Determination of the Level of Education, Knowledge and Behavior of University Hospital Personnel Against Chemical, Biological, Radiological and Nuclear Incidents

Ayşe Handan Dökmeci; Öznur Akduman; Enis Karakus

doi:10.37989/gumussagbil.1366633

Araştırma Makalesi

Determination of the Level of Education, Knowledge and Behavior of University Hospital Personnel Against Chemical, Biological, Radiological and Nuclear Incidents

Yıl 2025, Cilt: 14 Sayı: 2, 553 - 567, 26.06.2025

Ayşe Handan Dökmeci , Öznur Akduman , Enis Karakus

https://doi.org/10.37989/gumussagbil.1366633

Öz

In our study, we aimed to determine the knowledge and behavior levels of occupational groups working in the hospital, such as physicians, nurses, personnel in the hospital disaster response plan, technicians, security personnel, and cleaning personnel, in case of a Chemical, Biological, Radiological, Nuclear (CBRN) attack/incident in two university hospitals. We conducted a descriptive, cross-sectional study of 477 hospital employees in 2 university hospitals in the Thrace region. Data were collected by face-to-face interview method. Descriptive statistical methods were used while evaluating the data (number, percentage). Chi-square analysis was applied to determine the relationship between the variables. 10% of the participants generally said yes to the preparedness of health institutions for future earthquakes or chemical and nuclear incidents, and biological epidemics since the 1999 earthquake, and 75% of them stated that as a healthcare professional, they were not sure that the healthcare system would protect them during a large-scale epidemic of infectious disease or any natural or man-made disaster, revealing their distrust of the institutions they work for. Because CBRN events involve unique hazards, hospital staff must be specially trained and have access to the necessary equipment and equipment. We found that most hospital staff have insufficient preparation and education levels against CBRN events. Inadequate training and lack of knowledge can negatively affect CBRN preparation. The roles and responsibilities of hospital staff regarding managing CBRN incidents should be determined before the event and supported by training.

