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Nursing Homes in Public Health Emergencies

Public Health Emergency Preparedness

This resource was part of AHRQ's Public Health Emergency Preparedness program, which was discontinued on June 30, 2011, in a realignment of Federal efforts.

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Appendix A: Focus Group Moderator's Guide

Introductory Remarks

Brief Project Overview: RTI is a leading non-profit research organization located in Research Triangle Park, North Carolina. We have a contract with the AHRQ to explore the role and special needs of nursing homes in planning and response in the event of a disaster.

Staff introductions...

Review general rules of focus group operation and data capture:

  • One person talks at a time, speaking clearly to facilitate note taking.
  • Using first names only.
  • Facilitator will attempt to be sure everyone has a chance to respond to all questions.

Privacy and confidentiality assurance. Exempted from informed consent by RTI IRB; data only reported in the aggregate without revealing the names of any focus group participants or their affiliated nursing home

Questions from participants?

Discussion Questions

1. Has your nursing home thought about the impact of bioterrorism or other public health emergencies on your facility?
Probe: Has anyone from your facility been involved in any State/local bioterrorism planning activities?

2. Has your facility done any planning or training specifically for bioterrorism or other public health emergencies? Please describe...
Probes: What about planning and training for natural/man-made disasters (e.g., fires, floods)? Do you have a disaster plan? Do you do regular drills?

3. In the event of a terrorist attack or other public health emergency, what are your principle concerns regarding your facility and continued service for your residents? In other words, do you have special needs that we should know about?
Probes: Water loss, sewer or power outage, natural gas leaks, food supplies, issues around quarantine or needs of special patient populations (e.g., Alzheimer's). Also, with respect to staffing, getting staff there and keeping them there in light of their own personal family responsibilities.

4. What role, if any, do you envision your facility playing in disaster response or recovery?
Probe: Augmented capacity for local hospitals (i.e., beds; converting to a quarantine facility); trained staff to assist with local response such as giving vaccinations; gear and pharmaceutical supply storage.

5. Would you be prepared to receive a rapid influx of transferred residents back from acute care facilities in your area?
Note patient transfers usually take many hours with lots of required paperwork; patients may be transferred back at a higher level of acuity than would be the case normally; and there are likely transport issues.

6. How long could your facility be self-sustaining without external supply of water and food, medical supplies, pharmaceutical therapeutics, electric power?
Probes: Do they have food/water stores? Are these mandated by the State? Do they have a generator? Do they have back-up plans? Do they have experience with natural disasters (earthquakes, fires, floods)?

7. How do State regulations influence the ability of nursing homes to offer support and/or surge capacity in the event of bioterrorism or other public health emergency?
Probes: If the governor of your State declared a state of emergency, would you have concerns about bed licensure limits and/or nurse shift limits?

8. Take a look at this survey and try to complete it as best you can, marking those questions you know you would have an answer for with a "Y" and those you would not be able to answer even with more time with a "DK." Any questions that you feel are not applicable, please mark "NA." Additional comments or observations can be made directly on this copy.

9. What do we need to let State and Federal governments know about nursing homes and their ability to function in a time of disaster?

10. Is there anything we haven't asked you about that would be good for us to know as we attempt to explore the role and special needs of nursing homes in preparedness planning?
Probe: Administrators from other States have mentioned the role of the Red Cross. Would the Red Cross be a key resource for your facility in a disaster?

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