I need two copies. One for my and one for my friend. Total 6 pages. It’s 3 Pages each. I attached the articles. Read the Instruction what you required to do. I also attached the example of my previous week Case summary so you know how it’s should like. No Plagiarism.  

Scoring Guide (20% for each section)

Part 1: Article Summary

In 3 or 4 sentences the student correctly and clearly summarizes the key points in the chosen article. Make sure the exact title of the article and the author(s) is identified in the first sentence or in the heading above this section.

Part 2: Problem section

In a paragraph or two the student briefly describes their current or former company. Then the student describes a problem or issue this company is having that relates to the article in part 1. The student’s writing is clear, complete, and professional.

Part 3: HR initiative section

The student comes up with a HR initiative that addresses the problem described in part 2. The student’s writing is clear, complete, and professional.

Part 4: Implementation challenge section

The student identifies a major implementation challenge associated with his/her initiative described in part 3. The student’s writing is clear, complete, and professional.

Part 5: Evaluation section

The student describes how he/she would evaluate the success of his/her initiative. The criteria that will be used and when the data will be collected is also described in this section. The student’s writing is clear, complete, and professional.

Please make sure you
use these headings in your paper
so it’s clear to me when one section ends and the next one begins.

1/27/2020

Hiring a coder: How to recruit and retain the right candidate

PART 1: SUMMARY.

According to Kimberly Clark, the main cause of o lost revenue in medical practice is inaccurate coding which shows just how significant it is to have a professional coder on the staff. Because of the demand available for skilled coders, it is a challenge to find and recruit the right candidate due to the competition available for the employers. Ms. Clark therefore suggests training an internal employee within the organization or company who the company preferentially wants to retain to have those coding skills instead of hiring an outsider. However, if this option is not available, Ms. Clark suggests 5 tips to help recruit a coder: determine your coding needs, describe your ideal candidate, create a compelling job advertisement, recruiting from the right place and asking the right questions. These tips are meant to establish the roles and responsibilities of the coder, their qualifications, where to find them as well as the right questions to ask so as to identify if you are hiring the right person for the job. She particularly emphasizes on the need to focus on the skills that the person has and not just hiring anybody to fill up the position.

PART 2: PROBLEM.

I have previously worked at the North-western memorial hospital in the position of a nurse on internship. During my internship, I noticed several documentation issues that arose at the hospital. There was only one coder who was often overwhelmed by the magnitude of the work from the patients. Some documentations went missing from the patient files or were simply not documented due to poor follow up. In some cases, the information provided to the coders was not enough leading to the problem of not coding to the highest level. The coder sometime reported less expensive or more expensive medical services than was actually performed hence leading to the problem of under coding or over coding due to lack of system audits.

PART 3: HR INITIATIVE.

The HR team needs to take initiatives to change their perception of the importance of a coder in the health care sector. As Ms. Clark puts it in her article, it is very important to have a professional coder as part of the medical staff. They therefore need to hire more professional coders to be part of the medical staff. Hiring coders from outside would help to manage the huge volume of information that needs to be coded at the healthcare facility and enable a smooth flow of work. A better solution that the HR team can come up with is training part of their staff in coding so that they avoid the high costs of hiring a coder from outside. The HR team may still hire a professional coder from outside but they need to change their hiring criteria so as to hire the right person by following the five tips given by Ms. Clark in her article. The HR team needs to focus not just on the skills but also the ethics of the coders such that they are able to record the true values of the medical services in order to eliminate the problem of under coding and over coding. The HR team might also introduce human resource assessment and audit plans so as to get reduce the instances of infidelity or doing substandard work than is required. This would prevent the providers from giving incomplete or less information to the coders hence eliminating the problem of failing to code to the highest level. Automating the process and using up to date protocols would also help to fast track the speed of the work hence reducing piling of information that needs to be coded.

PART 4: IMPLEMENTATION CHALLENGE.

The implementation challenge that is likely to emerge include ethical challenges. If the hired person has no ethics, they may increase the problem of under coding or over coding as well as not coding to the highest level. Furthermore, if part of the employees is trained to code, they may have a conflict of interest between their initial work and coding. Apart from the training interfering with their initial work, trainees may also opt for another job in the more lucrative coding field.