Anahtar Kelimeler

CBRN , Hospital Disaster Plan , Hospital Preparation

Kaynakça

1. Wetter, D.C, Daniell, W.E. and Treser, C.D. (2001). “Hospital preparedness for victims of chemical or biological terrorism”, Am J Public Health., Vol.91, No.5, pp.710–6. DOI: 10.2105/ajph.91.5.710
2. Baker, D. (2009). “Civilian exposure to toxic agents: emergency medical response”.Prehosp Disaster Med. Vol.19, No.2, pp.174–8.
3. Eddy C. and Sase, E. (2015). “Implications of the Fukushima Nuclear Disaster”, Journal of Environmental Health, Vol. 78, No.1, pp. 26-33. https://www.jstor.org/stable/e26330305
4. Okumura, T, Hisaoka, H, Yamada, A, Naito, T, Isonuma, H, Okumura, S, Miura, K, Sakurada, M, Maekawa, H, Ishimatsu, S, Takasu, N. and Suzuki K. (2005). “The Tokyo subway sarin attack-lessons learned”. Toxicol Appl Pharm, Vol. 1, No. 207, pp. 471-6. doi: 10.1016/j.taap.2005.02.032
5. Sejvar, J.J. (2020). “Neurochemical and neurobiological weapons”. Neurol Clin Appl Neurotoxicol. 2020; 38:881‐896. doi:10.1016/j.ncl.2020.07.
6. El Sayed MJ. Beirut Ammonium Nitrate Explosion: A Man-Made Disaster in Times of the COVID-19 Pandemic. Disaster Med Public Health Prep. 2022 Jun;16(3):1203-1207. doi: 10.1017/dmp.2020.451.
7. Titus, E, Lemmer, G, Slagley, J. and Eninger, R.(2019). “A Review of CBRN Topics Related to Military and Civilian Patient Exposure and Decontamination”, Am J Disaster Med. Vol.14, No.2, pp.137–149.
8. Sandström, B.E, Eriksson, H, Norlander, L, Thorstensson, M. and Cassel, G. (2014). “Training of public health personnel in handling CBRN emergencies: A table-top exercise card concept”. Environ Int. Vol.72, pp.164–9. Doı: 10.1016/j.envint.2014.03.009
9. Farhat, H, Alinier, G, Gangaram, P, El Aifa, K, Khenissi, M.C, Bounouh, S, Khadhraoui, M, Gargouri, I. and Laughton, J. (2022a). “Exploring pre-hospital healthcare workers’ readiness for chemical, biological, radiological, and nuclear threats in the State of Qatar: A cross-sectional study”, Health Sci Rep. Vol.5, No. 5, pp. e803. Doı: 10.1002/hsr2.803
10. Farhat. H, Laughton, J, Gangaram, P, El Aifa, K, Khenissi, M.C, Zaghouani, O, Khadhraouif, M, Gargouri, I. and Alinier G. (2022b). “Hazardous material and chemical, biological, radiological, and nuclear incident readiness among prehospital care professionals in the State of Qatar” Glob Secur Health Sci Policy., Vol.7, No.1, pp.24–36.https://doi.org/10.1080/23779497.2022.2069142
11. Aminizadeh, M, Farrokhi, M, Ebadi, A, Masoumi, G.R, Kolivand, P. and Khankeh, H.R. (2019). “Hospital management preparedness tools in biological events: A scoping review”, J Educ Health Promot.,Vol.8, pp. 234. doi: 10.4103/jehp.jehp_473_19.
12. Kako, M, Hammad, K, Mitani, S, Arbon, P. (2018). “Existing approaches to chemical, biological, radiological, and nuclear (CBRN) education and training for health professionals: Findings from an integrative literature review”. Prehospital Disaster Med., Vol.33, No.2, pp.182–90. Doı: 10.1017/S1049023X18000043
13. Wanner GK, Atti S, Jasper E. Chemical Disaster Preparedness for Hospitals and Emergency Departments. Dela J Public Health. 2019 Oct 28;5(4):68-74. doi: 10.32481/djph.2019.10.019.
14. Gyllencreutz, L., Karlsson, S., Sjölander, A., Björnstig, J., & Hedberg, P. (2024). Chemical Incident Preparedness Among Emergency Medical Service Personnel: A Qualitative Study. International Journal of Paramedicine, (5), 103–117. https://doi.org/10.56068/ZWIC1429
15. Hassan, F., Guillaume, A., Mariana, H., Ioannis, G., Denis, J., Nelson, O., Dökmeci A.H, et.al. (2024). Exploring attitudes towards health preparedness in the Middle East and North Africa against chemical, biological, radiological, and nuclear threats: A qualitative study. Journal of Contingencies and Crisis Management. 10.1111/1468-5973.12592, 32(3)
16. Beyrami Jam, M., Aminizadeh, M., Akbari-Shahrestanaki, Y. et al. Evaluating the disaster preparedness of emergency medical services (EMS) facilities: a cross-sectional investigation in Iran. (2024). BMC Emerg Med 24, 48. https://doi.org/10.1186/s12873-024-00932-z
17. Mortelmans, L.J.M, Gaakeer, M.I, Dieltiens, G, Anseeuw, K. and Sabbe, M.B. (2017). “Are Dutch Hospitals Prepared for Chemical, Biological, or Radionuclear Incidents? A Survey Study”, Prehosp Disaster Med. Vol.32, No,5, pp. 483–491. DOI: 10.1017/S1049023X17006513
18. Treat, K.N, Williams, J.M, Furbee, P.M, Manley, W.G, Russell, F.K. and Stamper, C.J. (2001), “Hospital preparedness for weapons of mass destruction incidents: An initial assessment”, Ann Emerg Med., Vol.38, No,5 pp.562–5. doi: 10.1067/mem.2001.118009.
19. Noorihekmat, S, Rahimi, H, Mehrolhassani, M.H, Chashmyazdan, M, Haghdoost, A.A, Ahmadi Tabatabaei, S.V. and Dehnavieh, R. (2020). “Frameworks of Performance Measurement in Public Health and Primary Care System: A Scoping Review and Meta-Synthesis”, Int J Prev Med., Vol.11, pp.165. doi: 10.4103/ijpvm.IJPVM_34_19
20. Jasper, E, Miller, M, Sweeney, B, Berg, D, Feuer, E. and Reganato, D. (2005). “Preparedness of hospitals to respond to a radiological terrorism event as assessed by a full-scale exercise”, Journal of Public Health Management and Practice : JPHMP, Vol.11, No. 6, pp 11–16. doi: 10.1097/00124784-200511001-00003
21. Carli, P, Telion, C. and Baker, D. (2003). “Terrorism in France”. Prehospital Disaster Medicine, Vol.18, No. 2, pp. 92-9
22. Okumura, T, Ninomiya, N. and Ohta, M. (2003). “The chemical disaster response system in Japan”. Prehospital Disaster Medicine, Vol.18, No. 3, pp. 189-92.
23. Beaton, R.D. and Johnson, L.C. (2002). “Instrument development and evaluation of domestic preparedness training for first responders”, Prehospital Disaster Medicine, Vol.17, No.3, pp.119-25.
24. Tucker, J.B. (1997). “National health and medical services response to incidents of chemical and biological terrorism”, JAMA, Vol.278, No:5, pp.362-8.
