الفهرس 
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Abstract
Aim of the study:
The aim of study is to develop a disaster management plan and to implement an educational program for the study subjects at Emergency Unit.
Research Hypotheses:
3. The proposed disaster management plan will be applicable to be followed after ensuring the validity and reliability of the plan.
4. The preparedness, expectation, and awareness of study subjects about disaster management will be increased after implementing the educational program.
Research Design:
In this study a quasi-experimental research design was used.
Setting
The study was conducted at the Emergency Unit, Minia University Hospital.
Subjects
All available health care team was included in study subject (total no 69) who work in the Emergency Unit at Minia University Hospital, and they were classified as follows; nursing personnel (40), physicians (20), and workers (9). Also, a purposive sample of (31) jury group who is experts in the disaster management plan was included in this study.
Data collection tools: Data was collected by using three tools as follows:
Tool I: Interview Questionnaire, this tool was adopted from Mostafa, (2003) &Mostafa, (2009) and modified by the researcher to assess study subjects’ knowledge, expectation, and awareness of the disaster preparedness in the study setting. This tool was included four parts as follows:
1st part the personal data of the studied subjects (nursing personnel, physicians, and workers); it was including (age, gender, marital status, years of experience, qualification, job title, and previous attendance of training course related to disaster management).
2nd part: Knowledge preparedness for Internal Disasters a Questionnaire (KPIDQ); this part consisted of (41) multiple- choice questions to assess knowledge of study subjects about the various aspect of internal disaster preparedness.
3rd part Disaster Expectation Assessment (DEA); this part was used to assess the study subjects’ expectations regarding the possible occurrence of disaster in the setting. This part consisted of (18 items) categorized into (2 dimensions) namely, natural disasters, and manmade disasters.
4th part: Awareness of the Internal Disaster Preparedness (AIDP); to assess the study subjects’ awareness regarding the internal disaster preparedness; this part consisted of (174 items) categorized into (9 dimensions).
Tool II: Observational Checklist, this tool was developed by Mostafa, (2003), and it was modified by the researcher and used to check the availability of various resources needed for internal disaster management in the Emergency Unit of Minia University Hospital. This tool consisted of (174 items) categorized in (5 dimensions) namely, Medical devices, permanent supplies, Consumables Supplies, Medical cabinet for emergency drugs, and Emergency Crash cart.
Tool III: Opinionnaire Sheet, this tool were developed by Mekky, (2009), to assess the validity of designed proposed plan by the jury group, and it was be modified by the researcher. The tool divided into three parts in this study:
1st part the personal data for jury group; it was including (age, gender, marital status, and years of experience).
2nd part the face validity of the proposed disaster plan; this part consisted of (9 items) categorized into (6dimensions).
3rd part the content validity of the proposed disaster plan; this part consisted of (123 items) categorized into (11dimensions).
Data Collection Procedures:
Official permissions were obtained from the Dean of Faculty of Nursing at Minia University and from the Director of Minia University Hospitals to carry out the study. The study was conducted in five phases; Assessment phase, designing phase, validity phase, implementation phase, and evaluation phase.
Phase (I): Initial Assessment:
• Reviewing the literature as well as assessing the Emergency Unit of Minia University Hospitals was done as an initial step to modify the study tools.
• Then the validity and reliability of the tools and pilot study was done.
• Obtaining the permissions from the director of the Emergency Unit and the nursing director at Minia University Hospitals was done.
• A pre-test was done to all available health care team who work at the Emergency unit of Minia University Hospital. The data was collected in two months from the beginning of October 2019 to the end of December 2019 by using tool one the interview questionnaire with the study subjects. This tool filled from each study subject within (20 to 40) minutes.
• Then the researcher was assessing the various resources needed for internal disaster management for the Emergency unit at Minia University Hospitals by using tool II (observational Checklist) which filled within 30 to 40 minutes in the presence of the nursing director and assistant director of the unit
Phase (II): Designing the plan:
• After reviewing the literature and analyzed the pre-test data of the study subjects (physicians, nurses, and workers), the researcher developed a proposed disaster management plan for the Emergency Unit at Minia University Hospital.
• Accordingly, the proposed disaster management plan was presented to jury groups for examining the validity and reliability of the plan.
Phase III: Validity of proposed plan:
• A jury group of (31) evaluated the validity and reliability of the proposed disaster management plan by using the opinionnaire sheet (tool III). Then the statistical analysis of the opinionnaire sheet from the jury group was done.
• In the initial form; the content of the proposed plan consisted of (109 items) categorized into (9 dimensions). After the modification of the jury group and statistical analysis there were (14) invalid items omitted and added two dimensions, and (28) items.
• Thus, in the final form of the proposed disaster management plan content consisted of (123) items categorized into (11 dimensions).
• After completing the design of the proposed disaster management plan, a guided booklet was prepared about internal disasters of the Emergency Unit at Minia University Hospital.
