Document Type
DNP Project
Department
School of Nursing
Date of Degree
Spring 2026
Degree
Doctor of Nursing Practice (DNP)
Primary Advisor
Joyce Knestrick, PhD, FNP-BC, FAANP, FAAN
Keywords
Mass Casualty Incident; MCI; Emergency; Nurse; Simulation; Preparedness; CBRNE; Incident Command
Abstract
Background: This quality improvement (QI) project used a pre-test/post-test design to evaluate whether targeted emergency management training improved emergency department (ED) nurses’ preparedness for mass casualty incidents (MCIs). A purposive sample of 25 ED nurses with fewer than ten years of experience from a community-level ED participated. The PICOT question examined whether participation in structured emergency management education would significantly improve nurses’ knowledge, skills, and abilities, as measured by the Emergency Preparedness Information Questionnaire (EPIQ).
Aims/Objectives: The project aimed to enhance ED nurses’ preparedness for chemical, biological, radiological, nuclear, and explosive (CBRNE) MCIs. Objectives included delivering a comprehensive CBRNE-focused educational session, conducting a high-fidelity MCI simulation after completing demographic data and the EPIQ pretest, and distributing a quick-reference guide for use during actual events.
Methods: Nurses attended a didactic training session, followed by a high-fidelity CBRNE MCI simulation aligned with the organization’s Emergency Operations Plan. The EPIQ was administered before and after the intervention to assess changes across preparedness domains.
Results: Post-intervention EPIQ scores showed significant improvement across all domains. Paired t-tests revealed positive mean differences from 1.48 to 1.84, all statistically significant (t[24] = 9.24–13.91, p < .001). Effect sizes (Cohen’s d) ranged from 1.72 to 2.78, indicating moderate to strong effects. The incident command domain showed a strong effect size, while the remaining domains showed moderate effects.
Conclusions and Implications: Participation in structured education and simulation significantly improved ED nurses’ preparedness for CBRNE-related MCIs. Additional targeted training is recommended for domains with lower posttest scores, including biological agent detection, access to critical resources, and reporting processes. Structured emergency management education, combined with simulation, is an effective strategy to strengthen disaster readiness and professional development in the Emergency Department.
Copyright Notice
©2026 Christian Lanphere. All rights reserved.
Recommended Citation
Lanphere, C. (2026). Improving Emergency Management Standards in a Community Hospital Emergency Department. , (). Retrieved from https://hsrc.himmelfarb.gwu.edu/son_dnp/197
Open Access
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