Module Components

• Overview

Topics

• Case Study
• Definitions
• Environmental Health Risks at Home, Work, and in the Community
• Climate Change
• Disaster/Emergency Preparedness and Management
• Role of the PHN

Nurs 467 - Public Health Nursing

Module 11: Environmental Health and Emergency Preparedness

ROLE OF THE PHN

Assessment/Surveillance

In environmental health, health risks can be determined on both an individual and a population basis (Maurer et al., 2013, p. 260). See the PowerPoint slides for an example of a tool that can be used for assessing environmental threats in the home. No federal law requires the reporting of environmental diseases; however, some states require the reporting of certain health outcomes that are associated with environmental exposures. This includes cancer registries and birth defects registries, as well as registries that track blood lead levels. Nurses can be involved in or initiate environmental surveillance programs in other states or for other environmental health problems (Maurer et al., 2013, p. 260).

Watch this video for images of what disaster nursing looks like. Before, during or after disasters/emergencies, the PHN may be asked to:

• Review the disaster history of a community. How have past disasters affected health care delivery systems in the area? How do these systems, such as emergency departments and home health agencies, fit into the overall disaster management plan? What is their expected role during an emergency?
• Initiate/Update record of vulnerable populations in the community. For example, what are the numbers of elderly, disabled, and homeless in the community? How will they be evacuated and cared for during an emergency?

In the Curtis Bay Elementary/Middle School video, you heard the school nurse discussing trends in visits to the nurse’s office before and after the chemical leak. He was smart to have a tracking system in place already, the information it provided was helpful in alleviating community fears.

Risk Communication

The C/PHN might be called upon to talk to individuals, families, or communities about environmental health risks. Risk communication involves the provision of accurate, relevant information to those affected and/or concerned about a health issue, delivered in a timely manner for the purpose of educating, reassuring, and minimizing feelings of fear. Risk communication is critically important in environmental health and is something that PHNs must practice. Guidance documents on risk communication can be found here.

Before, during or after disasters/emergencies, the PHN may be asked to educate special populations about the effects a disaster might have on them, or help them review their individual strategies and develop emergency plans if needed.

We saw the school nurse discussing emergency plans AND risk communication. PHNs are knowledgeable in these areas, but other people experiencing the disaster/emergency may not be.

Prevention Efforts

Primary

• Health promotion and illness prevention aimed at reducing the risk of exposure and illness (home, work, and communities).
• Role model by reducing your own carbon footprint.
• Review emergency plans and resources with private and community facilities, such as childcare organizations and halfway houses. Make sure a communication system is in place to notify family and others of patient conditions and to assist in family reunification.

Secondary

• Screen children and workers at risk for environmental exposures. For example, lead screening in Maryland is required for all children, regardless of where they live.
• Help recruit others to assist during an emergency. Recruit those who are uninjured and capable to help in triage and care efforts, in the distribution of food, water, and supplies, and in search and rescue efforts.

Tertiary

• Treatment and palliative care for those with illness from environmental exposure.
• Understand what community resources are available after a disaster. What other volunteer agencies are available to help? Are there organizations who will donate food and water? Are there individuals or families with intact homes willing to provide shelter to those who have lost theirs?
• Help address important community needs, such as water, food, shelter, sanitation, safety, transportation, communication, and endemic and epidemic diseases.