Hospital Flood Preparedness and Flood-Related Psychological Consequences in 15 Provinces in Central Thailand after Implementation of a National Guideline

Abstract

A survey was conducted to evaluate hospital flood preparedness and the psychological impact of floods among infection preventionists (IPs) in the initial 6-month interval after flooding. All 104 secondary and tertiary care hospitals in 15 central Thailand provinces were asked to participate, and hospitals that met the inclusion criteria were identified between 1 July and 31 October 2012. The chief of IPs in each participating hospital was interviewed. 101 (97.1%) of 104 eligible hospitals responded to the survey (69 were not flooded and 32 were damaged by the flood). Among the responding hospitals, 55 (55%) had one or more infectious diseases specialist, 46 (46%) had one or more hospital epidemiologist, 65 (65%) reported good to excellent support of the infection control programmes from hospital administration, and 40 (40%) were affiliated with a medical school. The median amount of time that the respondents had been in their current position was 9 years (range, 3-30 years), and the median institutional safety score was 7 (range, 2-10). Overall, the major gaps in flood preparedness plan during floods were: (1) lack of an environmental cleaning and fungal decontamination protocol (26 (81%) of 32); (2) lack of surge capacity plans for patients and family (21 (66%) of 32); and (3) lack of exercise drill of flood protocol (16 (50%) of 32). Overall, at the initial 6-month interval, 20 (63%) of 32 lead IPs in the flood-affected hospitals complained of having some psychological consequence related to the floods (e.g., post-traumatic stress disorder (PTSD), depression, inability to concentrate, insomnia and having difficulties with family relationships). Five (20%) of the 20 lead IPs met the definition of PTSD, and 3 (15%) met the definition of depression, whereas 12 (60%) of the lead IPs complained of having some psychological consequences related to floods (difficulties with family relationship (n=6), insomnia (n=3), and inability to concentrate (n=3)). Several gaps identified during the flooding (e.g., surge capacity plans for patients and staff, plan for environmental cleaning, and fungal decontamination protocols) were significantly improved by 50-100% after implementation of the national guideline for hospital flood preparedness.