prescription medication. The hospital itself must offer a safe
storage space for these patient belongings with no chance of loss. With the help of this
provision, employees would feel more secure, less alone, and more inclined to report
emergencies.
In light of this, to create a safe working environment for nurses, ensure enough
staffing levels, and provide physical and mental health support services for prolonged
crisis events, hospitals and other companies that employ nurses, nurse leaders,
doctors, and others should be held accountable. Hospital managers, nursing
executives, and medical executives must be held accountable for policies that ensure a
safe working environment for nurses during crisis response. Planning for hospital
disasters must consider adjustments in clinical duties and nurse staffing to fulfill
demand, as well as identify alternate nurse staffing choices to aid in the response.
Hence, as a recommendation, these problems are not just a one-man problem

with simple solutions. Thus, we recommend that all parties involved work hand-in-hand
to be able to fix the problem and come up with a solution that is beneficial to all.
Consequently, in terms of concepts and technicalities, if future researchers would utilize
the same case study, we recommend the use of other principles and concepts to see
whether the solutions vary or they still end up with the same outcome.
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Tals-and-other-healthcare-providers-during-disaster
START Adult Triage
Victim No. 4 - 35 years old, RR - 20, radial pulse present, capillary refill 2 seconds, obeys command,
sitting on shoulder of road, unable to walk due to sprain on his right ankle and complaints of dizziness
Able to walk? Triage Categories

EXPECTANT (Black Triage Color)
victim unlikely to survive given
No
severity of injuries, level of
available care or both
palliative care and pain relief
Spontaneous should be provided
breathing
IMMEDIATE (Red Triage Color)
victim can be helped by immediate
intervention and transport
Yes requires medical attention within
minutes for survival (up to 60)
includes compromises to patient's
airway, breathing, circulation
Respiratory DELAYED (Yellow Triage Color)

Rate victim's transport can be delayed
includes serious and potentially
life-threatening injuries, but status
not expected to deteriorate
<30
significantly over several hours
MINOR (Green Triage Color)

victim with relatively minor injuries
status unlikley to deteriorate over
Perfusion
days
may be able to assist in own care:
"walking wounded"
Radial pulse or capillary refill

present <2 seconds
For victim 4, START adult triage was utilized since he is 35
years old which is considered to be an adult. The triage
category is Delayed. During the assessment, the patient is
Mental unable to walk due to sprain on his right ankle and
status complaints of dizziness. There is spontaneous breathing and
a respiratory rate of 20 bpm. For perfusion, radial pulse is
present and capillary refill of 2 seconds which are normal. For
Obeys commands mental status, the victim obeys command. Even though the
patient needs medical assistance and treatment, the
transport can be delayed. The status is not expected to
DELAYED deteriorate significantly over several hours.
JumpSTART Pediatric Multiple Casualty Incident Triage
Victim No. 9 - 7 years old, male, RR - 40, pulseless, unresponsive, withdraws
from painful stimuli; with arm deformity, sucking chest wound
Able to walk?
No
Spontaneous Position airway

breathing
No
Apnea
No
Palpable
EXPECTANT
pulse?
For victim 9, JumpSTART pediatric multiple casualty incident triage was utilized since he
was 7 years old which is considered to be a pediatric patient. During mass casualty crises,
emergency responders use the JumpSTART algorithm to quickly assess and evaluate a
large number of pediatric patient. The triage category is Expectant. During the assessment,
the patient has an arm deformity and sucking chest wound. The patient has a respiratory
rate of 40 bpm, does not have a palpable pulse and unresponsive. For the neurological
assessment, the patient withdraws from painful stimuli.
Angeles City
COLLEGE OF NURSING
Second Semester, Academic Year 2022 – 2023
NCM 0120 | Related Learning Experience
Evidence-Based Journal
Article Review
Submitted by:
Loanzon, Patricia O.
BSN 4-D, Group 14
Submitted to:
Michelle Kho Enriquez, RN, MN
April 17, 2023

TITLE
Research Title: iiDisaster iipreparedness iiknowledge iiand iiits iirelationship iwith

itriage iidecision-making iiamong iihospital iiand iipre-hospital iiemergency iinurses
i- iiArdabil, iiIran
Authors: iiIslam iiAzizpour, Saeid iiMehri, Aghil Habibi Soola ii