25. Jadidi, A. Irannejad, B., Bahrami, P. Moradi, Y. and Tarzam, M.Z. (2019). “Is Emergency Medical Services (EMS) in Islamic Republic of Iran Practical and Efficient in Facing Ebola”. Bulletin of Emergency & Trauma , Vol.7, No.3, pp.315. doi: 10.29252/beat-0703016
26. Mohammadi, S.B, Amirheidari, B, Danesh, T, Nekouei Moghadam, M, Yazdi-Feyzabadi, V, Hassani, E. and Habibzadeh, H. (2022). “Identification and Analysis of Parameters and Global Experiences of Hospital Preparedness Against Chemical, Biological, Radiological and Nuclear Disasters: A Scoping Review”, Journal of Clinical Research in Paramedical Sciences. Vol.11, No. 1, pp.e123626. DOI: 10.5812/jcrps-123626
27. Beyramijam, M, Farrokhi, M, Ebadi, A, Masoumi, G. and Khankeh, H.R. (2021). “Disaster preparedness in emergency medical service agencies: A systematic review”, J Edu Health Promot, Vol.10, pp.258. doi: 10.4103/jehp.jehp_1280_20
28. Grimes, D.E. and Mendias, E.P. (2010) ‘Nurses’ Intentions to Respond to Bioterrorism and Other Infectious Disease Emergencies’, Nursing Outlook, Vol.58, No.1, pp.10-16. https://doi.org/10.1016/j.outlook.2009.07.002
29. Azeem, A.R, Sharif. M.V, Akhtar. A, Sohail, C.S, Dar, A, Han, M. and Aleem, M. (2019). “Perception of Preparedness of Health Care Professionals in Case of a Nuclear, Chemical, Biological Attack/Emergency in a Tertiary Care Hospital”. Cureus, Vol.11, No.5, pp.e4657. DOI: 10.7759/cureus.4657
30. Alahmari, A. and Khan A. (2020). “Chemical, biological, radiological, and nuclear preparedness of public hospitals in Riyadh”. Disaster Med Public Health Prep. 2023 Jun 2;17:e401. doi: 10.1017/dmp.2023.66. PMID: 37264827.
31. Manav, G. (2019). “Hastane Çalışanlarının Kimyasal, Biyolojik,Radyoaktif, Nükleer Vakalarına Karşı Bilgi ve Davranış Düzeyinin İncelenmesi”. Yüksel Lisans Tezi. Üsküdar Üniversitesi Sağlık Bilimleri Enstitüsü, İstanbul.
32. Luther, M, Lenson, S. and Reed, K. (2006). “Issues associated in chemical, biological and radiological emergency department response preparedness”. Australasian Emergency Nursing Journal, Vol. 9, No.2, pp.79–84. doi: 10.1016/j.aenj.2006.03.007.
33. Harriet Morton, Christopher Johnson. (2021). Chemical, biological, radiological and nuclear major incidents, Surgery (Oxford), Volume 39, Issue 7; 416-422. ISSN 0263-9319, https://doi.org/10.1016/j.mpsur.2021.05.005.
34. Farhat H, Alinier G, Bajow N, Batt A, Helou MC, Campbell C, Shin H, Mortelmans L, et.al. (2024). Preparedness and Response Strategies for Chemical, Biological, Radiological, and Nuclear Incidents in the Middle East and North Africa: An Artificial Intelligence-Enhanced Delphi Approach. Disaster Medicine and Public Health Preparedness, 18, e244, 1–10 https://doi.org/10.1017/dmp.2024.160
35. Dökmeci, A. H., Deniz, E. (2023). Kimyasal, Biyolojik, Radyolojik, Nükleer (KBRN) Olaylarında Sağlık Okuryazarlığı, Afet ve Risk Dergisi, 6; 273-293.
36. Al-Shareef, A.S, Alsulimani, L.K, Bojan, H.M, Masri, T.M, Grimes, J.O, Molloy, M.S. and Ciottone G.R. (2017). “Evaluation of Hospitals” Disaster Preparedness Plans in the Holy City of Makkah (Mecca): A Cross-Sectional Page 15/17 Observation Study’, Prehospital Disaster Med., Vol.32, No.1, pp.33–45. DOI: 10.1017/S1049023X16001229
37. Edwards, N. A, Caldicott, D.G.E, Aitken, P, Lee, C.C. and Eliseo, T. (2008). “Terror Australis 2004: preparedness of Australian hospitals for disasters and incidents involving chemical, biological and radiological agents”, CritCareResusc., Vol.10, No. 2, pp.125-136. PMID: 18522527
38. Chan, J.T, Yeung, R.S. and Tang, S.Y.(2002). “Hospital preparedness for chemical and biological incidents in Hong Kong”. Hong Kong Med J., Vol.8, No,6, pp.440–6. [PubMed: 12459601].
39. Park CL, Grier GR. Provision of pre-hospital medical care for terrorist attacks. (2022). Br J Anaesth. Feb;128(2):e85-e89. doi: 10.1016/j.bja.2021.10.023. Epub 2021 Dec 11. PMID: 34903363.
40. Kaynak, C. (2020). “Örnek Bir Hastane Afet Ekibinin Doğal Afetler Sonrasında Ortaya Çıkabilecek KBRN (Kimyasal, Biyolojik, Radyoaktif, Nükleer) Tehlikeler ile İlgili Bilgi Düzeylerinin Ölçülmesi”. Yüksek Lisans Tezi. Çanakkale Onsekiz Mart Üniversitesi Fen Bilimleri Enstitüsü, Çanakkale.
41. Alahmari, A., & Khan, A. (2023). Chemical, biological, radiological, and nuclear preparedness of public hospitals in Riyadh. Disaster Medicine and Public Health Preparedness, 17, e401. doi:10.1017/dmp.2023.66
42. Aminizadeh, M., Farrokhi, M., Ebadi, A., Masoumi, G. R., Kolivand, P., & Khankeh, H. R. (2019). Hospital management preparedness tools in biological events: A scoping review. Journal of Education and Health Promotion, 8, 234. doi:10.4103/jehp.jehp_473_19
43. Jama, T. J., & Kuisma, M. J. (2022). Preparedness of Finnish emergency medical services for chemical emergencies. Prehospital and Disaster Medicine, 31(4), 392-396. doi:10.1017/S1049023X16000546
44. Mohammadi, S. B., Amirheidari, B., Danesh, T., Nekouei Moghadam, M., Yazdi-Feyzabadi, V., Hassani, E., & Habibzadeh, H. (2022). Identification and analysis of parameters and global experiences of hospital preparedness against chemical, biological, radiological, and nuclear disasters: A scoping review. Journal of Clinical Research in Paramedical Sciences, 11, e123626. doi:10.5812/jcrps-123626
45. Mortelmans, L. J. M., Gaakeer, M. I., Dieltiens, G., Anseeuw, K., & Sabbe, M. B. (2021). Are Dutch hospitals prepared for chemical, biological, or radionuclear incidents? A survey study. Prehospital and Disaster Medicine, 32(5), 483–491. doi:10.1017/S1049023X17006513
46. Farhat, H., Alinier, G., Chaabna, K., Aifa, K.E., Abougalala, W., Laughton, J., Dhiab, M.B. (2024). Preparedness and emergency response strategies for chemical, biological, radiological and nuclear emergencies in disaster management: A qualitative systematic review. Journal of Contingencies and Crisis Management, 32; (3).
47. Dökmeci, A.H., Çavlan B. (2020). Biological Weapon- Biological Wars, Pandemics and Covid-19., EJONS, 4;841-859.

