Progress of disaster nursing

education in Japan
Japanese Red Cross College
of Nursing

The Japanese Red Cross

College of Nursing
International & Disaster Nursing Field

Mariko Ohara RN. Phd.

Contents of Presentation
1. Disaster Nursing Assignment in the World

2. Research of the Current Situation of Disasters and Disaster

Nursing Education in Asian Universities
3. Development of Disaster Nursing in Japan

4. Progress of Disaster Nursing Education in JRCCN

5. Action of Disaster Nursing Education Project
in Asian Prone Countries supported by JRCCN

Disaster Nursing Assignment

in the World & Japan

Natural and manmade disaster in the world

Complexity, diversity, lengthening

Heavy
Global
Warmin Snowfall
Bio
g
Nuclear
Drought
Terror
Power
Drogght
Infectious
Disease

Terror

Terror

Conflict
Flood

Starvation
Storm & Flood Damage
Forest Fire
Air plain
Crash

Abnormal Weather
Motivation for disaster nursing
Inspiring works

Hurricane

Important matter in whole

nursing society Terror

More than half number of the dead in natural disaster is found in Asian region.

The Japanese Red Cross College of Nursing

Background of Disaster
Natural and manmade disaster in the world
Complexity, diversity, lengthening
More than half number of the dead in disaster is
found in Asian region.
Must be considered geographical situation,
the aging of the population, environmental
degradation, poverty, for political reasons.
The need for disaster nursing education and
disaster nursing activities in Asia has been found.

Transition of Population in Japan

Japans population is 127.51 million (2009/10)
The proportion of the population aged 65-year
20.2%(2005
40.5%2055
In contrast, the proportion of the population under 15
13.8%(2005)
8.4%(2055)

going on Further aging society

to Link to increasing on Vulnerable Group in Disaster

The Current Situation of Disasters and

Disaster Nursing Education in Asian
Universities

The Japanese Red Cross

College of Nursing
Ikumi Sasaki , Mariko Ohara , Hiroshi Higashiura,
Tomoko Nishida and Naoko Okamoto

INTRODUCTION AND PURPOSE

INTRODUCTION
Many people have long recognized a need for teaching
methods and specialized curricula given that natural disasters
have occurred frequently in Asia.
In 2007, the Japan Natural Disaster and Nursing Association
conducted a survey among eleven universities and found that
curricular development and implementation in the areas of
disaster nursing were still at an early stage of development.

PURPOSE The purpose of the study is to clarify the scope of

and problems related to disasters and disaster nursing education in
Asian nursing colleges and universities.

METHODS-1
Design Descriptive design (Fact-finding Survey)
Area 16 Asian countries including Japan
Subject Japan:164 universities and/or nursing departments
Asian countries except Japan:256 Universities and/or
nursing departments
The questionnaire was distributed to presidents or deans of the
nursing universities and/or nursing departments.
We asked them to give the attached questionnaire to appropriate
persons within the Department of Nursing Faculty who teach courses
on disaster nursing would be most appropriate.

METHODS-2
Sample
Country
Bangladesh
(BGD)
Cambodia
(KHM)
China
(CHN)
India
(IND)

N
2
2
48

22

Country
Indonesia
(IDN)
Japan
(JPN)
Korea
(KOR)
Malaysia
(MYS)

N
49
164
27

Country
Myanmar
(MMR)
Nepal
(NPL)
Pakistan
(PAK)
Philippines
(PHL)

N
1
1
3

50

Country
Singapore
(SGP)
Taiwan
(TWN)
Thailand
(THA)
Vietnam
(VNM)

About Philippines, we select 50 universities from listed 417

universities.

N
1
14
24

DESIGN and METHODS-3

Period From February to April in2013
Data Collection Data collection was by mail or email .
Contents Self-administered questionnaire consisting of
demographics, content of disaster nursing education, educational
content for disaster nursing, teacher who teach disaster nursing, and
others.

