Importance of Disaster Management

The paradigm shift of the passage of legislation on disaster management

was an important step that represented the country's resolve and
determination to respond in a more scientific manner. UPA Chairperson Sonia
Gandhi said more attention should be paid to environment. Expressing
concern over damage to coastlines and ignoring soil and seismic conditions
before taking up construction work, she said a good and reliable
communication system was crucial during a disaster4
The field of Disaster management is finding new tools to managehazards
and to deal with disasters; it is professionalizing and promises to become
one of the most challenging occupations in government5
The need for disaster preparedness pears to be greater today than at any
previous time in history. embers of the American Nephrology Nurses'
Association (ANNA) recognized this fact as they formed for a second time a
committee to explore disaster preparedness. The first committee was the
Disaster Registry Task Force headed by Barbara Prowant. The next group
was a subcommittee of the Professional Practice Committee -- the Disaster
Management Ad Hoc Committee chaired by Sue Robertson. This issue of the
Nephrology Nursing Journal is a direct result of that committee's work and
recommendation.

Why does the need for disaster preparedness continue to surface? There are
several reasons that contribute to the concern expressed regarding this
topic.

First is the underlying fear that people who have not personally experienced
a disaster will not fully realize the potential toll a disaster can have in both
human and economic terms. There may be a tendency to ignore the need for
disaster planning. Obviously, the greatest toll connected with disaster is the
tragedy of the loss of human life and the associated human suffering. But,
the economic costs have to also be considered. It has been estimated that
the cost of natural disasters in the United States alone would run $18 billion
annually starting in the year 2000. Yet, with adequate preparation and timely
response this figure could be decreased by 20% - 40% (Clark, 1996). And, if
only one human life is spared through planning, is it not worth it?

Second, there are more people being kept alive today through the advances
in modern technology in our field. Given the right set of circumstances,
hundreds of people may suddenly be without a facility to receive their life
sustaining treatments.

Third, it is a well-known fact that the dialysis population of today is older and
has more comorbid conditions than the previous patients of years gone by.
Hassmiller (1996) states that the elderly and the disabled are at greatest risk
for disruption from a disaster. The elderly react more deeply to loss of
personal possessions, but yet may cover up the seriousness of their losses
out of fear they may then also lose their independence.

Journal Philosophy Statement

The Nephrology Nursing Journal is a refereed clinical and scientific resource

that provides current information on a wide variety of subjects to facilitate
the practice of professional nephrology nursing. Its purpose is to disseminate
information on the latest advances in research, practice, and education to
nephrology nurses to positively influence the quality of care they provide.

The Nephrology Nursing Journal is designed to meet the educational and

information needs of nephrology nurses in a variety of roles at all levels of
practice. It also serves as a resource for nonnephrology nurses. Its content
expands the knowledge base for nephrology nurses, stimulates professional
growth, guides research-based practice, presents new technological
developments, and provides a forum for review of critical issues promoting
the advancement of nephrology nursing practice.

The Potential Disaster of Infectious Disease

The monograph also addresses another type of potential disaster, a type of

natural disaster that can be caused by microorganisms. Infectious diseases
pose a deadly threat to human life, especially to those who are
immunocompromised. Some infectious diseases, as you will read, have
required that the victims be treated with dialysis.

The thought of an outbreak of an infectious disease in our hospitals and

facilities is frightening, and we must do all that we can to prevent this from
happening. Hence, it was decided to include the Center for Disease Control's
(CDC's) guidelines for dialysis units. The CDC previously published the final
form of these recommendations on April 27, 2001.

The Ultimate Medical Disaster

The American Heart Association recently changed their guidelines regarding

cardiopulmonary resuscitation and the use of the automatic external
defibrillators (AED). Information on these topics can also be found in this
issue of the Journal, as they too are disaster related.

Reevaluate Your Disaster Plan

In conclusion, it is hoped that the information contained within this issue of

the Journal will inspire its readers to assess the disaster preparedness plan in
their own facilities. First, is there a plan? Does it need to be updated? Based
on the experiences shared by others, are there modifications that need to be
made? Do all involved parties know of the plan and know their expected
roles? Is it realistic? You decide -- take action now while there is time and
disaster preparedness is on your mind. And, while you are at it ... wash your
hands, one more time!