感染症流行下の病院における多数傷病者受入訓練の在り方に関する調査報告—COVID-19を経験した災害看護専門看護師の視点から

A Survey Report on Mass Casualty Incident Training in Japanese Hospitals during a Pandemic: Perspectives from Clinical Nursing Specialists in Disaster Who Experienced COVID-19

要　　約

【背景】新型コロナウイルス感染症（以下COVID-19）パンデミックは、病院の医療体制に大きく影響した。その余波として、病院内の災害対策訓練の中でも、多くの人が集まる多数傷病者受入訓練への影響が推察され、病院の防災機能低下が懸念された。

【目的】COVID-19下での病院の訓練実施状況に影響する要因を、災害看護を専門とする看護師の視点から探究することを目的とした。

【方法】国内の病院に勤務する災害看護専門看護師を対象に、Webアンケート調査を実施した。

【結果】9名の参加者全員が、所属病院の訓練は「流行により中止」もしくは「流行前より規模が縮小された」と回答した。また訓練実施の主な障壁は流行による「職員の行動制限」だった。訓練実施で重要なのは、訓練規模や形態の変更、感染症対策、病院の意思決定組織の訓練実施への理解だった。

【考察】感染症流行下での訓練実施には、十分な感染症対策に加え、訓練形態や規模を含めた意思決定組織との協議、関連職種との関係性構築と連携が不可欠であることが示された。

Introduction: The novel coronavirus disease （COVID-19） pandemic had a significant impact on the medical system at hospitals. As an effect, it is believed that the mass casualty incident training that had been held regularly up until that point was also affected, and the hospital disaster prevention function seemed to be weakened.

Objectives: This study was designed to explore the effect of the situation on the success, influence, and implementation of disaster training during the COVID-19 pandemic conducted by Clinical Nursing Specialists in Disaster Nursing（CNSs）.

Methods: This study was conducted questionnaire from March to April 2023. Registered CNSs by the Japan Nursing Association were requested to access a web-based and inquired about disaster training before, during, and after the COVID-19 pandemic.

Results: Nine registered CNSs completed the questionnaire, and all reported that the disaster training was reduced or canceled during the COVID-19 pandemic. The main barrier to implementing the training was “ Restrictions on direct interactions with others ”. “ Changing the scale ” and “ Changing the way ” of training, ensuring“ Appropriate infection control ”, and“ Understanding the significance of disaster training by a decision-making organization ” were required to ensure disaster training.

Conclusion: Changing the scale and way of training as well as ensuring adequate infection control are needed to continue disaster training during pandemics. It was suggested that the key decisive factors were discussing with decision-making organizations and practice teams for how to deal with these problems, building relationships, and collaborating with related professions.