Data Analysis Descriptive statistics were calculated using the

Statistical Package for Social Sciences Version 21.

Ethical Consideration This research was approved by the

Ethics Review Committee of the Japanese Red Cross College of
Nursing, Japan (Reference Number 2012-89).

RESULTS-1SUBJECT CHARACTARISTIC
Participants: 89 universities (Response rate: 21.2%)
Country

Bangladesh
Cambodia

China
India

Country

0
0.0%

1
50.0%

1
(2.8%)

4
(18.2%)

Indonesia
Japan

Korea
Malaysia

Country

8
16.3%

56
34.1%

1
(3.7%)

3
(37.5%)

Myanmar
Nepal

Pakistan
Philippines

Country

0
0.0%

0
0.0%

0
0.0%

7
(14.0%)

Singapore
Taiwan

Thailand
Vietnam

0
0.0%

1
(7.1%)

7
(29.2%)

0
0.0%

RESULT-2-1COVER THE SUBJECT AREAS

OF DISASTER NURSING
Yes
Cambodia

China
India

Indonesia
Japan
Korea

Malaysia
Philippines
Taiwan

Thailand
Total

1
1
4
7
48
1
3
6
1
6
78

No
100.0%
100.0%
100.0%

87.5%
85.7%
100.0%

100.0%
85.7%
100.0%

85.7%
87.6%

0
0
0
1
8
0
0
1
0
1
11

Total
0.0%
0.0%
0.0%

12.5%
14.3%
0.0%

0.0%
14.3%
0.0%

14.3%
12.4%

1
1
4
8
56
1
3
7
1
7
89

100.0%
100.0%
100.0%

100.0%
100.0%
100.0%

100.0%
100.0%
100.0%

100.0%
100.0%

RESULT3-1EDUCATIONAL CONTENT FOR DISASTER

NURSING <Basic Knowledge Related to Disaster Nursing>
JPN Except JPN KHM
N=48

Definition, History,
Types of Disease
Structure in Disaster
Cycle of Disasters
Disaster Management

Information Gathering
During Disaster
Laws and Regulations
regarding Disasters
National Policy on
Disaster Prevention,
Mitigation,
Preparedness
Ethics and Disasters

