Date of Conferral





Health Services


Kourtney Nieves


An improvised nuclear device (IND) is considered by the DHS to be the most catastrophic terrorist incident that could befall the United States, causing severe economic damage, extensive property damage, and enormous loss of life. Effective response to an IND is best accomplished with preparation including emergency operations plans (EOP) specific to an IND and training for staff on how to respond. The literature documents several areas of weakness in U.S. health services' preparation that affects entire communities and puts lives at risk. The purpose of this study was to assess the strengths, weaknesses, and gaps in Detroit, Michigan hospitals' EOP for responding to an IND terrorist attack. The conceptual framework used systems theory to look at how an event's complex individual components work as parts of a larger whole. Specifically, the interconnections that the individual parts of an event have on the outcome were assessed as means of evaluating the IND EOP that Detroit area hospitals have in place. This qualitative study consisted of an interview approach with the emergency management representatives of Detroit hospitals responsible for EOP development. Data analysis was completed using categorization based on research questions to look for commonalities and trends. This study revealed gaps that the 5 participating Detroit hospitals have in their preparation, training, and staff knowledge in response to an IND. Implications for positive social change, at local and national levels, include creation and dissemination of an improved model for disaster planning and training in the hospital setting, which correlates to improved community response and community care for health service organizations and throughout health services as a whole.