HD599 Unit 10 Capstone Document Example

Fourteen Pages for the Chief: A Unit 10 Capstone Document on Cutting Post-Fire Exposure Among Kessling Valley's Volunteers

[Student Name]

Purdue University Global

HD599: Master's Capstone in Health Education and Promotion

Unit 10 Capstone Document

[Instructor Name]

[Date]

Kessling Valley Fire Protection District, its board, members, meetings and figures are composite; the cancer classification, exposure, decontamination, behavior and reporting sources cited are real.

Preface: Why Two Parts

A fire chief will not read a methods chapter, and a program reviewer needs one. This document therefore has two parts. Part one, fourteen pages, is written for the district and stands alone; it could be detached and filed at Station 1. Part two carries what the program requires and refers forward to part one's pages rather than repeating them, so every figure exists in one version only. Throughout both parts, past tense describes what was done and conditional tense describes what is proposed or pending. The second gear extractor, for example, would be installed if the board funds it; it is not installed.

Part One: For the District

The problem. In the six months before this project, the decontamination box was checked in 19 forms out of 141 (13 percent), and members carried unbagged gear home in their own cars. An international expert panel placed firefighting in the top cancer-hazard category in 2022 (Demers et al., 2022), and studies have found contamination on firefighters' gear, hoods and necks after fires (Fent et al., 2017).

What was done. A barrier survey of the 58 volunteer interior firefighters drew 41 responses; the most common barrier was having no spare hood. The district's 2024 guideline was revised with members and issued as an interim guideline. Decontamination kits went on six apparatus, twenty spare hoods went into service, a twelve-minute drill was held at each station, and the exposure form was reissued with fields for hood exchange and how gear traveled home. A cold-weather variant was added after water froze at a vehicle fire, and a radio call was added after crews were seen waiting for someone to start.

What changed. Over five weeks and seven fires, forms recorded gross decontamination for 27 of 44 member exposures, 61 percent; gear bagged before entering a vehicle for 30 of 44, 68 percent; and hood exchange for 25 of 44, 57 percent. At three fires with an independent observer, forms and observation agreed on gross decontamination for 17 of 19 exposures.

What these results do and do not mean. The rise from 13 to 61 percent happened in the district's own records, but seven fires is a small base, there was no comparison district, the form was revised during the project, and the person collecting data was a district lieutenant. The results show that the practices are workable at Kessling Valley fires. They do not prove that the project alone caused the change or that members' exposure fell.

The guideline as adopted. The board of fire commissioners adopted SOG 4.12 at its regular meeting and funded forty additional hoods for $5,200. The second extractor, quoted at $13,400 installed, was placed in the draft capital plan for next year and would shorten hood routing from Station 3 if funded.

Decisions still open. Mutual aid: does the district offer its guideline to the neighbors who answer half its structure fires? Vehicles: must members who have no trunk or bed leave gear at a station? Capital: does the extractor go into next year's budget?

Part one can be handed to the chief as it stands, because it says what happened, what the numbers mean and do not mean, and what the district still has to decide, without asking the chief to read anything written for the program.

Part Two: For the Program

Methodology, revised. The design remained a within-district before-and-after comparison restricted to the unchanged gross decontamination field, as defended in Unit 3. Two revisions followed from execution: observation took place at three fires rather than five, and the cold-weather variant was recorded as a separate method on the form. Context and concurrent events were logged as reporting guidance for improvement work recommends (Ogrinc et al., 2016).

Evidence base. The Unit 4 synthesis found strong evidence of contamination on gear and skin, strong evidence that washing gear on the fireground and wiping the neck lower surface contamination (Fent et al., 2017), limited evidence on absorbed dose, with one package of fireground changes lowering urinary markers in most crew positions (Burgess et al., 2020), limited evidence on what changes firefighters' habits (Harrison et al., 2018), and almost none on volunteers who carry gear home in private vehicles. See part one, page 3, for the summary the district received.

Execution record. Four deviations were logged with dates, decisions and approvers: the hood backorder, the canceled Station 3 drill, the frozen water and the waiting crews. Each is summarized in part one, page 5.

