Date of Award


Degree Name

PhD Nursing

Dissertation Committee

Jane M. Georges, PhD, RN, Chair; Lois Howland, DrPH, MS, RN; Donna L. Agan, EdD


disaster preparedness, nursing, provider response to emergency pandemic tool, Psychometric evaluation


Background: History and science would suggest that a worldwide influenza pandemic is near and its implications are on the minds of healthcare workers (HCWs). Previous studies revealed that HCW have loss-related fears and concerns associated with working during a disaster, especially one with a biologic component. Most healthcare organizations have well-crafted disaster plans in place; however, these plans often rely on the assumption that HCWs will report to work as usual, which may not be the case. Objective: The purpose of this study was to determine if HCWs' fears and concerns are a predictor of their willingness to report to work (RTW) during a sustained biologic emergency. To achieve this, the Provider Response to Emergency Pandemic (PREP) Tool was developed, piloted, and evaluated. Methods: The 31 PREP Tool items were based on four Loss-subscales plus five exploratory items using a four-point Likert format. In addition, the survey included 11 demographic questions. The PREP Tool was constructed by an expert panel and pretested with a focus group. The instrument was then pilot tested with a cross-sectional convenience sample of 452 HCWs over a 3-month period. Setting: The principle investigator administered the PREP Tool survey during staff meetings at a midsized acute care hospital in the southwestern United States. Data analysis: Descriptive statistics, reliability assessment, correlations, and exploratory factor analysis were used. Results: The Cronbach's alpha reliability coefficient for each Loss-subscale to the total score was between .81 and .85. All items retained demonstrated correlation with the RTW response (Spearman's rho; p < .001) and the ability to distinguish between yes and no RTW responses (Mann-Whitney U; p < .05). Exploratory factor analysis was useful in evaluating item retention. Conclusion: The PREP Tool is a valid instrument for the assessment of HCW RTW concerns and intentions in a biologic emergency. Implications: This study provides new insights into the HCW RTW decision and introduces an instrument designed to evaluate this largely unexplored aspect of healthcare. Results from this research and future PREP Tool-based studies can inform evidence-based disaster planning.

Document Type

Dissertation: Open Access



Included in

Nursing Commons