Adapting Standards of Care Under Extreme Conditions 


Kristine Gebbie, RN, DrPh
Public Health Nurse
Elizabeth Standish Gill Professor of Nursing
Director, Center for Health Policy 
Columbia University

Kathleen M. White, PhD, RN, CNAA, BC
Associate Professor
Department of Acute and Chronic Care
Director of Faculty Practice
Johns Hopkins University

The American Nurses Association recently released: Adapting Standards of Care Under Extreme Conditions: Guidance for Professionals During Disasters, Pandemics, and Other Extreme Emergencies which identifies significant policy questions to be addressed and suggests strategies to guide health professionals, institutions and policy makers in such challenging situations. The speakers, who co-chaired the development of the document will discuss how decisions will have to be made regarding changes in usual practices due to changes in resources available, practice in unusual settings, or practice in a setting with patient care needs unfamiliar to the clinician. 

Learning Objectives
  1. Describe the continuing role of basic standards of practice, code of ethics, competence and values of healthcare professionals, even during extreme conditions 
  2. Describe the ways in which legal structures for health professional practice MAY change IF the emergency is in a state allowing for such alterations under emergency powers 
  3. Describe specific strategies to guide health professionals, institutions and policy makers before, during and after challenging emergency and disaster situations
  4. Advocate for the involvement of all health professionals in community settings or within healthcare institutions in planning, training and exercising for emergencies
  5. Model good preparedness practices to other community members 
Public Health Preparedness Core Competencies

Domain I:  
 1.1 Solve problems under emergency conditions 
 1.4 Maintain situational awareness 
 1.6 Act within the scope of one’s legal authority 

Domain II:  
 2.1 Manage info related to an emergency 
 2.3 Report info through chain of command 

Domain III:  
 3.3 Participate in improving organizations capacities 

Domain IV:  
 4.1 Maintain personal/family emergency preparedness plans 
 4.2 Employ protective behaviors

Public Health Emergency Preparedness Capabilities

PHEP Capability 10: Medical Surge  

PHEP Capability 14: Responder Health and Safety 

PHEP Capability 15: Volunteer Management

The archived webcast is available via Real Player