PART 5: EVALUATION.

To evaluate the impact of the HR initiative, the organization may use statistical tallying of the number of recorded cases of over coding, under coding or failing to code to the highest level. Self-appraisal of the employees including the coders and the providers of information can also help to ensure accuracy in coding.

References

Heywood, N. A., Gill, M. D., Charlwood, N., Brindle, R., Kirwan, C. C., Allen, N., … &Forrest, L. (2016). Improving accuracy of clinical coding in surgery.

Sehjal, R., & Harries, V. (2016). Awareness of clinical coding.

10 American Nurse Today Volume 13, Number 5 AmericanNurseToday.com

ROBERT, a 78-year-old patient, re-

quests help getting to the bath-

room. When the nurse, Ellen, en-

ters the room, Robert’s lying in

bed, but when she introduces her-

self, he lunges at her, shoves her to

the wall, punches her, and hits her

with a footstool. Ellen gets up from

the floor and leaves the patient’s

room. She tells her colleagues what

happened and asks for help to get

the patient to the bathroom. At the

end of the shift, Ellen has a

swollen calf and her shoulder

aches. One of her colleagues asks

if she’s submitted an incident re-

port. Ellen responds, “It’s all in a

day’s work. The patient has so

many medical problems and a his-

tory of alcoholism. He didn’t in-

tend to hurt me. What difference

would it make if I filed a report?”

These kinds of nurse-patient in-

teractions occur in healthcare set-

tings across the United States, and

nurses all too frequently minimize

their seriousness. However, accord-

ing to the National Institute for Oc-

cupational Safety and Health, “…

the spectrum [of violence]…ranges

from offensive language to homi-

cide, and a reasonable working

definition of workplace violence is

Patient violence:
It’s not all in a day’s work

Strategies for reducing patient violence and
creating a safe workplace

By Lori Locke, MSN, RN, NE-BC; Gail Bromley, PhD, RN; Karen A. Federspiel, DNP, MS, RN-BC, GCNS-BC

AmericanNurseToday.com May 2018 American Nurse Today 11

as follows: violent acts, including

physical assaults and threats of as-

sault, directed toward persons at

work or on duty.” In other words,

patient violence falls along a con-

tinuum, from verbal (harassing,

threatening, yelling, bullying, and

hostile sarcastic comments) to

physical (slapping, punching, bit-

ing, throwing objects). As nurses,

we must change our thinking: It’s

not all in a day’s work.

This article focuses on physical

violence and offers strategies you

can implement to minimize the

risk of being victimized.

Consequences of patient
vio

lence

In many cases, patients’ physical vi-

olence is life-changing to the nurses

assaulted and

those who witness it.

(See Alarming statistics.) As a re-

sult, some nurses leave the profes-

sion rather than be victimized—a

major problem in this era of nurs-

ing shortages.

Too frequently, nurses consider

physical violence a symptom of the

patient’s illness—even if they sus-

tain injuries—so they don’t submit

incident reports, and their injuries

aren’t treated. Ultimately, physical

and psychological insults result in

distraction, which contributes to a

higher incidence of medication er-

rors and negative patient outcomes.

Other damaging consequences in-

clude moral distress, burnout, and

job dissatisfaction, which can lead

to increased turnover. However,

when organizations encourage

nurses to report violence and pro-

vide education about de-escalation

and prevention, they’re able to alle-

viate stress.

Workplace violence prevention
Therapeutic communication and as-

sessment of a patient’s increased

agitation are among the early clini-

cal interventions you can use to

prevent workplace violence. Use

what you were taught in nursing

school to recognize behavioral

The statistics around patient violence against nurses are alarming.

67% of all nonfatal workplace violence injuries occur in healthcare, but health-
care represents only 11.5% of the U.S. workforce.

Emergency department (ED) and psychiatric nurses are at
highest risk for patient

violence.

Hitting, kicking, beating, and shoving incidents are most reported.

25% of psychiatric nurses experience disabling injuries from patient assaults.

At one regional medical center, 70% of 125 ED nurses were
physically assaulted in 2014.

