Document Type : Original Article


Health School, Shahrekord University of Medical Sciences, Shahrekord, Iran


BACKGROUND: It is necessary to assess the level of preparedness to reduce the side effects 
of disasters, so regarding to the role of nurses in responding to the disasters, this is of particular 
importance. Holding a maneuver and exercises is one of the ways to increase the level of capability 
and assess the level of readiness, so the aim of the current study was to investigate the impact of 
the implementation of the operational exercises program on the competency of nurses in disaster 
response in 2020.
MATERIALS AND METHODS: The present study is a quasi‑experimental study in two groups, 
in which seventy nurses of hospitals affiliated to Shahrekord University of Medical Sciences 
were selected by census and randomly divided into two groups. Before the intervention, a native 
questionnaire to assess the competence of nurses in the disaster response was completed. Then, the 
empowerment program including educational workshop, tabletop, and operational maneuvers were 
performed. Immediately and 3 months after the intervention, the questionnaires for both groups were 
completed, and the data were analyzed using SPSS 21 through descriptive‑analytical statistical tests.
RESULTS: The results showed that the mean score of nurses’ competence in all domains of 
management, ethics, personal, team work, and technical immediately and 3 months after the 
intervention in the intervention group increased significantly (P = 0.001), while in the control group, 
these changes were not significant (P > 0.05).
CONCLUSION: According to the results of a recent study, the implementation of the empowerment 
program and the implementation of maneuvers as a part of the process of preparing nurses to deal 
with disasters have been effective. Therefore, it is suggested to use periodic maneuvers in in‑service 
training programs to improve the level of competence of nurses.