Date of Publication: ii07 -20 - 2022
Name of the Journal: iiBMC iiHealth iiServices iiResearch
Journal Details: iiArticle number: ii934 i(2022); PMID: ii35854268; PMCID:
PMC9296334, DOI: ii10.1186/s12913-022-08311-9
INTRODUCTION
Once iicatastrophes iicaused iiby iihumans iior iinature iistrike, iithey iican
iioverwhelm iilocal iiresources iiand iinecessitate iithe iideployment iiof iinational iior
iiinternational iiaid. iiA iidisaster iiis iian iiunexpected iiand iiusually iirapid iioccurrence iithat
iiresults iiin iiwidespread iimaterial iiloss iiand iihuman iisuffering. iiOne iiof iia iicountry's
iimost iivaluable iiresources iiduring iia iicrisis iiis iiits iihealth iicare iiworkforce, iiwhich
iiincludes iipeople iifrom iia iiwide iirange iiof iiservice iiindustries. iiQuality iicare iiand
iireducing iiunnecessary iicomplications iiand iideath iirely iion iithe iiexpertise iiand
iipreparation iiof iifirst iiresponders. iiIn ii2019, iiCenter iifor iiResearch iion iithe
iiEpidemiology iiof iiDisaster iireports iithat ii396 iinatural iidisasters iiare iilikely iito iioccur
iielsewhere iiin iithe iiworld. iiTo iidate, ii11,755 iiindividuals iihave iilost iitheir iilives; ii95
iimillion iihave iibeen iiimpacted; iiand iithe iieconomy iias iia iiwhole iihas iilost ii130 iibillion
iidollars.
Hospital iiand iipre-hospital iiemergency iinurses iiare iiamong iithe iifirst
iiresponders iito iia iidisaster iiscene, iitreating iivictims iiof iithe iidisaster iiand iiensuring
iithat iithey iireceive iithe iimedical iiattention iithey iineed. iiHowever, iiemergency iinurses
iiare iioften iithe iifirst iimedical iipersonnel iion iithe iiscene iiduring iiemergency iisituations.
iiThey iiare iian iiimportant iipart iiof iithe iipeople iithat iiaid iidisaster iivictims iiby iitaking iiin,
iiassessing, iiand iitreating iithem. iiKnowledge iiand iipreparedness iiin iidisaster
iiresponse iiwere iifound iito iibe iilow iito iimoderate, iiin iiaccordance iiwith iisurveys iiof
iithis iipopulation iidone iiover iithe iiprevious iidecade. iiAccording iito iiinternational
iiprotocols iisuch iias iithe iiSendai iiFramework iifor iiDisaster iiRisk iiReduction ii(SFDRR)
ii2015-2030, iipreparedness iiis iithe iimost iicritical iiphase iiin iithe iiDisaster iiRisk
iiManagement ii(DRM) iiprocess, iiand iiit iicomprises iiactivities iithat iihave iialready iibeen
iicompleted iito iiguarantee iia iisuccessful iiresponse. iiThe iihealth iisystem, iias iithe
iimost iisignificant iientity iiin iiDRM, iimay iidesign iisuitable iipolicies iiand iimeasures iito
iiprevent iiboth iisocial iiand iifinancial iiconsequences. iiDisaster iipreparation iiknowledge
iiis iithe iicapacity iito iicharacterize iia iicatastrophic iievent, iicomprehend iithe iiincident
iicommand iistructure, iitriage, iiand iievaluation, iias iiwell iias iitheir iiinvolvement iiin iia
iicatastrophic iioccurrence. iiSince iidisaster iipreparedness iiknowledge iimay iiassist
iipreserve iistability iiin iicatastrophes, iiemergency iinurses iimust iibe iitrained iiwith iithe
iiinformation iineeded iito iicope iiwith iia iidisaster.

