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Crisis Standards of Care

Declarations implemented in disaster or emergency situations to recognize that resource shortages or limitations inhibit the continuation of everyday standards of clinical care.

Although not included as one of ICN’s core competencies, crisis standards of care are a relevant topic for disaster nursing. These resources include academic literature examining crisis standards of care and tools that may help further educate and inform disaster nursing practice.

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Academic Articles and Books

Legal Decision-making and Crisis Standards of Care: Tiebreaking During the COVID-19 Pandemic and in Other Public Health Emergencies – JAMA Health Forum (2022)

  • Viewpoint article outlining the legal challenges of crisis standards of care implementation and the standards for making tiebreaker decisions.

Hospital Planning for Contingency and Crisis Conditions: Crisis Standards of Care Lessons from COVID-19 – The Joint Commission Journal on Quality and Patient Safety (2022)

  • Reviews several gaps in planning and provides recommendations for hospitals to help ensure the ability to respond effectively and justly across the range of conventional, contingency, and crisis conditions.

Implementation of Crisis Standards of Care – Nurse Leader (2019) [paywall]

  • Describes the legal, ethical, and economic implications of disaster response within the context of nursing practice.

Diminishing disparities in U.S. crisis standards of care: Medical and legal challenges – eClinical Medicine (2021)

  • Commentary relaying guidance on how to best avoid disparities in crisis standards of care implementation within the context of the United States.
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Guidance and Training Documents

Crisis standards of care: Guidance from the AMA Code of Medical Ethics – The American Medical Association (2020)

  • Aims to provide medical providers with ethical guidelines to inform crisis standards of care implementation.

Ethics and Crisis Standards of Care – American Nurse Journal (2021)

  • Response to inquiry outlines nuances between conventional, contingency, and crisis standards of care.

Crisis Standards of Care Lessons from COVID-19 – The Joint Commission (2022)

  • Shares findings from The Joint Commission in its effort to glean lessons from the COVID-19 pandemic response on the challenges associated with the implementation of crisis standards of care practice across the United States.

COVID-19 Crisis Standards of Care: Frequently Asked Questions for Counsel – Association of American Medical Colleges (2020)

  • Provides answers to frequently asked questions about crisis standards of care.

Crisis Standard of Care COVID-19 Pandemic – American Nurses Association (2020)

  • Provides guidelines for crisis standards of care during the COVID-19 pandemic, including insights for both nurse practitioners and their institutions.

Crisis Standards of Care and COVID-19: What Did We Learn? How Do We Ensure Equity? What Should We Do? – National Academy of Medicine (2021)

  • Relays lessons in crisis standards of care management and insights into how to ensure equitable application of the practice in future health emergencies.
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Webinars, Podcasts, and Other New Media

Crisis Standards of Care – American Nurses Association

  • 10-minute video outlines the American Nurses Association’s Code of Ethics and provides insights on crisis standards of care and the management of scarce medical resources.

Evolving Crisis Standards of Care and Lessons Learned: A Workshop Series – The National Academies of Science, Engineering, and Medicine (2021)

  • Series of 5 public workshops designed to provide a complete overview of crisis standards of care for those in medical practice.

Crisis Standards for Care and Staffing for Surge During COVID-19 – American Association of Colleges of Nursing (2020)

  • Webinar describing nuances of crisis standards of care and staffing for nurse practitioners, specifically tied to the COVID-19 pandemic response.
International Resource Center for Pandemic and Disaster Nursing
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