Through the Lens of Contextual Inquiry: Examining the Conceptual Model “Comprehensive Multi-Level Nursing Practice (CMLNP)” for Emergency Preparedness Issues in Populations with Medical Vulnerabilities

Emergencies create physical and emotional health crises in the affected population, particularly in medically vulnerable families. An approach dealing with readiness which increases community capacity is significant in that it is aligned with the World Health Organization’s overall strategy for disaster preparedness in decreasing adverse public health consequences of morbidity and mortality. Further, evaluating conceptual models considering population outcomes provides the foundation for evidence-based practice in nursing, and across public health disciplines. Utilizing the Comprehensive Multi-Level Nursing Practice (CMLNP) conceptual framework, this mixed methods study examined the nursing role in educating families on issues of emergency preparedness, which are essential for individuals with medical vulnerabilities. The purpose was to integrate nursing components of the CMLNP model, and extend to participants, to include: Personal prevention and preparedness; organization of neighboring communities; and community enrichment, using “Tell One” educational strategies for sharing information.  Consenting participants attended an educational workshop and participated in pre/posttests, and follow-up surveys. Population outcomes regarding preparedness were evaluated contextually, using assessments of cognitive knowledge and changes in behavior, and compared with the CMLNP components for the nursing role. Evaluation of the CMLNP model was performed with the stakeholders as partners in process. Themes addressed tenets of individual growth, organizational development in neighborhoods, and community empowerment. In order to formulate a basis of evidence for the conceptual model, an integrative logic model was assessed collaboratively with stakeholders, to assess short-term gains and establish future goals for readiness in families with medical vulnerabilities – utilizing an appropriate nursing framework.