When iiit iicomes iito iidisaster iipreparedness iiin iithe iinursing iiprofession, iithere
iiare iinumerous iiinquiries iithan iianswers, iias iinurses iiplay iia iicritical iirole iiin iidisaster
iiresponse. iiDespite iithis, iiresearch iihas iishown iithat iithe iimajority iiof iiregistered
iinurses iiare iinot iiconfident iiin iitheir iiability iito iirespond iito iisignificant iicrisis
iioccurrences. iiA iivariety iiof iifactors iiinfluence iiemergency iinurses' iiunderstanding iiof
iidisaster iipreparation. iiFrom iithe iiworldwide iilevel, iiextant iiliterature iiidentifies
iidisaster iiresponse iiexperience iiand iidisaster iieducation/training iias iitwo iielements
iithat iihave iithe iimost iipowerful iiand iimost iireliable iiconnection iiwith iiboosting iinurses'
iiobjective iiand iimental iipreparation. iiWhen iicaring iifor iia iipatient, iione iiof iithe iifirst
iimedical iifactors iiis iitriage iidecision-making. iiThe iigoal iiof iitriage iiis iito iipromptly
iiassess iithe iidegree iiof iiseverity iiof iian iiinjury iiand iiminimize iiits iinegative
iiimplications. iiThis iistudy iiaims iito iidetermine iiand iiidentify iithe iilevel iiof iidisaster
iipreparedness iiknowledge iiamong iipre-hospital iiand iihospital iiemergency iinurses iiin
iiArdabil, iiIran, iiand iiits iirelationship iiwith iitriage iidecision-making.
METHODOLOGY
The iitotal iiparticipants iiin iithis iistudy iiare ii472 iiemergency iinurses iiworking iiin
iihospitals iiand iiother iimedical iifacilities iiassociated iiwith iiArdabil iiUniversity iiof
iiMedical iiSciences, iiboth iiin-hospital iiand iimobile iiemergency iicare iinurses iiwork iiin
iiIran. iiOf iithe ii821 iieligible iinurses, ii218 iideclined iito iitake iipart iiin iithe iistudy, ii89
iiquestionnaires iiwere iinever iireturned, iiand ii42 iiwere iieither iinot iifilled iiout iior iiwere
iiincomplete. iiIn iithe iiend, ii472 iipersons iiwho iihad iipreviously iifilled iiout iia iiresearch
iiparticipation iiform iiwere iiincluded. iiThe iiresearchers iiutilized iiconvenience iisampling
iitechnique. iiDescriptive cross sectional iiwas iiutilized iiand iiconducted iiin iiArdabil
iiprovince, iinorth iiwestern iiof iiIran, iifrom iiMarch ii2021 iito iiApril ii2021. iiThe iidata
iicollection iiwas iicollected iithrough iitriage iidecision-making iiinventory ii(TDMI) iiand
iiemergency iipreparedness iiinformation iiquestionnaire ii(EPIQ). iiThe iiEPIQ iiwas
iicreated iiin ii2004 iiby iiWisniewski iiet iial. iiand iiincludes ii44 iiitems iithat iihave iibeen
iiutilized iiin iivarious iiresearch iiprojects. iiThere iiare iitwo iisections iito iithe
iiquestionnaire. iiThere iiare ii14 iiquestions iiin iithe iifirst iisection iithat iiinquire iiabout
iidemographic iiinformation iiand iiprofessional iiexperiences. iiThe iisecond iisection
iievaluates iinurses' iidisaster iipreparedness iiknowledge. iiThe iisurvey iiis iigraded iion iia
ii5-point iiLikert iiscale ii(where ii1 iimeans ii“unfamiliar" iiand ii5 iimeans ii"very iifamiliar").
iiCone iicreated iithe iiTriage iiDecision iiMaking iiInstrument ii(TDMI) iiin ii2000 iito
iiobjectively iievaluate iithe iiconfidence iiof iiemergency iiroom iinurses iiin iitheir iiown
iidecision-making iiduring iipatient iitriage. iiA iitotal iiof ii27 iiitems iiwere iiutilized iiin iithe
iiquestionnaire, iiwhich iitested iicognitive iiability, iiexperience, iiand iiintuition. iiThe
iisurvey iiis iigraded iiusing iia ii6-point iiLikert iiscale, iiwhere ii1 iirepresents iistrongly
iidisagreeing iiand ii6 iirepresents iistrongly iiagreeing. iiFollowing iithe iicollection iiof
iiquestionnaires, iithe iiresearchers iiutilized iiSPSS iiversion ii22. iiInitially, iipercentages,
iimeans, iiand iistandard iideviations iiwere iiused iito iireport iidata iiregarding
iidemographic iiand iiemployment iicharacteristics, iipreparedness iifor iidisasters
iitraining, iicare iiduring iia iidisaster, iiresponsibility iiduring iia iidisaster, iiand iitriage
iitraining. iiMoreover, iithe iiANOVA iitest iiwas iiused iito iiexamine iithe iirelation iibetween
iijob iiexperience, iiyears iias iian iiemergency iinurse, iidegree iiof iieducation, iiand
iicompletion iiof iispecial iidisaster iimanagement iiand iicare iicourses. ii iiPearson
iicorrelation iianalysis iiwas iiutilized iito iiexamine iithe iiassociation iibetween iitriage
iidecision-making, iidisaster iipreparedness iiknowledge, iias iiwell iias iithe iisections iiof
iithe iitriage iidecision iimaking iiinventory. iiThrough iimultiple iilinear iiregression
iianalysis, iipredictors iiof iidisaster iipreparedness iiknowledge iiwere iidetermined. ii
iiCollinearity iiwas iimanaged iiusing iithe iiVIF iiindex. iiThe iiKolmogorov-Smirnov iitest
iiwas iiutilized iito iiassess iithe iiinformation iinormality. ii
RESULTS AND DISCUSSION
The iiresults iiof iithe iit-test iiand iiANOVA iishowed iia iisignificant iirelationship
iibetween iidisaster iipreparedness iiknowledge iiand iiyears iiworking iias iian iiemergency
iinurse, iiworkplace, iidisaster iipreparedness iitraining, iicaring iiduring iia iidisaster,
iiworking iion iiduty iiduring iia iidisaster, iipassing iispecial iimanagement iior iicare
iicourses iion iidisaster, iitriage iitraining, iiand iiresidence. iiThere iiwas iia iisignificantly
iipositive iirelationship iibetween iidisaster iipreparedness iiknowledge iiand iitriage
iidecision–making iiand iitriage iidecision iisubscales. iiAccording iito iian iianalysis iiof
iiemergency iinurses, iitheir iiaverage iiscore iion iia iitest iimeasuring iidisaster iireadiness
iiwas iipoor. iiAge, iiresidence, iidisaster iipreparedness iitraining, iitriage iidecision-
making, iiduty iiduring iia iidisaster, iiand iitraining iiorganization iiwere iialso iisignificant
iipredictors iiof iidisaster iipreparedness iiknowledge iiamong iihospital iiand iipre-hospital
iiemergency iinurses iiin iia iimultiple iilinear iiregression iianalysis. iiAge iiwas iifound iito
iihave iia iistatistically iisignificant iiand iiinverse iirelationship iiwith iidisaster
iipreparedness iiknowledge. iiThe iivast iiamount iiof iiparticipants iiand iithe iifact iithat
iithey iicome iifrom iia iiwide iirange iiof iisettings iiwithin iithe iihealthcare iisystem iiare iithe
iistudy's iistrongest iipoints. iiOn iithe iiother iihand, iithe iiweakness iiof iithe iistudy iiis iithe
iisample iiwas iilimited iito iia iispecific iiregion, iithe iifindings iimay iinot iibe iiapplicable iito
iinurses iiworking iiin iiother iiareas iiof iithe iicountry iior iiwho iifollow iidifferent iicultural
iitraditions.
Knowledge iiconcerning iidisaster iipreparedness iiis iinecessary iifor iithose iiwho

