Training Suggestions for Japanese Head Nurses with Inaccurate Understanding of their Roles and Responsibilities in Initial Phases of Disaster Incidents

Abstract

Background: During large-scale disasters, hospitals must respond immediately. In such situations, different levels
of nurses have different roles and responsibilities. Head nurses in Japan have two types of responsibilities based
on the shift, day or night. Assuming that head nurses do not clearly recognized these differences due to their lack
of appropriate institutional education, this study aimed to clarify actual conditions of institutional education and
head nurses’ level of understanding.
Methods: Three questionnaires were developed: one for nursing directors regarding departments’ implementation
based on the disaster response manual and two true/false questionnaires for head nurses regarding their
recognition of roles and responsibilities in disaster response. Twenty hospitals in a national hospital organization
in Japan, located in two regions, were studied.
Conclusion: Of the 17 hospitals that responded, 52.2%–35.3% had written roles, responsibilities, and action
procedures for head nurses on the day and/or night shift. Education, including orientation and training, was
provided for the two shifts in 35.3%–23.5% of the hospitals. In terms of the true/false questions, 154 head nurses
from both shifts responded with high accuracy; however, they did not appear to understand that they were
commanders of the ward on the day shift and of the hospital on the night shift. The results indicate the need to
stipulate head nurses’ roles, responsibilities, and action procedures in the disaster response manual and implement
institutional education and the provision of action assistant tools.