CHN IND

IDN

KOR

MYS PHL

TWN

THA

Total

N=30

N=78

42

25

87.5%

75.8%

43

19

89.6%

57.6%

0.0%

0.0%

28

23

58.3%

69.7%

0.0%

30

15

62.5%

45.5%

0.0%

0.0%

75.0%

85.7%

0.0%

36

17

75.0%

51.5%

0.0% 100.0%

75.0%

29

19

60.4%

57.6%

18

12

37.5%

36.4%

0.0% 100.0%

67

75.0% 100.0% 100.0% 66.7% 83.3% 100.0% 83.3%

85.9%

75.0% 100.0% 100.0% 33.3% 66.7%

62

0.0% 50.0%

79.5%

51

0.0% 100.0% 100.0% 100.0% 33.3% 83.3% 100.0% 66.7%

65.4%

0.0% 100.0%

75.0%

85.7% 100.0%
6

0.0% 66.7%
0

0.0% 83.3%
2

85.7% 100.0% 66.7% 50.0%

0.0% 100.0%

50.0%

42.9%

0.0% 33.3% 66.7%

45

0.0% 33.3%

57.7%

53

0.0% 16.7%

67.9%

48

0.0% 50.0%

61.5%

30

0.0% 16.7%

38.5%

RESULT3-2EDUCATIONAL CONTENT FOR DISASTER

NURSING <Basic Knowledge Related to Disaster Nursing>
JPN Except JPN
N=48

KHM CHN IND

0

29.2%

27.3%

0.0%

12

25.0%

18.2%

0.0%

28

58.3%

21.2%

0.0%

41
Medical Care and Disaster
Nursing Defined
85.4%

19

57.6%

38

13

79.2%

39.4%

0.0%

43

24

89.6%

72.7%

Volunteering in Disaster
Affected Areas

Definition and Types of

Vulnerable Group
Role of Disaster Nursing

TWN THA

Total
N=78

Gender Issues

KOR MYS PHL

N=30

14

Evaluation & Assessment

of Different Cultures in
Disaster

IDN

0.0% 25.0% 42.9% 100.0%

0

0.0% 25.0% 28.6%

0.0%

0.0% 25.0% 28.6% 100.0%

1

0.0% 100.0% 50.0% 85.7% 100.0%

0

0.0% 75.0% 85.7%

0.0%

0.0% 50.0%

23

0.0% 16.7%

29.5%

18

0.0% 50.0%

0.0%

0.0%

23.1%

35

0.0% 50.0%

0.0%

0.0%

44.9%

60

0.0% 66.7% 100.0% 66.7%

76.9%

0.0% 50.0%

51

0.0% 16.7%

65.4%

67

0.0% 100.0% 100.0% 85.7% 100.0% 66.7% 83.3% 100.0% 66.7%

85.9%

RESULT3-3
EDUCATIONAL CONTENT FOR DISASTER NURSING
<Disaster-based Care/ Theory and Research>
JPN Except JPN KHM

Man-made
Disasters (airplane
accident, train
accident)
NBC Disaster:
Nuclear, Biological,
Chemical Disasters

Terrorism
Theory and
Research of
Disaster Nursing

IND

IDN

KOR

MYS

PHL

TWN THA

Total

N=30

N=48

Natural Disasters

CHN

N=78

42

22

87.5%

66.7%

27

20

56.3%

60.6%

24

18

50.0%

54.5%

16

12

33.3%

36.4%

18.8%

24.2%

0.0%

64

66.7% 66.7%

0.0%

66.7%

82.1%

47

57.1% 100.0% 100.0% 66.7%

0.0%

66.7%

60.3%

42

33.3% 66.7% 100.0%

33.3%

53.8%

0.0% 100.0% 75.0% 100.0% 100.0%

0

0.0% 100.0% 75.0%

100.0% 100.0% 75.0%

0

0.0% 100.0% 50.0%

0

57.1% 100.0%
2

28.6% 100.0%

0.0% 25.0%

42.9%

0.0%

28

33.3% 66.7%

0.0%

16.7%

35.9%

17

0.0% 33.3%

0.0%

33.3%

21.8%

RESULT3-4EDUCATIONAL CONTENT FOR DISASTER

NURSING <Psychological Care During a Disaster>
JPN Except JPN
N=48

KHM

CHN IND

85.4%

48.5%

24

14

50.0%

42.4%

27

56.3%

18.2%

0.0%

0.0%

22

10

45.8%

30.3%

0.0%

22

10

45.8%

30.3%

0.0%

Care and Stress

39
Management for Relief
81.3%
Effort Staff

13

Coordination between
Psychiatrists
Psychological Care for
Children
Psychological Care for
the Elderly

MYS PHL

TWN THA

Total
N=78

16

Psychological Triage

KOR

N=30

41

Basics of Psychological
and Social Care for
Victims (Stages of
Psychological Distress)

IDN

39.4%

57

0.0% 100.0% 50.0% 71.4% 100.0% 33.3% 50.0% 100.0% 33.3%

73.1%

100.0% 100.0% 25.0% 71.4% 100.0% 33.3% 50.0%

0

0.0% 57.1%

0.0%

0.0% 100.0% 50.0% 57.1% 100.0%

38

0.0% 16.7%

48.7%

33

0.0% 33.3%

0.0%

0.0%

42.3%

32

0.0% 16.7%

41.0%

0.0% 25.0% 57.1% 100.0% 33.3% 33.3%

1

0.0% 25.0% 57.1% 100.0% 33.3% 33.3%

0

0.0% 66.7%

32

0.0% 16.7%

41.0%

52

0.0% 16.7%

66.7%

RESULT3-4EDUCATIONAL CONTENT FOR DISASTER

NURSING <Psychological Care During a Disaster>
JPN Except JPN
N=48

KHM

CHN IND

85.4%

48.5%

24

14

50.0%

42.4%

27

56.3%

18.2%

0.0%

0.0%

22

10

45.8%

30.3%

0.0%

22

10

45.8%

30.3%

0.0%

Care and Stress

39
Management for Relief
81.3%
Effort Staff

13

Coordination between
Psychiatrists
Psychological Care for
Children
Psychological Care for
the Elderly