iiwork iiin iiemergency iinursing. iiThe iiWorld iiHealth iiOrganization ii(WHO) iisuggests
iithat iiall iicountries, iiirrespective iiof iithe iiregularity iiwith iiwhich iithey iiare iistruck iiby
iicatastrophic iievents, iimust iieducate iitheir iimedical iipersonnel iito iirespond
iieffectively iiin iiemergency iisituations. ii iiIn iiaddition, iithe iifindings iiof iipast iiresearch
iiindicate iithat iinurses iiwho iihave iilittle iiunderstanding iion iidisaster iipreparedness
iimight iicause iimore iiharm iithan iigood iito iivictims iiof iidisasters. iiAs iia iiconsequence
iiof iithis, iiit iiis iiadvised iithat iiproper iidisaster iipreparedness iiknowledge iishould iibe
iiprovided iito iiemergency iinurses iiin iiorder iito iiraise iithe iidegree iiof iireadiness iithey
iihave. iiThis iistudy's iifindings iialso iirevealed iithat iireceiving iidisaster iiand iiemergency
iipreparedness iitraining iiand iithe iiorganization iithat iiprovided iithe iitraining iiare
iifactors iithat iipredict iione's iilevel iiof iiknowledge iiregarding iidisaster iipreparedness. iiIt
iiis iinecessary iito iiprovide iitraining iiprograms iifor iinurses iiin iiorder iito iiexpand iitheir
iiknowledge iiand iicomprehension iiof iithe iiroles iiand iiduties iithat iithey iiplay iiin iiorder
iito iiproperly iirespond iito iidisasters. iiEngaging iiin iidisaster iiplanning, iiwhich iiis iihelpful
iifor iistrengthening iithe iinurses' iiunderstanding iiof iihealthcare iiservices, iiis iione iiof
iithe iipreparedness iimeasures; iiadditional iimethods iiinclude iiefficient iieducation,
iisimulation iitraining, iiand iiannual iitraining iidepending iion iistaff iineeds. iiIt iiis iia
iiserious iiproblem iidue iito iithe iifact iithat iiare iinot iienough iitraining iiprograms
iiavailable, iiwhich iileads iito iia iidearth iiof iiunderstanding iiamong iimedical
iiprofessionals iiabout iiemergency iipreparation. iiThe iicompetencies iiof iiemergency
iinurses iishould iibe iiused iiefficiently iiin iitimes iiof iiurgent iisituations, iiand iithey iishould
iiadopt iiclinical iiinterventions iithat iiare iisuccessful. iNurses iishould iibe iiable iito iiswiftly
iassess iipriorities iiduring iitriage iiutilizing iithe iiabilities iithey iihave iieven iiwhile iworking
iin iiconditions iithat iiare iibusy, iinoisy, iiand iistressful. Given iithe iilarge iinumber iiof
people iiwho iiare iiinjured iior iiill iias iia iiresult iiof iithe iitragedy, iimaking iithe iichoice iiof
prioritizing iipatient iicare iiis iiof iithe iiutmost iiimportance. Hence, iian iiemergency inurse
who iiis iicompetent iiin iithe iidecision-making iiprocesses iiinvolved iiin iitriage iiis ilikely ito
have iia iigreater iilevel iiof iiknowledge iiregarding iidisaster ipreparation icompared iito ian
emergency iinurse iiwhom iiis iinot iifluent iiin iithe idecision-making iiprocesses iinvolved
with iitriage.
IMPLICATION TO NURSING PRACTICE
Since this study offered information regarding the relationship of disaster

preparedness knowledge and triage decision making, I was able to expand and
widen my knowledge about the topic. As a student nurse, this may provide me
sufficient knowledge to my future patients in the hospital setting, specifically in
emergency department. I will be more aware and knowledgeable vital is the parts of
nurses in times of emergency. The findings are useful and applicable to nursing
practice, education, and research. This can help through having a wider perspective
and knowledge to student nurses so that in the future when they encounter patients
in emergency situation during a disaster they know what to do. This gives us a
background and additional knowledge. Moreover, it also help student nurses to have
an in-depth apprehension and understanding as this can also serve as a foundation
or framework for future studies. As a nursing student, I discovered and learned that
nurses help in the coordination of care in the aftermath of a disaster, with a focus on
the most at-risk populations, and ensure they have access to basic necessities like
water, sanitation, food, housing, and medication. During and after a crisis, nurses
must be prepared to act rapidly and efficiently to treat those who have been harmed
or affected. Concentration, calmness, and readiness are crucial in any situation.
As front liners who help people when something bad happen, nurses need to
be ready to help in the best way possible. Therefore, nurses' disaster management
abilities need to be evaluated to determine how well-equipped and prepared they
are. Continuous nursing education is strongly linked to nurses learning more, getting
better at their jobs, and being better prepared for emergencies. This lowers the death
rate and improves the level of care. Nurses are the most prevalent healthcare
professionals who work directly with disaster victims. They play a huge role of
alleviating the effects of disasters. Hence, they need to enhance their knowledge,
skills, and habits by going to classes on how to prepare for disasters or by continuing
to learn. There aren't sufficient programs to keep nurses prepared to handle
emergencies and tragedies, and there aren't sufficient of them. Nurses can also
provide health education like a teaching for crisis preparation can save and improve
lives during and after an emergency. A nurse in a disaster zone or a dangerous area
needs to pay attention to the different things that need to be done to make sure that
the disaster reaction is done right, safely, and on time. Communication is
fundamental to maintaining a good operation when an adverse event happens. But
the Philippines government has made progress in making people more aware of the
sudden effects disasters can have on people, communities, and the economy. It has
done this by including natural hazard risks in its initiatives, expanding institutions,
and implementing projects such as early warning systems, more accurate weather
forecasting, and more powerful disaster response. This can be used by the academe
or clinical instructors as an additional reference when they teach and discuss to
student nurses about disaster preparedness and triage decision-making. This study's
findings can serve as a foundation or framework for assessing the degree of
knowledge and preparation of nurses in the case of epidemics and pandemics,
which is another area of nursing research that is made more important by the
occurrence of new illnesses like coronavirus disease. Furthermore, this research
might serve as a starting point for future researchers interested in triage decision-
making and disaster preparedness knowledge.
CONCLUSION AND RECOMMENDATION
In conclusion, the ability to make decisions on triage is a vital skill for emergency
nurses to possess during disasters of any kind. Triage is an efficient method for
prioritizing victims of the catastrophe. Due to the relationship between knowledge of
disaster readiness and the ability to make decisions about triage, it has been shown
that emergency nurses that possess an increased level of competence in this area
have a greater degree of disaster preparedness. There is a link between
preparedness knowledge and factors such as having had training in disaster
preparedness, the training organization, having previous experience of participation
in disasters, location, and age. It has been suggested that this problem can be
solved in two distinct ways: first, by providing regular disaster-related training for
nurses so that they can continue to work as volunteers in a variety of different
disaster conditions; and second, by disseminating accurate disaster-related
information through conferences, flyers, posters, practice and maneuver, brochures,
seminars, and other forms of media. Therefore, it is advised that hospital
administrators, emergency medical services administrators, and associations of
professionals understand the significance of disaster preparedness knowledge, and
that these organizations provide emergency nurses with disaster preparedness
training programs, taking into account the nurses' ages and locations, so that the
nurses can acquire more information regarding this topic.
Consequently, in order to successfully respond to unanticipated occurrences