Üniversite Hastanesi Personelinin Kimyasal, Biyolojik, Radyolojik ve Nükleer Olaylara Karşı Eğitim, Bilgi ve Davranış Düzeyinin Belirlenmesi

Yıl 2025, Cilt: 14 Sayı: 2, 553 - 567, 26.06.2025

Ayşe Handan Dökmeci , Öznur Akduman , Enis Karakus

https://doi.org/10.37989/gumussagbil.1366633

Öz

Çalışmamızda iki üniversite hastanesinde Kimyasal, Biyolojik, Radyolojik, Nükleer (KBRN) saldırı/olay olması durumunda hastanede görev yapan doktor, hemşire, hastane afet müdahale planında yer alan personel, teknisyen, güvenlik personeli ve temizlik personeli gibi meslek gruplarının bilgi ve davranış düzeylerinin belirlenmesi amaçlanmıştır. Trakya bölgesindeki 2 üniversite hastanesinde 477 hastane çalışanı üzerinde tanımlayıcı, kesitsel bir çalışma gerçekleştirdik. Veriler yüz yüze görüşme yöntemiyle toplandı. Veriler değerlendirilirken betimsel istatistiksel yöntemler (sayı, yüzde) kullanıldı. Değişkenler arasındaki ilişkiyi belirlemek için ki-kare analizi uygulandı. Katılımcıların %10'u genel olarak sağlık kurumlarının 1999 depreminden bu yana gelecekteki depremlere veya kimyasal ve nükleer olaylara ve biyolojik salgınlara karşı hazırlıklı olmalarına evet derken, %75'i bir sağlık çalışanı olarak büyük çaplı bir bulaşıcı hastalık salgını veya herhangi bir doğal veya insan kaynaklı afet sırasında sağlık sisteminin kendilerini koruyacağından emin olmadıklarını belirterek çalıştıkları kurumlara olan güvensizliklerini ortaya koydu. KBRN olayları benzersiz tehlikeler içerdiğinden, hastane personeli özel olarak eğitilmeli ve gerekli ekipman ve ekipmana erişebilmelidir. Çoğu hastane personelinin KBRN olaylarına karşı hazırlık ve eğitim düzeylerinin yetersiz olduğu tespit edildi. Yetersiz eğitim ve bilgi eksikliği, KBRN hazırlığını olumsuz etkileyebilir. KBRN olaylarının yönetimine ilişkin hastane personelinin rol ve sorumlulukları olay öncesinde belirlenmeli ve eğitimlerle desteklenmelidir.

