Nurses’ Preparedness for a Bioterrorist Attack

Subject: Nursing
Pages: 5
Words: 1110
Reading time:
4 min
Study level: College


The study by Smith and Hewison (2012) aimed at analyzing and evaluating the nurses’ level of preparedness in the event of a bioterrorist event. The authors saw the need to carry out the study due to the fact that terrorism is a global issue and several attacks have been reported. In addition to this, the author thought that it was still unclear whether the nurses were prepared to face a possible future bioterrorist event.

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Study Purpose

Research questions or hypotheses

This paper aimed at determining how prepared the nurses were for a bioterrorist attack. This was the main question that needed to be answered. In addition to this, the paper also attempted to determine the factors that affect the nurses’ level of preparedness. The authors also purposed to provide suggestions as to how to increase the nurses’ level of preparedness for a bioterrorist attack.


Study Design

The study design employed was the use of narrative synthesis. This involved the use of scenarios extracted from relevant literature. The sources required to have both qualitative and quantitative studies. This approach involved the combination of findings from different studies. This way, it was possible to identify some of the recurring issues and the major themes in the literature. In order to determine the suitability of an article for the study, it was necessary to examine it and note its strengths and limitations. These strengths and limitations were compared with those of other articles. The authors identified the relevant research articles by conducting a systematic search in appropriate databases (Hewison, 2012, p. 2598).


The study involved the retrieval of articles related to nurses’ preparedness for bioterrorist attacks. The databases used were credible and this ensured that the results were reliable.

Population and Sample

The authors sourced articles from various databases. However, they had to refine their searches. For this reason, they sampled four databases from which they would obtain the relevant articles. These databases included BNI, MEDLINE, EMBASE, and CINAHL. In order to single out key articles, the authors used keywords and specific dates of publishing. The authors went ahead to read the abstracts and citations in order to determine their relevance. From the total, 21 articles were selected due to relevance.

Ethical Considerations

Since this study did not involve the use of primary data, there were no major ethical considerations to make. However, it was necessary for the authors to ensure that all information sourced from the respective articles was referenced in order to acknowledge the source of the information. The researchers were also careful to avoid conflict of interest.

Data Collection


The authors conducted a narrative synthesis. Therefore, they used information from various sources to build an argument. The source of the articles was in relevant databases. However, a three-phase model was necessary to provide more refined searches. The articles were searched using specific words. The articles selected were those that were published between March 1996 and 2010. Specific areas of the articles were read in order to determine their usefulness in the current study.

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Validity and Reliability

In this study, validity and reliability were determined with the use of specific appraisal tools. It was established that the majority of the studies employed the use of questionnaires to collect data. In only one of them, there was the use of focus groups. The eight articles were checked for reliability using Greenhalgh’s appraisal tool. This was particularly due to the fact that this tool is designed to review questionnaires. Another tool was then used to determine the reliability of the article that employed focus groups to obtain data. From this assessment, the authors were able to eliminate two articles due to low reliability.


Data analysis

The data were summarized in a table and the various themes were identified. Descriptive data were used in all the seven studies that had been selected. Of these studies, five of them were analyzed using statistical analysis. The significant levels were set for the studies in order to determine that the findings were reliable. Other tools of analysis used in the various studies included the Wilcoxon’s test, the goodness of fit test, and the Chi-square test. The use of t-tests was also necessary.

Significant Findings

One of the results indicated that the perceptions of bioterrorism affected the nurses’ preparedness. From the study, it was evident that the nurses believed that bioterrorist attacks were likely to occur in the country but believed that it was less likely to occur in their community. The results also indicated that the nurses’ willingness to respond to such attacks was dependent on their level of knowledge of the situation. This knowledge may be obtained through formal education or simply by being informed of the responsible agent. Unfortunately, most had not received any bioterrorism-related education. Therefore, they were not prepared for bioterrorist attacks. The results also indicated that the nurses’ preparedness was dependent on the emergency plans and policies available. The nurses’ main concern was the availability of support from the institution. Lastly, personal factors were identified to affect preparedness. Preparedness was dependent on gender, family circumstances, and the anticipated workload associated with the nursing care.

Testing the Null Hypothesis

The authors tested the null hypotheses by first predicting the outcome. The appropriate tests were used and then the results were used to accept the null hypothesis to be true. The authors also indicated that several studies had set significant levels.


From the study, four themes were identified. The first one was the perception of bioterrorism. Another theme that was prominent was the role of formal knowledge. The other two included personal factors and the significance of institutional policies and plans. However, the main one was the willingness of the nurses to respond to such attacks.


Strengths and weaknesses

One of the weaknesses of this study is its narrow scope. Another limitation is the fact that the appraisal process did not include a process of double-blind review. However, there are several strengths. Firstly, there is enhanced rigor due to the presence of oversight of the process. The structured approach used also helps to minimize bias. There was also trustworthiness and transparency during the study.

Application and Utilization

From the results, several strategies can be applied in order to increase nurses’ preparedness. For example, training on bioterrorism may be enhanced to make nurses more prepared.

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Generalizability, Credibility, and Rigor

Since there was oversight of the process, this led to the enhancement of rigor. The results are also credible because it is believable from the participants’ perspective. However, the generalizability of the review was limited due to the fact that questionnaires were the main tools used to collect data.


Smith, C., & Hewison, A. (2012). Are nurses prepared to respond to a bioterrorist attack: A narrative synthesis. Journal of Advanced Nursing, 68(12), 2597-2609.