such as disasters, recommendations can be given to the administrators of
emergency medical and hospital centers on the appropriate design of the centers
that are managed by those administrators. Supplementary seminar and workshops
may be done in order to increase the disaster preparedness of emergency nurses in
both pre-hospital and hospital settings. This is the recommendation in light of the
fact that the nursing profession has certain requirements that must be met, as well
as the exhaustion, heavy workload, and time constraints involved in completing the
questionnaires during the COVID-19 outbreak. Moreover, since the health situation
of various countries is improving seminars and workshops are recommended to gain
a more in-depth understanding about the relationship of triage decision-making and
disaster preparedness knowledge. It is possible to conduct research employing
qualitative method. It is also recommended that this type of research be conducted in
other nations, such as the Philippines; considering that patients in disaster zones
demand the highest level of care possible, mobilizing nurses from hospitals has
become an essential tactic. While disaster nursing training programs are so
significant it is essential to have a solid grasp of how effectively hospital nurses are
prepared to deliver care in the event of a disaster.
Reference:
Azizpour I, Mehri S, Soola AH. Disaster preparedness knowledge and its relationship
with triage decision-making among hospital and pre-hospital emergency nurses -
Ardabil, Iran. BMC Health Serv Res. 2022 Jul 20;22(1):934. doi: 10.1186/s12913-
022-08311-9. PMID: 35854268; PMCID: PMC9296334.
Angeles City
College of Nursing
NURSING CARE MANAGEMENT (NCM) 0120 RLE
Second Semester, Academic Year 2022 – 2023
ENTREPRENEURIAL PLAN
Presented to the Faculty of the
College of Nursing
Angeles University Foundation
Submitted by:
Advincula, Kyla Sophia Nicole B.

Agustin, Christine P. Loanzon, Patricia O.
Cabiling, Gerna Maie Anne S. Mangalino, Joshua Renz D.
David, Alyssa Mae D. Reynolds, Bianca Rachel Bonnie D.
Espinoza, Lindsay Olive D. Sitson, Kelly Gale D.
Lacson, Clarence Denise R. Sunga, Gabriella Mari P.
Group 14, BSN 4-D
May 11, 2023

A. Description of the business plan
Life-threatening medical situations like suffocation, near-drowning, and
cardiac arrest (CA) nearly invariably take place outside of a hospital setting and
carry a high mortality risk. Cardiopulmonary Resuscitation (CPR) performed
quickly after a collapse can double or triple the survival rate. In contrast, the
chance of survival decreases by 7–10% for each minute CPR is delayed.
Saving Life Everywhere Emergency Pillow "SLEEP" Blanket is a compact,
efficient and high-performance convertible pillow-blanket composed of two
separate systems designed to provide for emergencies. It is a reliable,
ready-to-use, and practical way to lower the mortality rate in emergency
situations. The Philippines’ healthcare system is generally of very high quality.
Despite the lower quality of the facilities they work with than in upscale US or
European healthcare institutions, the medical staff in the Philippines is highly
qualified. Although public healthcare in the Philippines is of good quality, there
are significant differences between rural and urban areas. Private healthcare is
more reliable in the Philippines, and private clinics typically have greater
equipment than public ones.
In the Philippines, there is a wide range in the level of service of
ambulance services, which is made worse by a shortage of regulations governing
the operation of emergency services. As a result, pre-hospital treatment may not
be sufficient and emergency services frequently react slowly. Private ambulances
frequently offer superior equipment, more experienced staff, and quicker
response times.
Private ambulance service fees are frequently paid on a monthly basis or
are covered by regular medical insurance.With this invention, there would be a
significant reduction in emergency-related risks and an earlier start to first aid,
which would assist in managing the situation effectively, especially at the LGU
and RHU. This would benefit healthcare professionals and address the issue of
insufficient responsiveness to emergency needs.
B. SOLUTION (SWOT ANALYSIS)
a. Strengths/Uniqueness
➢ Conveniency (Immediate management and attention to patient).
➢ Ready-to-use and Practical (Convertible pillow-blanket which
contains a guide in positioning the victim, for CPR and recovery
position, placement of hand for CPR site, instructions in performing
CPR, and CPR kit.
➢ User-Friendly (Useful for emergency cases especially when the
victim is experiencing heart attacks, near drowning, electrical
injuries, suffocation, fires, and smoke inhalation).
➢ Provides immediate support for individuals in a disaster situation,
potentially saving lives.
➢ Compact and portable design allows for easy transportation and
storage.
b. Weaknesses
➢ Stability of the client is limited during the usage of the product since
patients could have sustained spinal cord and head injuries.
➢ High-cost of the product may lead to less consumer patronage.
➢ May not be as durable as other medical equipment, potentially
limiting its usefulness in prolonged disaster situations.
c. Opportunities
➢ Skills enhancement.
➢ Enhanced immediate response.
➢ New innovation.
➢ Could be marketed to individuals, emergency response teams, and
disaster relief organizations.
➢ Potential to expand the product line to include additional
emergency medical equipment.
➢ Could partner with disaster relief organizations to donate products
or provide discounted pricing.
d. Threats
➢ Unaware of the product usage and lack of training for CPR.
➢ Limited medical interventions in critical/severe cases.
➢ Legal liability if the product is used improperly or causes harm to
individuals.
➢ Potential for negative publicity if the product is ineffective or fails to
meet safety standards.
➢ Prices may fluctuate due to increases in the prices in the market.
➢ Fewer sales due to a lack of reviews and widespread testing by the
masses.
C. WHAT MAKES THE SOLUTION, PROJECT, OR SERVICES UNIQUE