Anahtar Kelimeler

KBRN , Hastane Afet Planı , Hastane Hazırlığı , Eğitim, Bilgi ve Davranış Seviyesi

Kaynakça

1. Wetter, D.C, Daniell, W.E. and Treser, C.D. (2001). “Hospital preparedness for victims of chemical or biological terrorism”, Am J Public Health., Vol.91, No.5, pp.710–6. DOI: 10.2105/ajph.91.5.710
2. Baker, D. (2009). “Civilian exposure to toxic agents: emergency medical response”.Prehosp Disaster Med. Vol.19, No.2, pp.174–8.
3. Eddy C. and Sase, E. (2015). “Implications of the Fukushima Nuclear Disaster”, Journal of Environmental Health, Vol. 78, No.1, pp. 26-33. https://www.jstor.org/stable/e26330305
4. Okumura, T, Hisaoka, H, Yamada, A, Naito, T, Isonuma, H, Okumura, S, Miura, K, Sakurada, M, Maekawa, H, Ishimatsu, S, Takasu, N. and Suzuki K. (2005). “The Tokyo subway sarin attack-lessons learned”. Toxicol Appl Pharm, Vol. 1, No. 207, pp. 471-6. doi: 10.1016/j.taap.2005.02.032
5. Sejvar, J.J. (2020). “Neurochemical and neurobiological weapons”. Neurol Clin Appl Neurotoxicol. 2020; 38:881‐896. doi:10.1016/j.ncl.2020.07.
6. El Sayed MJ. Beirut Ammonium Nitrate Explosion: A Man-Made Disaster in Times of the COVID-19 Pandemic. Disaster Med Public Health Prep. 2022 Jun;16(3):1203-1207. doi: 10.1017/dmp.2020.451.
7. Titus, E, Lemmer, G, Slagley, J. and Eninger, R.(2019). “A Review of CBRN Topics Related to Military and Civilian Patient Exposure and Decontamination”, Am J Disaster Med. Vol.14, No.2, pp.137–149.
8. Sandström, B.E, Eriksson, H, Norlander, L, Thorstensson, M. and Cassel, G. (2014). “Training of public health personnel in handling CBRN emergencies: A table-top exercise card concept”. Environ Int. Vol.72, pp.164–9. Doı: 10.1016/j.envint.2014.03.009
9. Farhat, H, Alinier, G, Gangaram, P, El Aifa, K, Khenissi, M.C, Bounouh, S, Khadhraoui, M, Gargouri, I. and Laughton, J. (2022a). “Exploring pre-hospital healthcare workers’ readiness for chemical, biological, radiological, and nuclear threats in the State of Qatar: A cross-sectional study”, Health Sci Rep. Vol.5, No. 5, pp. e803. Doı: 10.1002/hsr2.803
10. Farhat. H, Laughton, J, Gangaram, P, El Aifa, K, Khenissi, M.C, Zaghouani, O, Khadhraouif, M, Gargouri, I. and Alinier G. (2022b). “Hazardous material and chemical, biological, radiological, and nuclear incident readiness among prehospital care professionals in the State of Qatar” Glob Secur Health Sci Policy., Vol.7, No.1, pp.24–36.https://doi.org/10.1080/23779497.2022.2069142
11. Aminizadeh, M, Farrokhi, M, Ebadi, A, Masoumi, G.R, Kolivand, P. and Khankeh, H.R. (2019). “Hospital management preparedness tools in biological events: A scoping review”, J Educ Health Promot.,Vol.8, pp. 234. doi: 10.4103/jehp.jehp_473_19.
12. Kako, M, Hammad, K, Mitani, S, Arbon, P. (2018). “Existing approaches to chemical, biological, radiological, and nuclear (CBRN) education and training for health professionals: Findings from an integrative literature review”. Prehospital Disaster Med., Vol.33, No.2, pp.182–90. Doı: 10.1017/S1049023X18000043
13. Wanner GK, Atti S, Jasper E. Chemical Disaster Preparedness for Hospitals and Emergency Departments. Dela J Public Health. 2019 Oct 28;5(4):68-74. doi: 10.32481/djph.2019.10.019.
14. Gyllencreutz, L., Karlsson, S., Sjölander, A., Björnstig, J., & Hedberg, P. (2024). Chemical Incident Preparedness Among Emergency Medical Service Personnel: A Qualitative Study. International Journal of Paramedicine, (5), 103–117. https://doi.org/10.56068/ZWIC1429
15. Hassan, F., Guillaume, A., Mariana, H., Ioannis, G., Denis, J., Nelson, O., Dökmeci A.H, et.al. (2024). Exploring attitudes towards health preparedness in the Middle East and North Africa against chemical, biological, radiological, and nuclear threats: A qualitative study. Journal of Contingencies and Crisis Management. 10.1111/1468-5973.12592, 32(3)
16. Beyrami Jam, M., Aminizadeh, M., Akbari-Shahrestanaki, Y. et al. Evaluating the disaster preparedness of emergency medical services (EMS) facilities: a cross-sectional investigation in Iran. (2024). BMC Emerg Med 24, 48. https://doi.org/10.1186/s12873-024-00932-z