Sources: Emergency Nurses Association (ENA) Emergency department violence surveillance study 2011;
ENA Workplace violence toolkit 2010; Gates 2011; Li 2012.

Alarming statistics

Effective communication is the first line of defense against patient violence. These

tips can help:

• To build trust, establish rapport and set the tone as you respond to patients.
• Meet patients’ expectations by listening, validating their feelings, and respond-

ing to their needs in a timely manner.

• Show your patients respect by introducing yourself by name and addressing
them formally (Mr., Ms., Mrs.) unless they state another preference.

• Explain care before you provide it, and ask patients if they have questions.
• Be attentive to your body language, gestures, facial expressions, and tone of

voice. Patients’ behavior may escalate if they perceive a loss of control, and

they may not hear what you say.

• Control your emotions and maintain neutral, nonthreatening body language.
• Strive for communication that gives the patient control, when possible. Example:

“Which of your home morning routines would you like to follow while you’re in

the hospital? Would you like to wash your hands and face first, eat your break-

fast, and then brush your teeth?”

• Offer a positive choice before offering less desirable ones. Example: “Would
you prefer to talk with a nurse about why you’re upset, or do you feel as

though you will be so angry that you need to have time away from others?”

• Only state consequences if you plan to follow through.
• Listen to what patients say or ask, and then validate their requests.
• Discuss patients’ major concerns and how they can be addressed to their sat-

isfaction.

Despite these strategies, patients may still become upset. If that occurs, try these

strategies to de-escalate the situation before it turns violent.

• Nonverbal communication. “I see from your facial expression that you may
have something you want to say to me. It’s okay to speak directly to me.”

• Challenging verbal exchange. “My goal is to be helpful to you. If you have
questions or see things differently, I’m willing to talk to you more so that we

can understand each other better, even if we can’t agree with one another.”

• Perceptions of an incident or situation. “We haven’t discussed all aspects of
this situation. Would you like to talk about your perceptions?”

Communication strategies

12 American Nurse Today Volume 13, Number 5 AmericanNurseToday.com

changes, such as anxiety, confu-

sion, agitation, and escalation of

verbal and nonverbal signs. Individ-

ually or together, these behaviors

require thoughtful responses. Your

calm, supportive, and responsive

communication can de-escalate pa-

tients who are known to be poten-

tially violent or those who are an-

noyed, angry, belligerent, demeaning,

or are beginning to threaten staff.

(See Communication strategies.)

Other strategies to prevent work-

place violence include applying

trauma-informed care, assessing for

environmental risks, and recognizing

patient triggers.

Trauma-informed care
Trauma-informed care considers the

effects of past traumas patients ex-

perienced and encourages strategies

that promote healing.

The Substance Abuse and Mental

Health Services Administration says

that a trauma-informed organization:

• realizes patient trauma experi-

ences are widespread

• recognizes trauma signs and

symptoms

• responds by integrating knowl-

edge and clinical competencies

about patients’ trauma

• resists retraumatization by being

sensitive to interventions that

may exacerbate staff-patient in-

teractions.

This approach comprises six

principles: safety; trustworthiness

and transparency; peer support;

collaboration and mutuality; em-

powerment, voice, and choice;

and cultural, historical, and gender

issues. Applying these principles

will enhance your competencies

so that you can verbally intervene

to avoid conflict and minimize pa-

tient retraumatization. For more

about trauma-informed care, visit

samhsa.gov/nctic/trauma-interventions.

Environmental risks
To ensure a safe environment, iden-

tify objects in patient rooms and

nursing units that might be used to

injure someone. Chairs, footstools,

I.V. poles, housekeeping supplies,

and glass from lights or mirrors can

all be used by patients to hurt them-

selves or others. Remove these ob-

jects from all areas where violent

patients may have access to them.

Patient triggers
Awareness of patient triggers will

help you anticipate how best to in-

teract and de-escalate. (See Patient

triggers.) Share detailed information

about specific patient triggers dur-

ing handoffs, in interdisciplinary

planning meetings, and with col-

leagues in safety huddles.

What should you do?
You owe it to yourself and your fel-

low nurses to take these steps to

ensure that your physical and psy-

chological needs and concerns are

addressed:

• Know the definition of work-

place violence.