An accident, according to Merriam-Webster, is an unanticipated and
unforeseen incident or situation, or an unexpected and potentially harmful sale
physiological event, particularly when detrimental. The SLEEP Blanket can be
effective in emergency situations, particularly when an individual is suffering from
heart attacks, near-drowning, electrical injuries, breathing difficulties, fires, or
smoke inhalation. This is a blanket that includes directions for situating the victim
for CPR and recovery, hand placement for the CPR site, CPR instructions, and a
CPR kit.
D. POSSIBLE RISK AND ISSUE

1. Stabilization of the patient.
Some victims cannot be mobile because of their situation, specifically in
accidents that can cause further injuries, with that, SLEEP Blanket would
be useless, but since this contains a first aid kit, the emergency responder
can use it.
2. Price variation.
SLEEP Blankets are a big help in emergency cases, individuals or families
can purchase this as their first aid kit in their household but some
customers might have a dilemma in purchasing this blanket because of
the retail price compared to the distribution in the municipalities.
3. Fewer buyers
Since our product is new to the market, people might not purchase or buy
our product because of the lack of reviews, and still not been tested by the
masses.
E. NURSES’ ROLES
Nurse entrepreneurs may;
● Contribute to the development and distribution of this medical product or
device.
● Provide direct victim care by utilizing their skills.
● Promote patient advocacy by assisting/helping the victims
● Train and educate other health care providers or community members
● Make arrangements for health-care consultations.
● Determine best practices and skills that can assist in finding ways to
improve one's knowledge and skills.
● Provide nurses the opportunity to have a greater effect that can influence
and motivate others.
F. Mission-Vision
VISION
Our vision is to decrease preventable deaths, reduce mortality rates in
emergency cases and have competent emergency responders in the Philippines.
MISSION
Our mission is to decrease mortality rates in emergency cases by
providing a reliable, accessible, and convenient solution, while also increasing
the knowledge and competence of emergency responders by equipping them
with appropriate tools and complete instructions.
G. Goals and Objectives