17. Mortelmans, L.J.M, Gaakeer, M.I, Dieltiens, G, Anseeuw, K. and Sabbe, M.B. (2017). “Are Dutch Hospitals Prepared for Chemical, Biological, or Radionuclear Incidents? A Survey Study”, Prehosp Disaster Med. Vol.32, No,5, pp. 483–491. DOI: 10.1017/S1049023X17006513
18. Treat, K.N, Williams, J.M, Furbee, P.M, Manley, W.G, Russell, F.K. and Stamper, C.J. (2001), “Hospital preparedness for weapons of mass destruction incidents: An initial assessment”, Ann Emerg Med., Vol.38, No,5 pp.562–5. doi: 10.1067/mem.2001.118009.
19. Noorihekmat, S, Rahimi, H, Mehrolhassani, M.H, Chashmyazdan, M, Haghdoost, A.A, Ahmadi Tabatabaei, S.V. and Dehnavieh, R. (2020). “Frameworks of Performance Measurement in Public Health and Primary Care System: A Scoping Review and Meta-Synthesis”, Int J Prev Med., Vol.11, pp.165. doi: 10.4103/ijpvm.IJPVM_34_19
20. Jasper, E, Miller, M, Sweeney, B, Berg, D, Feuer, E. and Reganato, D. (2005). “Preparedness of hospitals to respond to a radiological terrorism event as assessed by a full-scale exercise”, Journal of Public Health Management and Practice : JPHMP, Vol.11, No. 6, pp 11–16. doi: 10.1097/00124784-200511001-00003
21. Carli, P, Telion, C. and Baker, D. (2003). “Terrorism in France”. Prehospital Disaster Medicine, Vol.18, No. 2, pp. 92-9
22. Okumura, T, Ninomiya, N. and Ohta, M. (2003). “The chemical disaster response system in Japan”. Prehospital Disaster Medicine, Vol.18, No. 3, pp. 189-92.
23. Beaton, R.D. and Johnson, L.C. (2002). “Instrument development and evaluation of domestic preparedness training for first responders”, Prehospital Disaster Medicine, Vol.17, No.3, pp.119-25.
24. Tucker, J.B. (1997). “National health and medical services response to incidents of chemical and biological terrorism”, JAMA, Vol.278, No:5, pp.362-8.
25. Jadidi, A. Irannejad, B., Bahrami, P. Moradi, Y. and Tarzam, M.Z. (2019). “Is Emergency Medical Services (EMS) in Islamic Republic of Iran Practical and Efficient in Facing Ebola”. Bulletin of Emergency & Trauma , Vol.7, No.3, pp.315. doi: 10.29252/beat-0703016
26. Mohammadi, S.B, Amirheidari, B, Danesh, T, Nekouei Moghadam, M, Yazdi-Feyzabadi, V, Hassani, E. and Habibzadeh, H. (2022). “Identification and Analysis of Parameters and Global Experiences of Hospital Preparedness Against Chemical, Biological, Radiological and Nuclear Disasters: A Scoping Review”, Journal of Clinical Research in Paramedical Sciences. Vol.11, No. 1, pp.e123626. DOI: 10.5812/jcrps-123626
27. Beyramijam, M, Farrokhi, M, Ebadi, A, Masoumi, G. and Khankeh, H.R. (2021). “Disaster preparedness in emergency medical service agencies: A systematic review”, J Edu Health Promot, Vol.10, pp.258. doi: 10.4103/jehp.jehp_1280_20
28. Grimes, D.E. and Mendias, E.P. (2010) ‘Nurses’ Intentions to Respond to Bioterrorism and Other Infectious Disease Emergencies’, Nursing Outlook, Vol.58, No.1, pp.10-16. https://doi.org/10.1016/j.outlook.2009.07.002
29. Azeem, A.R, Sharif. M.V, Akhtar. A, Sohail, C.S, Dar, A, Han, M. and Aleem, M. (2019). “Perception of Preparedness of Health Care Professionals in Case of a Nuclear, Chemical, Biological Attack/Emergency in a Tertiary Care Hospital”. Cureus, Vol.11, No.5, pp.e4657. DOI: 10.7759/cureus.4657
30. Alahmari, A. and Khan A. (2020). “Chemical, biological, radiological, and nuclear preparedness of public hospitals in Riyadh”. Disaster Med Public Health Prep. 2023 Jun 2;17:e401. doi: 10.1017/dmp.2023.66. PMID: 37264827.
31. Manav, G. (2019). “Hastane Çalışanlarının Kimyasal, Biyolojik,Radyoaktif, Nükleer Vakalarına Karşı Bilgi ve Davranış Düzeyinin İncelenmesi”. Yüksel Lisans Tezi. Üsküdar Üniversitesi Sağlık Bilimleri Enstitüsü, İstanbul.
32. Luther, M, Lenson, S. and Reed, K. (2006). “Issues associated in chemical, biological and radiological emergency department response preparedness”. Australasian Emergency Nursing Journal, Vol. 9, No.2, pp.79–84. doi: 10.1016/j.aenj.2006.03.007.
