From ICN Standards to Strategic Practice: The Impact of the Nursing Disaster Manager on Territorial Resilience and Mass Casualty Management

Abstract

Introduction. Effective management of large-scale local emergencies requires nursing leadership that integrates international standards with local operations. Although the Intenational Council of Nurse defines Level III nursing competencies for disaster management, the assignment of a sole Disaster Manager for provincial strategic planning remains an innovation within current healthcare system.

Methods. This study analyzes the implementation of the 'Health Specialist for Mass Emergencies' professional role at the Ferrara Local Health Authority from 2023 to 2025. The strategy transitioned from a reactive response to proactive risk analysis and inter-institutional synergy, focusing on cooperation between institutions and various emergency services.

Results. The Disaster Manager supported the updating of Mass Casualty Emergency Plans, coordinating nine annual interagency exercises and twelve in-hospital simulations across the province. Drills involved agencies to test command chains in conventional and CBRNe scenarios. Managing of four real events per year further validated the seamless coordination between the Corporate Crisis Unit and local emergency services.

Discussion. The Ferrara model demonstrates that a Nursing DM is essential for governance and safety at the hospital levels. By bridging the gap between clinical planning and interagency cooperation. This model translates ICN guidelines into evident results, creating a resilient system prepared to manage public health assistance and territorial emergency response.