GOALS
Our main goal is to be able to make an impact in the Philippines by
developing a product that decreases preventable deaths and also increases the
competency and capability of not only trained medical professionals, but also
regular citizens and bystanders by introducing them to Basic Life Support (BLS).
OBJECTIVES
Short-term
■ Introduce Basic Life Support to regular citizens.
■ In two years, provide and supply for at least 50% of all municipalities in
Pampanga.
■ Provide opportunities to improve the knowledge and proficiency of
rescuers on Basic Life Support (BLS).
■ Increase the number of competent rescuers.
Long-term
■ In ten years, further decrease in preventable deaths from Emergency
cases.
■ In ten years, provide and supply at least 20% of all municipalities in the
Philippines.
H. Organizational Structure
A company's organizational structure is essential because it offers a strategic
plan for the management of its human resources. The organization's structure clarifies
the duties and work processes of its personnel, directing their objectives and focus.
The key members of the organization and their duties and responsibilities are
listed below:
● Chief Executive Officer - The CEO will be responsible for the organization's
daily planning and general management functions. For improved function and
performance, the job attempts to maintain strategic, financial, and operational
leadership.
● Employer (HR) - The employer is the one in charge of thorough monitoring of
quality standards, allocation of supplies and/or equipment, hiring and training of
new workers.
● Finance Manager - A finance manager is in charge of creating accurate financial
reports and information and reporting the store's financial position on a daily or
weekly basis. This function will also involve dealing with the heads or investors,
budgeting, and cash flow monitoring.
● Market Analyst - Is in charge of trend analysis, and creation of business
marketing materials such as a logo, stationery, announcements, and PR.
● Developer - The one responsible for product development, improvement, and
quality control.
● Cashier - The cashier is in charge of selling goods to customers, offering product
details, and suggesting alternative products. oversees all transactions involving
consumer money. maintains the cleanliness and security of the retail department.
The nurse entrepreneur could take on a variety of roles that are closely related to the
technical and commercial components of the practice. Nurse entrepreneurs in the
context of Emergency Nursing can provide a wide array of services, including:
1. Teacher - through health teachings that promote health promotion, wellness, and
prevention
2. Researcher - through finding evidenced-based results and establishing
programs focused on improving health care services and/or the health of a
specific population
I. Product Offered
Convertible pillow-blanket — The convertible pillow-blanket serves as a versatile
sleep accessory, easily transforming from a compact pillow into a cozy blanket when
needed. It provides comfort and warmth during sleep or emergency situations.The
product incorporates visuals to assist individuals in performing CPR during emergency
situations. The pillow-blanket assists in positioning the victim correctly and provides
guidance for each CPR maneuver. Furthermore, it features a flap that covers the
victim's chest, ensuring the responder places their hands correctly for effective chest
compressions. It includes the following:
■ CPR guide and Instructions — It has a visual guide on how to perform
CPR effectively which is integrated into the convertible Pillow-Blanket. It
outlines the correct technique, compression depth, and rescue breaths.
The instructions may be accompanied by illustrations or diagrams for
clarity. The convertible Pillow-Blanket also contains emergency contact
information.
■ CPR Kit — The convertible Pillow-Blanket contains a compact CPR kit
with essential tools for performing CPR. The kit includes items such as
gloves, a CPR mask or face shield, and antiseptic wipes. These items
ensure the safety and hygiene of the rescuer during CPR procedures.
Includes:
○ CPR mask or face shield – A CPR mask or face shield is a device
that covers the responder's mouth and nose and has a one-way
valve. It is used during rescue breaths to create a barrier and
prevent direct contact with the victim's mouth, reducing the risk of
disease transmission.
○ Gloves – Gloves are an essential component of a CPR kit. They
are used to protect the responder's hands and provide a barrier
between the responder and the victim's bodily fluids, reducing the
risk of infection or contamination.
○ Alcohol pads or Antiseptic Wipes: – are used to clean the
responder's hands before and after administering CPR. They help
maintain hygiene and reduce the risk of infection.
○ Scissors – included in a CPR kit to quickly and safely cut through
clothing or fabric, allowing easy access to the victim's chest area for
CPR compressions.
○ Pulse Oximeter – To measure the oxygen saturation level in a
person's blood. During CPR, it can provide a quick and objective
assessment of the victim's oxygenation status. This information can
help responders determine the effectiveness of CPR and guide
decisions regarding the need for supplemental oxygen or other
interventions.
○ Pen light – A penlight can be used to assess the responsiveness
of a victim by checking their pupillary response. It can also be
helpful in assessing the airway for potential obstructions. During
emergency situations, lighting conditions may be less than optimal.
A penlight can provide additional illumination, allowing the
responder to better visualize the victim's condition, assess injuries,
or locate important landmarks for proper CPR positioning.
○ Tape – To secure bandages and dressings to skin.
○ Adhesive bandages – are included for minor wound care. In some
cases, the responder may encounter injuries or abrasions while
providing CPR, and these items can help address those minor
wounds.
○ Neck collar – to prevent the neck and spinal cord from moving too
much and to restrict neck and head mobility.
J. Financial Operations
Table 1. Financial Operations
Financial Operations
Raw Materials Base Price (wholesale price)
Pillow-Blanket (customized) Php 200
CPR mouth cover Php 70
Pulse oximeter Php 60
Cervical/Neck collars Php 150
Alcohol Php 15
Latex Gloves (5 pairs) Php 10
Penlight Php 45
Tape Php 30
Bandages & Gauze roll and pads Php 30
TOTAL CAPITAL/EXPENSES: Php 610
Price + profit (40%) Php 855
Table 2. Total Expected Sales
Total Expected Sales
Distribution in the Municipalities (RHU Sales

and Barangay health centers)
Angeles City (33 barangays) 33 x 855
Apalit (12 barangays) 12 x 855
Arayat (30 barangays) 30 x 855
Bacolor (21 barangays) 21 x 855
Candaba (33 barangays) 33 x 855
Floridablanca (33 barangays) 33 x 855

Guagua (33 barangays) 33 x 855
Lubao (44 barangays) 44 x 855
Mabalacat (27 barangays) 27 x 855
Macabebe (25 barangays) 25 x 855
Magalang (27 barangays) 27 x 855
Masantol (26 barangays) 23 x 855
Mexico (43 barangays) 43 x 855
Minalin (15 barangays) 15 x 855
Porac (29 barangays) 29 x 855
San Fernando (35 barangays) 35 x 855
San Luis (17 barangays) 17 x 855
San Simon (14 barangays) 14 x 855
Sasmuan (12 barangays) 12 x 855
Sta. Ana (14 barangays) 14 x 855
Sta. Rita (10 barangays) 10 x 855
Sto. Tomas (7 barangays) 7 x 855
INITIAL TOTAL SALES: 537 x 855 = Php 459,135
TOTAL EXPENSES: 537 x 610 (capital) = Php 327,570
TOTAL PROFIT: 537 x 245 (profit) = Php 131,565
Table 3. Retail price
Capital Retail price (with 50% profit)
Php 610 Php 915
Total profit per SLEEP Blanket: Php 305

