Are nurses prepared to respond to a bioterrorist attack: a narrative synthesis


C. Smith: e-mail:


Aim.  To report a review and narrative synthesis conducted to analyse and evaluate nurses’ preparedness to respond to a bioterrorist event.

Background.  The anthrax attack on the USA in 2001 resulted in the development of global response strategies for future bioterrorist events. However, despite these actions, it remains unclear whether nurses are prepared to respond to such events.

Data sources.  A search for relevant research articles was conducted using the MEDLINE, CINAHL, BNI, and EMBASE databases to locate articles published in the period 1996–March 2010.

Design.  Narrative Synthesis

Review methods.  A narrative synthesis of qualitative and quantitative studies was undertaken and the articles reviewed using Greenhalgh’s critical appraisal criteria. The review was conducted with inclusion and exclusion criteria applied to ensure the studies examined focussed on the hospital nurse’s role in responding to a bioterrorist event.

Results.  Seven original research studies were included in the review. Four themes were identified as affecting nurses’ preparedness for a bioterrorist attack. These were perceptions of bioterrorism, the role of formal knowledge, the role of institutional plans and policies, and personal factors. The overarching theme centred on nurses’ willingness to respond to a bioterrorist event. It was clear that, although nurses were willing to respond to a bioterrorist attack, they felt unprepared to do so.

Conclusions.  Existing nurse education in areas such as infection control can incorporate bioterrorism training to improve preparedness, yet nurses must also prepare themselves personally for a bioterrorist attack.