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Member Research and Reports

Member Research and Reports

Just-In-Time Disaster Training Not Enough, Says Saint Louis

Most public health agencies are planning to use “just-in-time” training to educate point-of-dispensing (POD) staff and volunteers – a strategy that may not be feasible due to time constraints during a large-scale biologic event, Saint Louis University researchers found.

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[Photo: Dr. Terri Rebmann]

“The more time spent on set up and just-in-time (JIT) training, the less time the POD has for dispensing medical countermeasures,” says the paper “Infection prevention and mass vaccination training for U.S. point of dispensing staff and volunteers: A national study.” Public health agencies should be able to dispense medical countermeasures to all citizens within 48 hours, according to CDC guidelines, and PODs are the primary mechanism to do so.

Slated for the upcoming issue of the American Journal of Infection Control, it is the first study to assess the pre-event and JIT training being planned for open POD staff and volunteers related to vaccine administration and infection prevention. The findings are based on a 2013 survey of 301 disaster planners from Cities Readiness Initiative (CRI) jurisdictions and non-CRI jurisdictions across the United States.

Current pre-event training is inconsistent and insufficient. Important training topics, such as screening POD clients for communicable diseases and conditions, vaccine administration, proper cold chain techniques, and the smallpox scarification procedure, are virtually being ignored, says first author Dr. Terri Rebmann, associate professor in the College for Public Health and Social Justice of Saint Louis University.

Most concerning is that less than 20 percent of jurisdictions have planned training of any sort for smallpox vaccine administration. “It is unclear how these jurisdictions plan to respond should a smallpox bioterrorism attack ever occur,” Dr. Rebmann says, adding: the recent discovery of Variola virus at a National Institutes of Health research building underscores the importance of preparedness whether the outbreak’s cause is accidental or intentional.

“Failure to prepare for mass vaccination could result in higher morbidity and mortality in communities,” she says.

Among its other findings, the paper noted: hand hygiene and the selection and use of Personal Protective Equipment were most frequently offered in pre-event training.

Also, jurisdictions provided more pre-event training to staff than to volunteers; since training could have easily been offered to both, the paper suggests future research could examine the discrepancy.

Rebmann, who also serves as Director of the Institute for Biosecurity at Saint Louis University, worked on the paper with SLU colleagues: Dr. Travis M. Loux, Assistant Professor in the department of biostatistics, Dr. Thomas K. Zink, associate professor of environmental & occupational health, and graduate student Ms. Mary Wakefield. Zachary Swick, domestic preparedness planner, Oregon Military Department, Oregon Office of Emergency Management, also collaborated.