MYS PHL

TWN THA

Total
N=78

16

Psychological Triage

KOR

N=30

41

Basics of Psychological
and Social Care for
Victims (Stages of
Psychological Distress)

IDN

39.4%

57

0.0% 100.0% 50.0% 71.4% 100.0% 33.3% 50.0% 100.0% 33.3%

73.1%

100.0% 100.0% 25.0% 71.4% 100.0% 33.3% 50.0%

0

0.0% 57.1%

0.0%

0.0% 100.0% 50.0% 57.1% 100.0%

38

0.0% 16.7%

48.7%

33

0.0% 33.3%

0.0%

0.0%

42.3%

32

0.0% 16.7%

41.0%

0.0% 25.0% 57.1% 100.0% 33.3% 33.3%

1

0.0% 25.0% 57.1% 100.0% 33.3% 33.3%

0

0.0% 66.7%

32

0.0% 16.7%

41.0%

52

0.0% 16.7%

66.7%

RESULT3-6
EDUCATIONAL CONTENT FOR DISASTER NURSING
<Specific Care for Each Vulnerable Groups>
JPN

Except JPN KHM CHN IND IDN

The Mentally
Handicapped
Minorities

PHL

TWN THA

Total

N=30

N=48

Personality Disorder
Patients

KOR MYS

N=78

19

39.6%

24.2%

11

22.9%

24.2%

16.7%

18.2%

0.0% 0.0%

0.0% 0.0%
0

0.0% 0.0%

25.0
57.1% 0.0%
%

25.0
57.1% 0.0%
%
2

50.0
42.9% 0.0%
%

27

0.0% 33.3% 0.0% 16.7%

34.6%

19

0.0% 33.3% 0.0% 16.7%

24.4%

14

0.0% 16.7% 0.0% 0.0%

17.9%

DISSCUSSION
I.

Response rate was low, but disaster nursing education

was expanded.
II. There were few universities including specific care for
vulnerable groups , consideration of different cultures
and gender issues in disaster, and theory and research
of disaster nursing to educational content.
III. Cultivation of human resources capable of teach
disaster nursing and development of educational
material and environment were an issue in the future.

Development of Disaster
Nursing in Japan

Development of Disaster Nursing

in Japan
1.

Established Japan Society of Disaster Nursing in 1998 Leading to Great

Hanshin-Awaji in 1995

2.

Started Disaster Nursing Seminar for general nurses by Japan Nursing

Association since 2000, also started to dispatch Disaster Support Nurses to
disaster site since 2004 as system

3.

Started to build in Disaster Nursing to Basic Nursing Education Curriculum

as system from 2009

4.

Established World Society of Disaster Nursing in 2010 lead to Japan Society

of Disaster Nursing

5.

Established of Disaster Nursing Field Certified Nursing Specialist (CNS) by

Japan Association of Nursing Programs in Universities (JANPU) in 2013

1.

