The objective is to determine if a practical face-to-face emergency disaster incident response training program delivered in the clinical setting will improve self-reported confidence and assessed knowledge of emergency department (ED) nurses to respond to disasters.

A single site prospective pre-test and post-test randomized controlled trial was adopted for this study. The intervention was a practical face-to-face training program, while the control group completed the required annual mandatory hospital online training.

There was a large difference in post-test median self-reported confidence between groups. There was also a large difference in the proportion of subjects who reached satisfactory levels of self-reported confidence post-test. Regarding assessed knowledge, there was a moderate difference in post-test median knowledge between groups. There was also a moderate difference in the proportion who reached satisfactory levels of knowledge post-test.

This study has shown that ED nurses who undertake a practical face-to-face disaster preparedness education program in the clinical setting, are better prepared to respond to emergency disaster incidents. Organizations should consider the use of a practical structured face-to-face emergency disaster incident response education program to complement and enhance any online emergency and disaster training.

Recent disasters emphasize the need for disaster risk mitigation in the health sector. A lack of standardized tools to assess hospital disaster preparedness hinders the improvement of emergency/disaster preparedness in hospitals. There is very limited research on evaluation of hospital disaster preparedness tools.

This study aimed to determine the presence and availability of hospital preparedness tools across the world, and to identify the important components of those study instruments.

A systematic review was performed using three databases, namely Ovid Medline, Embase, and CINAHL, as well as available grey literature sourced by Google, relevant websites, and also from the reference lists of selected articles. The studies published on hospital disaster preparedness across the world from 2011-2020, written in English language, were selected by two independent reviewers. The global distribution of studies was analyzed according to the World Health Organization’s (WHO) six geographical regions, and also according to the four categories of the United Nations Human Development Index (UNHDI). The preparedness themes were identified and categorized according to the 4S conceptual framework: space, stuff, staff, and systems.

From a total of 1,568 articles, 53 met inclusion criteria and were selected for data extraction and synthesis. Few published studies had used a study instrument to assess hospital disaster preparedness. The Eastern Mediterranean region recorded the highest number of such publications. The countries with a low UNHDI were found to have a smaller number of publications. Developing countries had more focus on preparedness for natural disasters and less focus on chemical, biological, radiological, and nuclear (CBRN) preparedness. Infrastructure, logistics, capacity building, and communication were the priority themes under the space, stuff, staff, and system domains of the 4S framework, respectively. The majority of studies had neglected some crucial aspects of hospital disaster preparedness, such as transport, back-up power, morgue facilities and dead body handling, vaccination, rewards/incentive, and volunteers.

Important preparedness themes were identified under each domain of the 4S framework. The neglected aspects should be properly addressed in order to ensure adequate preparedness of hospitals. The results of this review can be used for planning a comprehensive disaster preparedness tool.