Exploring disaster nursing core competencies and roles in Kingdom of Saudi Arabia (KSA)

Aim: The primary aim of this study was to develop a valid, reliable scale that identified and explored the core competencies of disaster nursing, nurses’ roles, and the barriers to developing disaster nursing management in Saudi Arabia. Background: Nurses must have the essential skills, knowledge, and attitudes to be ready, able, and more willing to respond to any type of disaster. This study is significant for several reasons. First, the current literature does not explore disaster nursing in Saudi Arabia; thus, this study will be the initial step in creating a body of literature on the subject for that country. Second, this study will be the first to provide evidence to employers, nurse educators, researchers, government officials and emergency services about the roles, essential knowledge, skills, and attitudes required for disaster nursing in Saudi Arabia. Finally, the research is expected to inform clinical leadership in this advanced practice area. Design: This research was based on a pragmatic paradigm that permitted the use of the sequential methods approach that was selected for the study design. This study design had two phases. First, the quantitative phase involved three stages: pre-pilot, pilot, and national. The aim of the pre-pilot study was to generate items of questioners and then validate and test the stability of the scale through testing and retesting. The pilot study deleted redundant items, summarised the data into small sets, and produced a new scale using principal component analysis (PCA). The national study aimed to identify the core competencies, roles, and barriers inherent in disaster nursing, as well as the strength of the dimensionality of the constructs of confirmatory factor analysis (CFA). In the second phase, the meanings of the most important findings from the national study were elaborated upon to develop better understanding of them. Results: In the pre-pilot study, a new scale was developed and its psychometric properties measured. The relevant literature generated 93 items that were valid in terms of both face and content validity and that were stable over time. The pilot study, in which 132 emergency nurses participated, resulted in 49 of the 93 items being deleted as redundant, and the remaining 44 items being summarised into three factors: core competencies; barriers and roles with good to excellent internal consistency (Cronbach’s alphas ranging from 0.86‒0.98). The most important core competencies for nurses in disaster nursing were found to be planning, communication, ethics, and triaging. The most important roles for nurses were in education and drilling, with a lesser role in planning. The main barriers to developing disaster management in Saudi Arabia were found to be research, education, qualification, and resources. The national study included 833 nurses as participants. Data were summarised into four factors: knowledge; barriers; roles and skills that also had excellent high reliability (ranging from 0.86‒0.98). In addition, these four factors had good construct validity, as CFA indicated a goodness of fit for all factors. Similar to the results of the pilot study, the national study found the most important core competencies to be planning, communication, and ethics. The most important roles were participating in education and drills. The most important barriers were education, research, qualification, and resources. Conclusions: This study has implications for developing and improving disaster planning. Recommendations included the following: 1) emphasising the identified core competencies in all disaster planning; 2) instituting drill plans; 3) recognizing the importance of the purpose and content of disaster plans; 4) addressing the identified communication, ethical, and cultural issues in all disaster planning; 5) involving emergency nurses in disaster planning; 6) planning for decontamination; and 7) improving disaster planning, since it was found to be a barrier to developing disaster nursing in Saudi Arabia.