33. Harriet Morton, Christopher Johnson. (2021). Chemical, biological, radiological and nuclear major incidents, Surgery (Oxford), Volume 39, Issue 7; 416-422. ISSN 0263-9319, https://doi.org/10.1016/j.mpsur.2021.05.005.
34. Farhat H, Alinier G, Bajow N, Batt A, Helou MC, Campbell C, Shin H, Mortelmans L, et.al. (2024). Preparedness and Response Strategies for Chemical, Biological, Radiological, and Nuclear Incidents in the Middle East and North Africa: An Artificial Intelligence-Enhanced Delphi Approach. Disaster Medicine and Public Health Preparedness, 18, e244, 1–10 https://doi.org/10.1017/dmp.2024.160
35. Dökmeci, A. H., Deniz, E. (2023). Kimyasal, Biyolojik, Radyolojik, Nükleer (KBRN) Olaylarında Sağlık Okuryazarlığı, Afet ve Risk Dergisi, 6; 273-293.
36. Al-Shareef, A.S, Alsulimani, L.K, Bojan, H.M, Masri, T.M, Grimes, J.O, Molloy, M.S. and Ciottone G.R. (2017). “Evaluation of Hospitals” Disaster Preparedness Plans in the Holy City of Makkah (Mecca): A Cross-Sectional Page 15/17 Observation Study’, Prehospital Disaster Med., Vol.32, No.1, pp.33–45. DOI: 10.1017/S1049023X16001229
37. Edwards, N. A, Caldicott, D.G.E, Aitken, P, Lee, C.C. and Eliseo, T. (2008). “Terror Australis 2004: preparedness of Australian hospitals for disasters and incidents involving chemical, biological and radiological agents”, CritCareResusc., Vol.10, No. 2, pp.125-136. PMID: 18522527
38. Chan, J.T, Yeung, R.S. and Tang, S.Y.(2002). “Hospital preparedness for chemical and biological incidents in Hong Kong”. Hong Kong Med J., Vol.8, No,6, pp.440–6. [PubMed: 12459601].
39. Park CL, Grier GR. Provision of pre-hospital medical care for terrorist attacks. (2022). Br J Anaesth. Feb;128(2):e85-e89. doi: 10.1016/j.bja.2021.10.023. Epub 2021 Dec 11. PMID: 34903363.
40. Kaynak, C. (2020). “Örnek Bir Hastane Afet Ekibinin Doğal Afetler Sonrasında Ortaya Çıkabilecek KBRN (Kimyasal, Biyolojik, Radyoaktif, Nükleer) Tehlikeler ile İlgili Bilgi Düzeylerinin Ölçülmesi”. Yüksek Lisans Tezi. Çanakkale Onsekiz Mart Üniversitesi Fen Bilimleri Enstitüsü, Çanakkale.
41. Alahmari, A., & Khan, A. (2023). Chemical, biological, radiological, and nuclear preparedness of public hospitals in Riyadh. Disaster Medicine and Public Health Preparedness, 17, e401. doi:10.1017/dmp.2023.66
42. Aminizadeh, M., Farrokhi, M., Ebadi, A., Masoumi, G. R., Kolivand, P., & Khankeh, H. R. (2019). Hospital management preparedness tools in biological events: A scoping review. Journal of Education and Health Promotion, 8, 234. doi:10.4103/jehp.jehp_473_19
43. Jama, T. J., & Kuisma, M. J. (2022). Preparedness of Finnish emergency medical services for chemical emergencies. Prehospital and Disaster Medicine, 31(4), 392-396. doi:10.1017/S1049023X16000546
44. Mohammadi, S. B., Amirheidari, B., Danesh, T., Nekouei Moghadam, M., Yazdi-Feyzabadi, V., Hassani, E., & Habibzadeh, H. (2022). Identification and analysis of parameters and global experiences of hospital preparedness against chemical, biological, radiological, and nuclear disasters: A scoping review. Journal of Clinical Research in Paramedical Sciences, 11, e123626. doi:10.5812/jcrps-123626
45. Mortelmans, L. J. M., Gaakeer, M. I., Dieltiens, G., Anseeuw, K., & Sabbe, M. B. (2021). Are Dutch hospitals prepared for chemical, biological, or radionuclear incidents? A survey study. Prehospital and Disaster Medicine, 32(5), 483–491. doi:10.1017/S1049023X17006513
46. Farhat, H., Alinier, G., Chaabna, K., Aifa, K.E., Abougalala, W., Laughton, J., Dhiab, M.B. (2024). Preparedness and emergency response strategies for chemical, biological, radiological and nuclear emergencies in disaster management: A qualitative systematic review. Journal of Contingencies and Crisis Management, 32; (3).
47. Dökmeci, A.H., Çavlan B. (2020). Biological Weapon- Biological Wars, Pandemics and Covid-19., EJONS, 4;841-859.