• Take care of yourself if you’re

assaulted by a patient or witness

violence.

• Discuss and debrief the incident

with your nurse manager, clinical

supervisor, and colleagues.

• Use the healthcare setting’s inci-

dent reporting to report and doc-

ument violent incidents and in-

juries.

• File charges based on your

state’s laws.

Your organization should pro-

vide adequate support to ensure

that when a nurse returns to work

after a violent incident, he or she

is able to care for patients. After

any violent episode, staff and nurse

leaders should participate in a thor-

ough discussion of the incident to

understand the dynamics and root

cause and to be better prepared

to minimize future risks. Effective

communication about violent pa-

tient incidents includes handoffs

that identify known risks with spe-

cific patients and a care plan that

includes identified triggers and clin-

ical interventions.

Influence organizational safety
You and your nurse colleagues are

well positioned to influence your

organization’s culture and advocate

for a safe environment for staff and

patients. Share these best practices

with your organization to build a

comprehensive safety infrastructure.

• Establish incident-reporting sys-

tems to capture all violent inci-

dents.

• Create interprofessional work-

place violence steering commit-

tees.

• Develop organizational policies

and procedures related to safety

and workplace violence, as well

as human resources support.

• Provide workplace violence-pre-

vention and safety education us-

ing evidence-based curriculum.

• Design administrative, director,

and manager guidelines and re-

sponsibilities regarding commu-

nication and staff support for

victims of patient violence and

those who witness it.

• Use rapid response teams (in-

cluding police, security, and pro-

Recognizing and understanding pa-

tient triggers may help you de-esca-

late volatile interactions and prevent

physical violence.

Common triggers

• Expectations aren’t met

• Perceived loss of independence

or control

• Upsetting diagnosis, prognosis,

or disposition

• History of abuse that causes an

event or interaction to retrauma-

tize a patient

Predisposing factors

• Alcohol and substance withdrawal

• Psychiatric diagnoses

• Trauma

• Stressors (financial, relational, sit-

uational)

• History of verbal or physical vio-

lence

Patient triggers

tective services) to respond to
violent behaviors.

• Delineate violence risk indicators
to proactively identify patients
with these behaviors.

• Create scorecards to benchmark
quality indicators and outcomes.

• Post accessible resources on the
organization’s intranet.

• Share human resources contacts.

Advocate for the workplace you
deserve
Physically violent patients create
a workplace that’s not conducive
to compassionate care, creating
chaos and distractions. Nurses
must advocate for a culture of
safety by encouraging their organ-
ization to establish violence-pre-
vention policies and to provide
support when an incident occurs.

You can access violence-preven-
tion resources through the Ameri-
can Nurses Association, Emergency
Nurses Association, Centers for Dis-
ease Control and Prevention, and
the National Institute for Occupa-
tional Safety and Health. Most of
these organizations have interactive
online workplace violence-preven-
tion modules. (See Resources.) When
you advocate for safe work envi-
ronments, you protect yourself and
can provide the care your patients
deserve.

The authors work at University Hospitals of Cleve-

land in Ohio. Lori Locke is the director of psychiatry

service line and nursing practice. Gail Bromley is the

co director of nursing research and educator. Karen A.

Federspiel is a clinical nurse specialist III.

Selected references
Cafaro T, Jolley C, LaValla A, Schroeder R.

Workplace violence workgroup report. 2012.

apna.org/i4a/pages/index.cfm?pageID=4912

Emergency Nurses Association. ENA toolkit:

Workplace violence. 2010. goo.gl/oJuYsb

Emergency Nurses Association, Institute for

Emergency Nursing Research. Emergency

Department Violence Surveillance Study.

2011. bit.ly/2GvbJRc

Gates DM, Gillespie GL, Succop P. Violence

against nurses and its impact on stress and

productivity. Nurs Econ. 2011;29(2):59-66.

