**4. Results**

Of the 200 nurses who answered the questionnaire, 181 (90.5%) were female and 19 (9.5%) were male. A majority of the respondents (45.5%) were 22–30 years old. About 39% of the nurses were 31–40 years old, while the remaining 15.5% were 40 years old or older. About 93.5% of the nurses had a Bachelor of Science in Nursing (BSN), 6% had a Master of Science in Nursing (MSN), and 0.5% had a Doctor of Philosophy (PhD) in Nursing. Most of the practicing nurses, especially those in EDs within MOH hospitals, possessed undergraduate qualifications from MOH-certified education and training institutions. About 12% of the nurses had more than 16 years of experience within EDs, 20% had 11–15 years of experience, and 34% had 6–10 years of experience, while the remaining 34% had 1–5 years of experience.

The remaining results of the study were categorised into the following 10 dimensions, which denote the extent to which nurses are aware of disaster risks and preparedness. Each dimension consisted of several questions, in which nurses were asked to indicate their familiarity with a topic based on a five-point Likert scale as follows: very familiar (5), somewhat familiar (4), familiar to neutral (3), somewhat unfamiliar (2), and not familiar (1). The positive threshold was 'familiar to neutral' to 'very familiar'.

Table 1 shows that most of the participants had good knowledge (familiar to very familiar) in most items of these dimensions: signs and symptoms (different biological agents: 49.5%, and better for Anthrax: 75%), modes of transmission (56.5%), antidote and adverse reaction (66% and 69.5%, respectively). However, participants seemed to be uncertain about their practical capabilities, skills, and evaluations of their own actions, including necessary first aid interventions such as ventilation and oxygen administration during a public health emergency (32% and 39.5%, respectively).


**Table 1.** Description of 200 nurses' responses regarding familiarity with Emergency Preparedness Terms and Activities.

Table 2 shows that a majority of the nurses surveyed had good knowledge regarding what they needed to do during a large-scale emergency. They also appeared to have good knowledge about the emergency operations plan (EOP), Incident Command System (ICS), physical locations of all entities, the importance of medical decision-making, etc.



Table 3 shows nurses' approaches to the assessment of affected people's health following a crisis and their familiarity with ethical issues in MIDs, such as during triage. Overall, they claimed that they had good knowledge and understanding of these issues.

**Table 3.** Description of nurses' responses regarding their familiarity with Ethical Issues in Triage (N = 200).


Table 4 shows nurses' knowledge in mitigating the further outbreak of a disease. Overall, most of the nurses claimed that they had good knowledge in handling the administrative measures needed in chemical, biological, radiological, and nuclear (CBRN) surveillance.

**Table 4.** Description of nurses' responses regarding their familiarity with Epidemiology and Surveillance (N = 200).


In Table 5, nurses evaluated their knowledge of isolation and quarantine issues. Most of the surveyed nurses seemed to have good knowledge in these areas.

**Table 5.** Description of nurses' responses regarding their familiarity with Isolation/Quarantine (N = 200).


Table 6 shows that most of the nurses had good knowledge of the decontamination process in their hospitals, including the use of personal protective equipment (PPE).

**Table 6.** Description of nurses' responses regarding their familiarity with Decontamination (N = 200).


Table 7 addresses the communication aspect of emergency response. A majority of the nurses had good knowledge of communication and information sharing during an emergency and of the need for debriefing and communication devices.

**Table 7.** Description of nurses' responses regarding their familiarity with Communication/Connectivity (N = 200).


Table 8 shows that a majority of the nurses had good knowledge of appropriate and necessary psychological support during MIDs, claimed that they could provide health counselling/education in issues related to chemical, biological, radiological, nuclear, and explosive (CBRNE) agents, and could communicate with, identify, and evaluate youth and adults with post-traumatic stress disorder (PTSD).

**Table 8.** Description of nurses' responses regarding their familiarity with Psychological Issues (N = 200).


Table 9 shows nurses' knowledge in handling special populations affected by a disaster. A majority of nurses claimed to have good knowledge and understanding of the unique needs and expectations required for care of vulnerable groups.


**Table 9.** Description of nurses' responses regarding their familiarity with Special Populations (N = 200).

Table 10 shows the ability of nurses to access critical resources during an MID. They seemed to have good knowledge and capabilities to perform necessary measures in all areas within this dimension.



The results of normality, measured with the Kolmogorov–Smirnov test, indicated the data to be significantly skewed (sig. 0.00). As a result of the skewness and the fact that the data were ordinal and presented as ranks, a non-parametric test, Spearman's rho, was chosen to measure bivariate correlations. The variables of age, qualification, and experience were tested for the 10 studied dimensions of nurses' familiarity responses. Significant correlations were found in the correlations on qualification and dimensions of Emergency Preparedness (sig. 0.006), Epidemiology and Surveillance (sig. 0.008), Isolation and Quarantine (sig. 0.000) and Critical Resources (sig. 0.019). All significant correlations represented a small to moderate association (Critical Resources, 0.185–Isolation and Quarantine, 0.266) (Table 11).


**Table 11.** Ranks and statistics of nurses' responses regarding their familiarity with Emergency Preparedness Terms and Activities, Epidemiology and Surveillance, Isolation/Quarantine, and Accessing Critical Resources/Qualification (sign ≤ 0.05, N = 200).

> CC = Correlation Coefficient, Sig.tt = Significant two-tailed.

The psychological issues dimension was significant when correlated to age (sig. 0.029), qualification (sig. 0.026), and experience (sig. 0.027). The correlations represented a small association (0.154–0.158) (Table12).

**Table 12.** Ranks and statistics of nurses' responses regarding their familiarity with Psychological Issues/Age, Qualification and Experience (sign ≤ 0.05, N = 200).


CC = Correlation Coefficient, Sig.tt = Significant two-tailed.