K. Target Customers
Saving Life Everywhere Emergency (SLEEP) Blanket target markets are:
● Emergency Responders - SLEEP is designed to be of use during emergency
health situations, something which emergency responders encounter more than
the general public. The first responders must be equipped and quick to act during
these emergencies, something the SLEEP Blanket may be able to assist in.
Moreover, the SLEEP Blanket can be converted into a blanket which could be
utilized for hypothermic victims during transport to the hospital.
● Filipino Households – Because the Philippines is located near the Pacific Ring
of Fire, the country is more prone to disasters. There is also a daily occurence of
health emergencies such as heart attacks, drowning, seizures, and etc. Having
said this, only 36% of Filipinos are determined that they are prepared for these
unforeseen events (Bollettino, 2018). The Filipino citizens, especially those
without medical training, are the target market in order to probably decrease
mortality rates during emergency health situations. The SLEEP Blanket will
provide comprehensible instructions in layman’s terms in order for civilians to
perform life saving measures.
L. Project name and Logo
● Product name: SLEEP (Saving Life Everywhere Emergency Pillow)
● Tagline: “Carry around SLEEP, and you can save lives no matter where you are
with comfort.”
● Logo:
The logo displayed in the figure above represents our business which
signifies that in cases of medical emergencies, reliability, time, and a fast
response is very crucial when medical interventions are needed especially in
critical situations. Each elements and color used in the design of our logo has a
meaning with regards to the objective of our business such as the following:
● Open hands - This symbolizes providing optimal and sincere care,
protection, and prevention from harmful phenomena to an individual’s
wellbeing. This also means that we, the SLEEP team, want to seek
connection to other people, and it also demonstrates our willingness to
help those in need.
● World Outline - This symbolizes what our team wants to offer, and that is
to save lives EVERYWHERE. This means that no matter where you are, if
you carry around SLEEP, you can save lives!
● Heart with cardiac rhythm - This symbolizes heart emergency and
SLEEP’s goal/purpose and that is to decrease cardiac deaths by
introducing BLS to bystanders and lay people.
● In our logo, the color blue and red dominates it. This is because red
means an emergency and blue represents medical emergencies such as
cardiac or respiratory arrest.
M. Sales Pitch and Deck (Poster with all information)
References:
American Heart Association. (n.d.). Adult and child CPR anytime training kits. Retrieved
from https://cpr.heart.org/en/courses/adult-and-child-cpr-anytime-training-kits
British Heart Foundation. (n.d.). Get a CPR kit for your community. Retrieved from
https://www.bhf.org.uk/how-you-can-help/how-to-save-a-life/cpr-training-in-comm
unities/get-a-cpr-kit-for-your-community
Ghrayeb, F., Amro, N., Rahseed, O., Yagi, H., Amro, R., & Amro, B. (2017). Knowledge
and attitude of basic life support (BLS) among school teachers in Hebron,
Palestine. Retrieved 11 October 2022, from
http://dx.doi.org/10.18203/2320-6012.ijrms20172432.

NCM 0120 Disaster Nursing RLE - Loanzon, Patricia O.

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NCM 0120 - DISASTER

MODULE 2: DISASTER MANAGEMENT CONTINUUM (PRE-IMPACT:

MODULE 3: ETHICAL AND LEGAL PRACTICE AND ACCOUNTABILITY

MODULE 4: DISASTER MANAGEMENT CONTINUUM (IMPACT

MODULE 5: RESEARCH STUDY ON DISASTER PREPAREDNESS

MODULE 7: OPPORTUNITIES FOR ENTREPRENEURIAL NURSING

Nursing is a fulfilling profession that will allow me to make a difference

This learning portfolio will be a collection and compilation of my work

CASE REPORT ANALYSIS

CASE BASED LEARNING

SUMMARY AND OBJECTIVE

St. Nicholas Academy Guagua, Pampanga

Psalms Academy Guagua, Pampanga

St. Raphael Foundation and Medical Center Mabalacat, Pampanga

Rafael Lazatin Memorial Medical Center (RLMMC) Angeles City, Pampanga

Angeles University Foundation Medical Center Angeles City, Pampanga

WEBINARS, WORKSHOP, AND TRAININGS

National Health Emergency Preparedness December 2021

The SDG Webinar Series: Tobacco and Alcohol Control and

their Implications on Public Health in the ASEAN Region

NSRC Webinar on Leadership October 2021

Cultural Competency: Attributes of Professional Nurses August 2021

towards Patient Care August 2021

to be a great mother! July 2021

Yakap Continues Amidst the COVID-19 Pandemic

Introduction to COVID-19: Methods for Detection,

AUF-NSTP: Basic Life Support Training September 2019

Warlito Penullar Reyes, RN, MN

mula Enero 1 hanggang

itinalagang “Fire Prevention Month”

(Presidential Proclamation No. 115-A)

ANO ANG MGA DAPAT GAWIN?

Turuan ang mga bata na hindi dapat magtago

madaling masunog na bagay.

dokumento o kaya ay magkaroon ng digital copy ng

Umalis sa lugar na nasusunog.

maalerto ang lahat. ANGELES CITY FIRE STATION

Ituring na mapanganib ang lahat ng uri ng sunog Angeles, 2009 Pampanga

Kung may usok at apoy sa inyong pangunahing ruta sa

usok, gumapang sa baba patungo sa labasan. San Nicolas Fire Sub-station

ng pangalawang ruta palabas. (045) 322-6758

pang taklob sa paglabas ng bahay Cellphone Numbers:

Magbigay ng first aid kung kinakailangan.

beterinaryo ang tao o hayop na naapektuhan sa

watch”. SUNOG AY IWASAN,

hanggat hindi pa sinasabi ng mga opisyal na ligtas BAWAT BUHAY AY

nang pumasok muli. PAHALAGAHAN,

nito. KAILANGAN, TARA NA’T

2023 from https://judy.co/blogs/content/wildfire-prep-101-what-to-do-before-during-and-after-

Tandaan: Theasianparent Philippines. theAsianparent. Retrieved February 21, 2023, from

Second Semester, Academic Year 2022-2023

Case Report Analysis:

Advincula, Kyla Sophia Nicole B. Loanzon, Patricia O.

These actions initiated a discordance of outrage, indignation, and criticisms. In

Although professional associations and national healthcare organizations support

The devastation caused by Hurricane Katrina exposed a number of deep-seated

Ethical Decision Making

Review of Relevant Concepts to the Case

Concept or Principle, Relevant Facts, and Most Important Issues

Issues involving the rights, responsibilities, and deployment of registered

4. Should professional and governing organizations for nursing declare

5. Was the nursing administrator’s decision ethically sound?

6. Should David receive a state board reprimanded for his actions?