Phase IV: Implementation of the program:
• According to the content of the proposed disaster management plan an educational program was planned for the study subjects (physicians, nurses, and workers). Also, the booklet was distributed for all study subjects.
• A researcher has implemented the program by dividing the study subject into three categories according to their specialties (physician, nurses, and workers). The researcher divided each category of (physicians, nurses, and workers) into small sub-groups; each small sub-group included from four to five members.
• There were (two) groups of each study subjects trained each day during morning and evening shifts according to their scheduled and break time. Each group attended (10) sessions that lasted for (8) weeks during November and December of the year (2020).
Phase (V): Final Evaluation
At the end of the program implementation for the study subjects (physicians, nurses, and workers) the researcher collected the post-test by using the interview questionnaire sheet (preparedness, expectation, and awareness of internal disaster management); and this data was collected during January of the year (2021).
The main findings of the study were:
The jury group had a ”moderate response” for all items in the initial phase; and these responses increased to had ”very high response” for all items in the final phase regarding the proposed disaster management plan.
The sample size and the responses of the jury group were adequate regarding the validity of the jury sample size.
The highest explained variance value was presented in dimensions of; an introduction of the Emergency unit at the Minia University Hospitals (71.19%), the emergency cases in the disaster management plan (9.66%), and disasters generally (8.38%).
The total Cronbach’s Alpha value for the proposed disaster management plan was (0.875) with good reliability; where the specific reliability coefficients of the proposed disaster management plan dimensions were ranged from (0.844) to (0.990).
The value of the RMSEA index was 0.125, the CFI was 0.62 and IFI was 0.67 at the initial disaster management plan were reasonable compared with the acceptable value of two fit indices of the CFI and IFI which were ≥ 0.90. The final disaster management plan is satisfactory (X2 (515) = 1125, P-Value < 0.02) in which the CFI and IFI increase slightly, but RMSEA decrease to 0.02.
The total knowledge levels about disaster management of the study subjects (physicians, nurses, and workers) were high after the implementation of the educational program with highly statistically significant differences.
The total expectation levels about disaster management of the study subjects (physicians, nurses, and workers) were high after the implementation of the educational program with highly statistically significant differences.
The total awareness levels of disaster management of the study subjects (physicians, and nurses) were high after the implementation of the educational program with highly statistically significant differences.
There were positive correlations for physicians and nurses between their knowledge level in post-program and their expectation of natural disaster (r= 0.344 & P – value < 0.03*), and (r= 0.475 & P – value < 0.04*) respectively.
Also, there were positive correlations for physicians and nurses between their knowledge level in post-program and their expectation of man-made disaster (r= 0.412 & P – value <0.05*), and (r= 0.521 & P – value < 0.001**) respectively.
Also there were positive correlations between physicians knowledge level in pre-program and their awareness regarding hospital disaster (r= 0.370 & P – value <0.019*), and nurses knowledge level of post-program and their awareness regarding hospital disaster (r=0 .469& P – value < 0.037*).
Also, it was noted regarding observation of total resources needed for internal disaster management that the follows; as for the availability of the resources that more than half (57.3%) of resources were available. For the resources work efficiently, the half of recourses (50.5%) were working efficiently. While the highest percentage of the resources had no different size (64.3%); the highest percentage of resources had no accessibility (56.9%); and highest percentage of resources had no proper storage (85.3%).
from this study it can be concluded that:
The present study concluded that the validity and the reliability of the developed proposed disaster management plan were satisfactory and effective from the jury group recommendation. As well, the study subject (physician, nurses, and workers) had an improvement in their levels of disaster preparedness’s knowledge, expectation, and awareness after the implementation of the program than the pre-program with statistically significant differences.
In addition, it was noted that the highest percentage of total resources needed for disaster management were available and work efficiently; but highest percentage of these resources were not accessible, had no different sizes, and not stored properly.
There were positive correlations between levels of knowledge among physicians, and nurses with their expectation level in post-program. Also, there was a positive correlation between physician’s levels of knowledge and their awareness level in pre-program; while nurses have a positive correlation in post-program between their knowledge level and awareness level.
Recommendations
Based on the current study results, the following recommendations are offered:
• Training programs should be implemented continuously by the administrative authorities for health care teams to improve their abilities in dealing with disaster.
• Hospital should ensure that the organization’s annual budget include adequate resources to implement, evaluate, and apply of the proposed disaster management plan
• Health care team should attend continuous training program on disaster preparedness, mitigation, and prevention to perform their roles effectively and efficiently.
• The Ministry of Health and Population should establish a committee to periodically follow up on the readiness of all health facilities to deal with and absorb the disaster, and to ensure that there is a solid plan to confront it.
• The Ministry of Higher Education should induce Faculties to have a curriculum for crises and disasters management for first academic year of higher education students.