National Institute for Occupational Safety

and Health. Violence in the workplace:

Current intelligence bulletin 57. Updated

2014. cdc.gov/niosh/docs/96-100/introduc

tion.html

Occupational Safety and Health Administra-

tion. Guidelines for Preventing Workplace

Violence for Healthcare and Social Service

Workers. 2016. osha.gov/Publications/osha

3148

Speroni KG, Fitch T, Dawson E, Dugan L,

Atherton M. Incidence and cost of nurse

workplace violence perpetrated by hospital

patients or patient visitors. J Emerg Nurs.

2014;40(3):218-28.

Substance Abuse and Mental Health Servic-

es Administration. Trauma-informed ap-

proach and trauma-specific interventions.

Updated 2015. samhsa.gov/nctic/trauma-

interventions

Wolf LA, Delao AM, Perhats C. Nothing

changes, nobody cares: Understanding the

experience of emergency nurses physically

or verbally assaulted while providing care. J

Emerg Nurs. 2014;40(4):305-10.

• American Nurses Association (ANA) (goo.gl/NksbPW): Learn more about

different levels of violence and laws and regulations, and access the ANA posi-

tion statement on incivility, bullying, and workplace violence.

• Centers for Disease Control and Prevention (cdc.gov/niosh/topics/vio-

lence/training_nurses.html): This online course (“Workplace violence preven-

tion for nurses”) is designed to help nurses better understand workplace vio-

lence and how to prevent it.

• Emergency Nurses Association (ENA) toolkit (goo.gl/oJuYsb): This toolkit

offers a five-step plan for creating a violence-prevention program.

• The Joint Commission Sentinel Event Alert: Physical and verbal violence

against health care workers (bit.ly/2vrBnFw): The alert, released April 17,

2018, provides an overview of the issue along with suggested strategies.

Resources Screen & Intervene:

Addressing Food

Insecurity Among

Older Adults

FREE Online Course

Check out
the course today at

senior health and hunger.org

Hunger is a

health issue.

People experiencing food

insecurity are more likely to

suffer from chronic

conditions such as

diabetes, heart disease and

depression. In just 60

minutes, health care

providers and community-

based partners can learn

how to screen patients age

50 and older for food

insecurity and connect

them to key nutrition

resources.

This Enduring Material activity, Screen and

Intervene: Addressing Food Insecurity

Among Older Adults, has been reviewed

and is acceptable for up to 1.00 Elective

credit(s) by the American Academy of

Family Physicians. AAFP certification

begins 10/28/2017. Term of approval is

for one year from this date. Physicians

should claim only the credit commensurate

with the extent of their participation in the

activity.

AmericanNurseToday.com May 2018 American Nurse Today 13

http://www.feedingamerica.org/research/senior-hunger-research/spotlight-on-senior-health.html

http://www.feedingamerica.org/research/senior-hunger-research/spotlight-on-senior-health.html

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30 Volume 82 • Number 1

A D V A N C E M E N T O F T H E PRACTICE

A D V A N C E M E N T O F T H E PRACTICE

 D I R E C T F R O M C D C E N V I R O N M E N T A L H E A L T H S E R V I C E S

I ntroductionEmergency response and recovery work-ers might be exposed to multiple hazard-
ous conditions and stressful work environ-
ments when responding to a public health
emergency. Previous emergency events have
demonstrated that significant gaps and defi-
ciencies in responder health and safety con-
tinue to exist (Michaels & Howard 2012,
Newman, 2012). Ensuring the health and

safety of emergency response and recovery
workers who might be exposed to hazardous
conditions and stressful work environments
when responding to a public health emer-
gency should remain a top priority (Kitt et al.,
2011). The National Response Framework
contains a Worker Safety and Health Annex
detailing responsibilities for safety and health
during major emergencies, including roles
for the National Institute for Occupational

Safety and Health (NIOSH) such as exposure
assessment and personal protective equip-
ment determination.

The NIOSH Emergency Preparedness
and Response (EPR) Program was created
in 2002 following the events of 9/11, which
included attacks on the World Trade Center
and Pentagon, and the anthrax letter terrorist
attacks. The goal of the NIOSH EPR Program
is to coordinate emergency preparedness
and response within NIOSH and improve
NIOSH’s ability to respond to future emergen-
cies and disasters. The NIOSH EPR Program
protects the health and safety of emergency
response and recovery workers through the
advancement of research and collaborations
to prevent diseases, injuries, and fatalities in
anticipation of and during responses to natu-
ral and human-induced disasters and novel
emergent events.