1. Shen S, Cheng C, Yang J, Yang S. Visualized analysis of developing 
trends and hot topics in natural disaster research. PLoS One 
2. Wang L, XueX, ZhangY, LuoX. Exploring the emerging evolution 
trends of urban resilience research by scientometric analysis. Int 
J Environ Res Public Health 2018;15:18‑21.
3. World Health Organization. Risk Reduction and Emergency 
Preparedness: WHO Six‑Year Strategy for the Health Sector 
and Community Capacity Development. Geneva: World Health 
Organization; 2007.
4. Insurance Information Institute. Natural Catastrophes; 
2018. Available from:‑statistic/
facts‑statistics‑global‑catastrophes. [Last accessed on 2019 Oct 27].
5. Bakhtiari A. Country report: The Islamic Republic of Iran 
on Disaster Risk Management. Iranian National Disaster 
Management Organization; 2014 Feb. Available from: https:// › country report › IRN › 2013 › IRN_CR2013B. [Last 
accessed on 2019 Oct 27].
6. Sheikhbardsiri H, Doustmohammadi MM, Mousavi SH, 
Khankeh H. Qualitative study of health system preparedness 
for successful implementation of disaster exercises in the Iranian 
context. Disaster Med Public Health Prep 2020;7:1‑10. doi: 
7. Kaviani F, Aliakbari F, Sheikhbardsiri H, Arbon P. Nursing 
Students' Competency to Attend Disaster Situations: A Study in 
Western Iran. Disaster Med Public Health Prep. 2021;22:1-5.
8. World Health Organization. Risk Reduction and Emergency 
Preparedness: WHO Six‑Year strategy for the Health Sector 
and Community Capacity Development. Geneva: World Health 
Organization; 2007. Available from: › iris › 
handle. [Last accessed on 2019 Oct 20].
9. Khankeh H, Mohhamadi R, Ahmadi F. Facilitator and barrier 
factor for health services in natural disaster. J Rehabil 2006;6:103‑9.
10. Aghaei MH, Ebadi A, Aliakbari F, Vafadar Z. The effectiveness 
of disaster management education based on inter‑professional 
approach on military nurses’ ability to confront with disaster. 
J Mil Med 2020;22:54‑63.
11. Meretoja R, Koponen L. A systematic model to compare nurses 
‘optimal and actual competencies in the clinical setting. J Adv 
Nurs 2012;68:414‑22.
12. Farokhzadian J, Forouzi MA, Sheikhbardsiri H. Mothers and 
nurses’ perceptions of the family-centered care barriers in 
pediatric departments of an educational hospital in Iran. J Child 
Adolesc Psychiatr Nurs 2021;34(3):219-224.
13. Aminizadeh M, Saberinia A, Salahi S, Sarhadi M, Jangipour 
Afshar P, Sheikhbardsiri H. Quality of working life and 
organizational commitment of Iranian pre‑hospital paramedic 
employees during the 2019 novel coronavirus outbreak. Int J 
Healthc Manag 2021:1‑9.
14. Bahrami M, Aliakbari F, Aein F. Iranian nurses’ perception of 
essential competences in disaster response: A qualitative study. 
J Educ Health Promot 2014;3:81.
15. International Council of Nurses. Nurses: A Voice to Lead Health 
for All. Geneva: International Council of Nurses; 2019.
16. Sheikhbardsiri H, Khademipour G, Nekoei‑Moghadam M, 
Aminizadeh M. Motivation of the nurses in pre‑hospital 
emergency and educational hospitals emergency in the southeast 
of Iran. Int J Health Plann Manage 2018;33:255‑64.
17. Putra D, Rusca Kuswantoro P. Factors related to disaster 
preparedness among nurses: A sytematic review. Int Nurs Rev 
18. Mitani S, Kuboyama K, Shirakawa T. Nursing in sudden‑onset 
disasters: Factors and information that affect participation. 
Prehosp Disaster Med 2003;18:359‑65.
19. Veenema TG, Lavin RP, Griffin A, Gable AR, Couig MP, 
Dobalian A. Call to action: The case for advancing disaster nursing 
education in the United States. J Nurs Scholarsh 2017;49:688‑96.
20. Molavi‑Taleghani Y, Ebrahimpour H, Sheikhbardsiri H. 
A proactive risk assessment through healthcare failure mode and 
effect analysis in pediatric surgery department. J Compr Pediatr 
21. Mkhabela MP. An empowerment program for nurses working 
in voluntary counselling and testing services in Swaziland. In: 
Doctoral Dissertation. Swaziland: University of South Africa; 
22. Seyedin H, Ryan J, Keshtgar M. Disaster management planning 
for health organizations in a developing country. J Urban Plan 
Dev 2010;137:77‑81.
23. Esfandiari A, Heidari A, Julaee H, Rahimi SH. Survey of natural 
disasters prepared‑ness in public and private hospitals of Islamic 
republic of Iran (case study of shiraz, 2011). Int J Health Syst 
Disaster Manag 2013;1:26.
24. Huh SS, Kang HY. Effects of an educational program on disaster nursing competency. Public Health Nurs 2019;36:28‑35.
25. Loke AY, Fung OW. Nurses’ competencies in disaster nursing: 
Implications for curriculum development and public health. Int 
J Environ Res Public Health 2014;11:3289‑303.
26. Aliakbari F, Aein F, Bahrami M, Arbon P. Development, 
Psychometric Testing, and Use of a Disaster Nursing Competency 
Scale in Iran: A Mixed Methods Study. Disaster Medicine and 
Public Health Preparedness. 2021.
27. Tzeng WC, Feng HP, Cheng WT, Lin CH, Chiang LC, Pai L, et al.
Readiness of hospital nurses for disaster responses in Taiwan: 
A cross‑sectional study. Nurse Educ Today 2016;47:37‑42.
28. Sheikhbardsiri H, Mousavi SH, Doustmohammadi MM, 
Karimi M, Salahi S. The effect of educational workshop on 
emergency department nurses’ self‑efficacy in patient training. 
J Educ Health Promot 2019;8:136.
29. Nakhaei M, Shahnaz Tabiee SH, Saadatjou SA, SabzehKar F. The 
effect of educational intervention on nurses’ preparedness in 
emergencies and disasters. J Birjand Univ Med Sci 2019;26:237‑48.
30. Keating E, Edwards F, Cheryl S, RN. Most effective interventions 
for disaster relief preparation. Nurs Undergrad Work 2018;3:4-10.
31. Arbon P, Ranse J, Cusack L, Considine J, ShabanRZ, WoodmanRJ,
et al. Australasian emergency nurses’ willingness to attend work 
in a disaster: A survey. Australas Emerg Nurs J 2013;16:52‑7.
32. Rahimkhanli M, Ahmari Tehran H, Hamta A, Saadatmand V, 
Parvaresh-Masoud M. Evaluation of clinical skills of emergency 
medical technicians in jahrom in caring for trauma patients. Qom 
Univ Med Sci J 2019;13:42‑9.
33. Kumar S, Agarwal AK, Kumar A, Agrawal GG, Chaudhary S, 
Dwivedi V. A study of knowledge, attitude and practice of 
hospital consultants, resident doctors and private practitioners 
with regard to pre‑hospital and emergency care in Lucknow. 
Indian J Surg 2008;70:14‑8.
34. Nejadshafiee M. Hospital nurses’ disaster competencies. Trauma 
Mon 2020;25:89‑95.
35. Amerioun A, Mahmoudi N, Alidadi A, Sepandi M. The study 
of effect of performaning a plan of training – Exercising trauma 
maneuver on preparedness of the selected military hos staff to 
deal with crisis. Journal of Nurse and Physician Within War.