Association of Nursing Programs in Universities

Recent Major Disaster Medical Relief

Team dispatched by JRCS
January 17th, 1995 Great Hanshin-Awaji Earthquake 981
teams
March 31st, 2000 Eruption of Mt. Usu 52 teams
July 18th, 2004 Fukui Floods 48 teams
October 23rd, 2004 Niigata Chuetsu Earthquake 162
teams
July 16th, 2007 Niigataken
Chuetsu-oki Earthquake 44 teams
March 11th, 2011 Great East Japan
Earthquake about 1000 teams

DVD of 2011.3.11East Japan

Earthquake & Tsunami,
Japanese Red Cross
Response

Human Damages in East Japan Great Earthquake

Date of Occurence11th Mar.,2011,14:46
Epicenter Miyagi Prefec. Sanriku Offing
Depth of Seismic Center24
Provisional value
Size of EarthquakeM9.0
Direct death 15,858 ps.
Indirect death 1,632
Missing
3,021
Total
20,511
Damage of Houses (all or partly)

Injured

5,948 ps.

Lost housing about 300,000ps

(Source: May, 2012, National Police Agency

25

What learned from East Japan great Earthquake 2011

Great
damage

EPA

The fact what peoples life

be saved by people

YahooJAPAN

Out of
assumption

Explosion of Nuclear
Power Plant

2011Google

Recognized fear for natural disaster & manmade disaster again!

26

Situation in Disaster
Base Hospital on
acute phase
Full of patients and
victims in Disaster Base
Hospital.

Ishinomaki Red Cross Disaster Base

Hospital of internal place 4.5km distant
from coast side which escaped from Many medical teams gathering to Disaster
Tsunami
Base Hospital In disaster site from all of Japan

From now on Assignment

of Disaster Nursing through Tsunami 2011
1. Collaborative works with nursing experts of other
organization and academic societies.
2. Information exchange with other teams and make
linkage more.
3. Work on health & living problem which we founded
through each activity.

Issue of Resource Person

on Disaster Nursing
To bring up leader of
Disaster Nursing

Nursing in Japan(2012)
Number of nurses: about 877,000
Ng. Colleges about 200/ Total
number of
Public and Private Univs. and colleges: 200
Diploma Course in Nursing School 800
Impact of College of Nursing in university education
Based on social needs, linkage with others and role as
professional are increased.
Establishment of the World Academy of Nursing Science
Lead disaster nursing of the world, information of new
activities

Transition in the number of 4-year

Nursing Universities 240
200
157

160

129

140
120

84

100
80

46

60
40
20
0

10 11

1952 1962 1972 1982 1986 1991 1996 2000 2005 2007

2015

Year

Disaster Nursing
Education in JRCCN

Characteristics of
the Japanese Red Cross College of
Nursing

Nursing Education of the Japanese Red Cross College of

Nursing continued for 120 years
Network of International Red Cross & Crescent

Principle of Nursing Education based on Humanity

in Red Cross/Crescent

Structure of
Disaster Nursing Education in JRCCN
Bachelor Course Basic Disaster Nursing Education since
2005
Master Degree Course of Disaster Nursing Science(MA.)
reseachers course since 2007
going on CNS(Certified Nursing Specialiest)

course started since 2013

Doctor Degree of Disaster Nursing Science(PhD.)
started since 2013.
Disaster Nursing Global Leader Doctor Degree Program
started since 2014.

Main Curriculum Structure in JRCCN

Clinical
Nursing
Practicum

Nursing specialized
areas
Red Cross,
International /
Disaster Nursing
Language

Human
Beings

Society

Foundation
Seminars

Nature and
Science

Figure 1: Overall Disaster Nursing Education Program (since 2005)

Required

Elective

Elective

Elective

Required

4th Year
1st Semester

3rd Year
1st Semester

2nd Year
2nd Semester
2nd Year
1st Semester

1st Year
2nd Semester

Disaster Nursing Theory II

Community based)

15

disaster nursing activity theory

(Nursing in evacuation
center& temporary house,
disaster preparedness to make
prevention & mitigation )

30

disaster nursing activity

(Disaster and mental health
care)

30

disaster nursing activity

(the nurses role in acute stage
of disaster)

30

15

Disaster Nursing Theory I

Basic knowledgeskill)