The NIOSH EPR Program participates in
response planning at the local, state, national,
and international levels to ensure the timely
identification of health hazards associated
with emergency responses and implementa-
tion of adequate protection measures; support
the Centers for Disease Control and Preven-
tion’s (CDC) emergency response efforts; and
use the Disaster Science Responder Research
Program to identify research needs to protect
emergency response and recovery workers
while identifying solutions to rapidly support
research during emergencies. Training for
emergency response and recovery workers is
an integral part of the NIOSH EPR Program.
This column highlights the NIOSH EPR Pro-
gram training opportunities and activities.

E d i t o r ’s N o t e : NEHA strives to provide up-to-date and relevant
information on environmental health and to build partnerships in the

profession. In pursuit of these goals, we feature this column on environmental

health services from the Centers for Disease Control and Prevention (CDC)

in every issue of the Journal.

In these columns, authors from CDC’s Water, Food, and Environmental

Health Services Branch, as well as guest authors, will share insights and

information about environmental health programs, trends, issues, and

resources. The conclusions in these columns are those of the author(s) and

do not necessarily represent the official position of CDC.

Kerton Victory is an environmental health specialist and emergency

coordinator with the National Institute for Occupational Safety and

Health’s (NIOSH) Emergency Preparedness and Response Office (EPRO).

Jill Shugart is a senior environmental health specialist and the Emergency

Responder Health Monitoring and Surveillance coordinator with NIOSH

EPRO. Sherry Burrer is a senior epidemiologist and emergency coordinator

with NIOSH EPRO. Chad Dowell is the NIOSH deputy associate director for

emergency preparedness and response. Lisa Delaney is the NIOSH associate

director for emergency preparedness and response.

Insights Into the National Institute
for Occupational Safety and
Health’s Emergency Preparedness
and Response Program

1 figure, 1 table, 1 photo, 1 sidebar, 5 authors

Kerton R. Victory, MSc, PhD, REHS
Jill Shugart, MSPH, REHS

Sherry Burrer, MPH-VPH, DVM, DACVPM
Chad H. Dowell, MS, CIH
Lisa J. Delaney, MS, CIH

National Institute for
Occupational Safety and Health

JEH7.19_PRINT.indd 30 6/14/19 9:53 AM

July/August 2019 • Journal of Environmental Health 31

A D V A N C E M E N T O F T H E PRACTICEA D V A N C E M E N T O F T H E PRACTICE

Training Opportunities
and Activities
The NIOSH EPR Program has trained over
1,000 public health professionals and emer-
gency responders through its Emergency
Responder Health Monitoring and Sur-
veillance (ERHMS) training courses from
2015−2018 (Table 1). ERHMS is a health
monitoring and surveillance framework
that includes recommendations and tools
specific to protect emergency responders
during all phases of a response—prede-
ployment, deployment, and postdeploy-
ment (Shugart, 2017). The goals of ERHMS
are to prevent short- and long-term illness
and injury in emergency responders and
to ensure workers can respond safely and
effectively to future emergencies. ERHMS
principles are scalable to both small and
large events, including federal-, state-,
local-, tribal-, and territorial-level responses
(Figure 1).

In addition to ERHMS, the NIOSH EPR
Program also created a responder health
and safety training module for CDC’s En-
vironmental Health Training in Emergency
Response and Public Health Readiness
Certificate Program courses. These courses
are offered to CDC staff, as well as to other
federal, state, and local health agencies, and
have trained over 450 public health profes-
sionals from 2015−2018 (Table 1). The re-
sponder safety and health training module
highlights the importance of critical per-
sonnel, equipment, training, and other re-
sources needed to ensure that all workers
are protected from all hazards during a pub-
lic health emergency. While space is limited
to attend these in-person trainings, anyone
wishing to attend this course can contact
CDC’s School of Preparedness and Emer-
gency Response.

