Improving Mass Casualty Readiness in the Emergency Department: A Quality Improvement Project DNP Project III: In partial fulfillment of the requirements for the Doctor of Nursing Practice

Abstract The problem under investigation: Rural hospitals are usually unprepared for mass casualty events. Background: A mass casualty event is an incident that overwhelmingly causes strain on emergency medical services, staff, resources, capacity, and equipment (DeNolf & Kawaii, 2020). Methods: A quality improvement project to improve mass casualty preparedness in a rural area of Missouri (Aspers & Corte,2019). The population of interest included sixty staff members, including nurses, providers, registration, security, unit secretaries, and patient care technicians (Bothwell Regional Health Center, 2022). The theoretical framework mirrored Dr. Kurt Lewin's change theory which includes the unfreezing, changing, and refreezing model (Chatha, 2020). Interventions: This project implemented the following interventions: a pre-test, formal education, a NetLearning module, a post-test, and finally, participate in a mock scenario. After the project's implementation, the legal team, medical director, board of directors, and executive leadership team reviewed it for final approval. Results: The scores for the pre-test ranged between 50% and 100%, with a mean score of 73%. Conclusions: Maintaining sustainability is vital after the implementation portion of the project. The host site should complete continuing education, mock scenarios, and ongoing training. Remaining confidence in their training would allow nurses to take the Certified Trauma Nurse (CTN) examination, distinguishing them from their peers (Deshaies, 2022). Lastly, ongoing public education is achievable by presenting poster education at the state and regional-level committee conferences. Keywords: Mass Casualty, Preparedness, Emergency Department, AHRQ, FEMA, CDC, Toolkit, Pre-Test, Post-Test, NetLearning, Mock Scenarios. 5 Improving Mass Casualty Readiness in the Emergency Department: A Quality Improvement Project Introduction More often than not, the emergency department is the first point of contact for patients who have a life-threatening illness or injury. For emergency health services to be effective, the emergency department must be open, operational, and ready for anything that comes through the door (Chatha, 2020). Staff who work in the emergency department must be competently trained to treat and attempt to sustain the life of all patients who present to the department. Instances of when patients may present to the emergency department may vary from acute abdominal pain to a broken bone to being a part of a mass casualty event (Coster et al., 2017).