Chemical and Biological Terrorism: Current Updates for Nurse Educators
Veenema, Tener Goodwin, Nursing Education Perspectives
ABSTRACT Schools of nursing need to adapt curricula and continuing education programs to provide nursing students, as well as nurses who are currently employed, with the knowledge and skills required to respond to a chemical or biological terrorist attack. This article addresses eight topic areas suitable for a one-semester elective course offering or for incorporation into the existing curriculum as assessment and management lectures: surveillance systems; identification, communication, and response; chemical agents; biological agents; recognizing covert exposure in a population; patient decontamination and mass triage; the availability and safety of therapies; and immunization and prophylactic antibiotics.
RECENT EVENTS HAVE DEMONSTRATED to Americans that terrorism is not something that happens solely on foreign soil. A terrorist attack is no longer a low-probability event, and our need to prepare an organized, national response to future biological and chemical threats is both pressing and immediate. * The national outbreak of anthrax infections that followed the events of September 11, 2001, have heightened the realization that the use of chemical or biologic weapons would have serious implications for the nation's health care workforce. In addition to being overtaxed by serious staffing issues, many nurses (and physicians) currently employed have little knowledge regarding the potential pathogens that could be released, or how to respond to a chemical or biological attack. ALONG WITH HOSPITALS AND HEALTH DEPARTMENTS, SCHOOLS OF NURSING NEED TO ADAPT EXISTING CURRICULA AND CONTINUING EDUCATION PROGRAMS TO PROVIDE NURSING STUDENTS, AS WELL AS NURSES WHO ARE CURRENTLY EMPLOYED, WITH THE KNOWLEDGE AND SKILLS REQUIRED TO PARTICIPATE IN A NATIONAL EMERGENCY RESPONSE.
Background The development, production, and use of biological and chemical weapons are prohibited by international treaties, including the 1925 Geneva Protocol, the 1972 Biological and Toxin Weapons Convention, and the 1993 Chemical Weapons Convention (1). While most countries have subscribed to these treaties, not all have done so. Serious concerns remain that some countries and rogue groups may resort to the use of these weapons.
A comprehensive curriculum for nurses to address chemical and biological warfare should include eight topic areas: Surveillance Systems; Identification, Communication, and Response; Chemical and Biological Agents; Recognizing Covert Exposure in a Population; Patient Decontamination and Mass Triage; the Availability and Safety of Therapies; and Immunization and Prophylactic Antibiotics. Ideally, this material should be taught online, or with PowerPoint presentations with live Internet access.
These topics can be addressed most comprehensively in a one-semester elective course offering to students. For degree programs where elective credits are limited, these topics can be incorporated into the existing curriculum as additional assessment and management lectures. (See Sidebar 1 for resources.)
Surveillance Systems To differentiate between an impending health care crisis and a hoax, it is imperative that nurses understand the national and international systems of surveillance currently in place. How would a government find out that a deliberate outbreak had taken place?
International System The World Health Organization (WHO) monitors disease outbreaks through the Global Outbreak Alert and Response Network (2). This network, formally launched in April 2000, electronically links the expertise and skills of 72 existing networks from around the world, several of which were uniquely designed to diagnose unusual agents and handle dangerous pathogens. Its purpose is to keep the international community constantly alert to the threat of outbreaks and ready to respond. It has four primary tasks:
1. Systematic disease intelligence and detection The first responsibility of the WHO network is to systematically gather global disease intelligence drawing from a wide range of resources, both formal and informal. …