The NIOSH EPR Program also developed
a number of free courses that are offered on
NIOSH’s website. Recognizing that many re-
sponse and recovery workers are required to
work long hours during responses, NIOSH
developed the Interim NIOSH Training for
Emergency Responders: Reducing Risks As-
sociated With Long Work Hours to describe
personal strategies to promote good sleep
and other safe work practices during a pub-
lic health emergency. Additionally, the NIOSH
EPR Program developed the Anthrax: Instruc-
tor Training in 2014. The training is a collec-

Overview of the Emergency Responder Health Monitoring and
Surveillance Info Manager software tool developed by the
National Institute for Occupational Safety and Health’s Emergency
Preparedness and Response Program

FIGURE 1

Number of Public Health Professionals Who Completed the ERHMS
and Responder Health and Safety Training Modules for EHTER and
PHRCP Courses, 2015−2018

Year ERHMS EHTER PHRCP Total

2015 255 19 − 274

2016 255 85 61 401

2017 225 70 83 378

2018 210 72 59 341

Total 945 246 203 1,394

ERHMS = Emergency Responder Health Monitoring and Surveillance; EHTER = Environmental Health Training in
Emergency Response; PHRCP = Public Health Readiness Certificate Program.

TABLE 1

JEH7.19_PRINT.indd 31 6/14/19 9:53 AM

32 Volume 82 • Number 1

A D V A N C E M E N T O F T H E PRACTICE

tion of train-the-trainer resources including
a slide presentation, videos, and handouts to
teach responders how to collect, decontami-
nate, and ship samples. Sampling procedures
taught in the training follow CDC’s recom-
mended gold-standard surface sampling pro-
cedures for Bacillus anthracis spores (Photo 1).

Through course feedback and program
evaluation, the NIOSH EPR Program con-
tinues to refi ne and update its trainings and
preparedness activities for the next genera-
tion of public health professionals and emer-
gency responders. The program also actively
works with other federal agencies such as
the Federal Emergency Management Agen-
cy, as well as state and local health agencies
and other stakeholders, to integrate key
components of responder health and safety

into new and existing trainings and provide
technical assistance to these agencies. More
information about the NIOSH EPR Program
can be found on its website (see Quick
Links).

Corresponding Author: Kerton R. Victory,
Environmental Health Specialist, Centers
for Disease Control and Prevention/National
Institute for Occupational Safety and Health,
1600 Clifton Road, MS E-20, Atlanta, GA
30329. E-mail: kvictory@cdc.gov.

References
Kitt, M.M., Decker, J.A., Delaney, L., Funk,

R., Halpin, J., Tepper, A., . . . Howard, J.
(2011). Protecting workers in large-scale
emergency responses: NIOSH experience

in the Deepwater Horizon response. Jour-
nal of Occupational and Environmental Med-
icine, 53(7), 711–715.

Michaels, D., & Howard, J. (2012, July 18).
Review of the OSHA-NIOSH response to
the Deepwater Horizon oil spill: Protecting
the health and safety of cleanup workers.
PLOS Currents Disasters, Edition 1.

Newman, D.M. (2012). Protecting disas-
ter responder health: Lessons (not yet?)
learned. NEW SOLUTIONS: A Journal of
Environmental and Occupational Health
Policy, 21(4), 573–590.

Shugart, J.M. (2017). Utilizing the Emer-
gency Responder Health Monitoring and
Surveillance System to prepare for and
respond to emergencies. Journal of Envi-
ronmental Health, 80(4), 44–46.

• National Institute for Occupational
Safety and Health’s (NIOSH)
Emergency Preparedness and
Response Program: www.cdc.gov/
niosh/programs/epr/default.html

• Emergency Responder Health
Monitoring and Surveillance: www.
cdc.gov/niosh/erhms/default.html

• Interim NIOSH Training for
Emergency Responders: Reducing
Risks Associated With Long Work
Hours: www.cdc.gov/niosh/emres/
longhourstraining

• Anthrax: Instructor Training: www.
cdc.gov/niosh/topics/anthrax/
training.html

Quick Links

Photo 1. The National Institute for Occupational Safety and Health’s (NIOSH) Emergency
Preparedness and Response Program staff demonstrate how to sample for Bacillus anthracis spores.
Photo courtesy of NIOSH.

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