Method & Content of Practice in Disaster Nursing

Activgity I Nursing in Disaster Emergencies
Desk Simulation

Pictorial triage of disaster scene,

select emergency measures

Use of disaster relief equipment

Technical Practice

Triage Practice

Full scale exercise

(tent, stretcher, wireless telephone, first-aid

treatment)

Play-acting by make-up patient,

triage & fill up triage tag
Playacting of make-up patient,
practice of full scale of relief
activities

Triage Image Simulation

Airplane Crash
Mutuishi mountain

Full scale exercise

CNS Master Course

Program for fostering advanced nurse who
work in practice along with disaster cycle
Need 6 abilities
Advanced Practice Ability
Leadership Ability
Consultation Ability
Coordination & collaboration Ability
between other organization
Research Activity Ability
Education Activity Ability

Subject of Disaster Nursing CNS

appointed by Japan Association of Nursing Programs
in Universities (JANPU).
Subject regarding nursing care with disaster cycle
Subject regarding nursing care for vulnerable group on
disaster
Subject regarding disaster nursing activity
Subject regarding law and system
Common Subject (Research, Education, Consultation ,
Nursing Management, Ethic,
Coorperation/Collaboration)
Essential Credit minimum 28 credit with Masters Thesis

Practice

Disaster nursing activity on

Reconstruction phase

In Bangladesh

Facilitation
for students

The Japanese Red Cross College of Nursing

Action of Disaster Nursing Education Project

in Asian Prone Countries

The Japanese Red Cross College of Nursing

Disaster Nursing Education Project in collaboration with
Bangladesh, Indonesia and Thailand

Base Building of Disaster Nursing Education Program

in Asian Country

Indonesia

Thailand

Overall Goal
The Japanese Red Cross College of Nursing will be the center
for education and research on disaster nursing at national and
international level.

Project purpose
In collaboration with Red Cross/Red Crescent of
disaster prone countries in Asia, to contribute to development of
disaster nursing education.

Methods of Project
1) Taking advantage of Red Cross network, encourage disaster
prone countries in Asia to apply to this project.

2) After screening of application and interview, research

fellows are invited to the JRCCN.

1ST Research/Training

of fellows in Japan
Participated Observation to
Disaster Simulation

Field Work in Affected Area

of 3.11 in Japan
Participated to Community Based Seminar

Visit JRCCN

The Japanese Red Cross College of Nursing

3) When research fellows organized workshops on disaster

nursing and held editorial meeting for the textbook,
JRCCN cooperated and dispatched experts.
1st Work Shop in BDRCS Sept. 2012
1st Work Shop in TRCCN July 2012

Editorial Meeting
In Indonesia

 Effort in 2012~2013
4) Development of draft curriculum, syllabus and textbook

through using support of editorial committee members

Trial usage of textbook

5) Workshop on trial usage of disaster nursing textbook be

held in Thailand where it locates geographically in the

middle among four countries.

6) Faculty members of the JRCCN are encouraged to proceed

with researches on the Great East Japan Earthquake with

this project fund.

7) As one of outcomes of 3-year project, international

symposium on disaster nursing be held in the end of

January, 2014 at the JRCCN.


countries in Asia, to contribute to development of disaster nursing
Expand to
whole Thailand

Thai Red
Cross
College
of Nursing

JRCCN
Expand to
whole
Bangladesh

Bangladesh
Red
Crescent
Holy Family
MW. School

Center for
Education/ Research
on Disaster Nursing

Expand to
whole Thailand

Thai Red
Cross
College
of Nursing
Indonesia
Red Cross
Society

Expand to
whole
Indonesia

JRCCN
Expand to
whole
Bangladesh

Bangladesh
Red
Crescent
Holy Family
MW. School

Center for
Education/ Research
on Disaster Nursing

Indonesia
Red Cross
Society

Expand to
whole
Indonesia

Conclusion
1 We have done the disaster nursing education
project in three years to target each
organization and researcher.
2. Through what gained regarding their
knowledge, attitude, behavior change and the
self-evaluation, we were able to confirm the
success of the support system.