Toplam 47 adet kaynakça vardır.

Ayrıntılar

Birincil Dil	İngilizce
Konular	Sağlığın Geliştirilmesi
Bölüm	Makaleler
Yazarlar	Ayşe Handan Dökmeci 0000-0002-4439-4422 Öznur Akduman 0000-0003-0258-2959 Enis Karakus 0009-0000-6702-7134
Yayımlanma Tarihi	26 Haziran 2025
Yayımlandığı Sayı	Yıl 2025 Cilt: 14 Sayı: 2

Kaynak Göster

APA	Dökmeci, A. H., Akduman, Ö., & Karakus, E. (2025). Determination of the Level of Education, Knowledge and Behavior of University Hospital Personnel Against Chemical, Biological, Radiological and Nuclear Incidents. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi, 14(2), 553-567. https://doi.org/10.37989/gumussagbil.1366633
AMA	Dökmeci AH, Akduman Ö, Karakus E. Determination of the Level of Education, Knowledge and Behavior of University Hospital Personnel Against Chemical, Biological, Radiological and Nuclear Incidents. Gümüşhane Sağlık Bilimleri Dergisi. Haziran 2025;14(2):553-567. doi:10.37989/gumussagbil.1366633
Chicago	Dökmeci, Ayşe Handan, Öznur Akduman, ve Enis Karakus. “Determination of the Level of Education, Knowledge and Behavior of University Hospital Personnel Against Chemical, Biological, Radiological and Nuclear Incidents”. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi 14, sy. 2 (Haziran 2025): 553-67. https://doi.org/10.37989/gumussagbil.1366633.
EndNote	Dökmeci AH, Akduman Ö, Karakus E (01 Haziran 2025) Determination of the Level of Education, Knowledge and Behavior of University Hospital Personnel Against Chemical, Biological, Radiological and Nuclear Incidents. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi 14 2 553–567.
IEEE	A. H. Dökmeci, Ö. Akduman, ve E. Karakus, “Determination of the Level of Education, Knowledge and Behavior of University Hospital Personnel Against Chemical, Biological, Radiological and Nuclear Incidents”, Gümüşhane Sağlık Bilimleri Dergisi, c. 14, sy. 2, ss. 553–567, 2025, doi: 10.37989/gumussagbil.1366633.
ISNAD	Dökmeci, Ayşe Handan vd. “Determination of the Level of Education, Knowledge and Behavior of University Hospital Personnel Against Chemical, Biological, Radiological and Nuclear Incidents”. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi 14/2 (Haziran2025), 553-567. https://doi.org/10.37989/gumussagbil.1366633.
JAMA	Dökmeci AH, Akduman Ö, Karakus E. Determination of the Level of Education, Knowledge and Behavior of University Hospital Personnel Against Chemical, Biological, Radiological and Nuclear Incidents. Gümüşhane Sağlık Bilimleri Dergisi. 2025;14:553–567.
MLA	Dökmeci, Ayşe Handan vd. “Determination of the Level of Education, Knowledge and Behavior of University Hospital Personnel Against Chemical, Biological, Radiological and Nuclear Incidents”. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi, c. 14, sy. 2, 2025, ss. 553-67, doi:10.37989/gumussagbil.1366633.
Vancouver	Dökmeci AH, Akduman Ö, Karakus E. Determination of the Level of Education, Knowledge and Behavior of University Hospital Personnel Against Chemical, Biological, Radiological and Nuclear Incidents. Gümüşhane Sağlık Bilimleri Dergisi. 2025;14(2):553-67.

Kapak Resmi İndir

Makale Dosyaları

Tam Metin