Framework. Intervention parts were matched to barriers classed as capability, opportunity or motivation (Michie et al., 2011). Hoods and kits addressed opportunity, drills addressed capability, and the radio call addressed a prompt the crews lacked.

Competency portfolio, updated. After the board meeting, the Advocacy entry moved from designed to executed, citing the meeting date and the minutes recording the motion's passage. The Communication entry for the guideline moved to executed when the chief signed the adopted version. The withdrawn outcome evaluation claim stays withdrawn.

Limitations of This Project

Seven fires and 44 exposures are too few to estimate a stable rate. The exposure form was revised during the project, so only one field supports a before-and-after comparison. The writer observed colleagues and is an officer in the district, and in the two disagreements between form and observation, the form recorded more decontamination than the observer saw. The mutual-aid companies, present at roughly every second structure fire in the valley, were outside scope. Hood exchange was limited for most of the period by a backorder. The cold-weather variant has not been tested by any study. None of these limits is general to all improvement projects; each is particular to what happened at Kessling Valley.

Handoff

Each piece of the project has a district owner once the term ends.

1. SOG 4.12 and its annual review: the fire chief.

2. Exposure form and quarterly summary of its fields: the training officer.

3. Hood routing between stations and the extractor schedule: the Station 1 duty officer.

4. Kit restocking and weekly clean-hood bin checks: the training officer.

5. The extractor request in next year's capital plan: the board treasurer, with the chief.

6. The question of a shared guideline with mutual-aid companies: the chief, at the county chiefs' meeting.

7. Drill at each station every six months: the station captains.

The writer remains a member and a lieutenant but owns none of these. A project that depends on its author after the term ends has not been handed off.

References

Burgess, J. L., Hoppe-Jones, C., Griffin, S. C., Zhou, J. J., Gulotta, J. J., Wallentine, D. D., Moore, P. K., Valliere, E. A., Weller, S. R., Beitel, S. C., Flahr, L. M., Littau, S. R., Dearmon-Moore, D., Zhai, J., Jung, A. M., Garavito, F., & Snyder, S. A. (2020). Evaluation of interventions to reduce firefighter exposures. Journal of Occupational and Environmental Medicine, 62(4), 279-288. https://doi.org/10.1097/JOM.0000000000001815

Demers, P. A., DeMarini, D. M., Fent, K. W., Glass, D. C., Hansen, J., Adetona, O., Andersen, M. H., Freeman, L. E. B., Caban-Martinez, A. J., Daniels, R. D., Driscoll, T. R., Goodrich, J. M., Graber, J. M., Kirkham, T. L., Kjaerheim, K., Kriebel, D., Long, A. S., Main, L. C., Oliveira, M., . . . Schubauer-Berigan, M. K. (2022). Carcinogenicity of occupational exposure as a firefighter. The Lancet Oncology, 23(8), 985-986. https://doi.org/10.1016/S1470-2045(22)00390-4

Fent, K. W., Alexander, B., Roberts, J., Robertson, S., Toennis, C., Sammons, D., Bertke, S., Kerber, S., Smith, D., & Horn, G. (2017). Contamination of firefighter personal protective equipment and skin and the effectiveness of decontamination procedures. Journal of Occupational and Environmental Hygiene, 14(10), 801-814. https://doi.org/10.1080/15459624.2017.1334904

Harrison, T. R., Muhamad, J. W., Yang, F., Morgan, S. E., Talavera, E., Caban-Martinez, A., & Kobetz, E. (2018). Firefighter attitudes, norms, beliefs, barriers, and behaviors toward post-fire decontamination processes in an era of increased cancer risk. Journal of Occupational and Environmental Hygiene, 15(4), 279-284. https://doi.org/10.1080/15459624.2017.1416389

Michie, S., van Stralen, M. M., & West, R. (2011). The behaviour change wheel: A new method for characterising and designing behaviour change interventions. Implementation Science, 6, 42. https://doi.org/10.1186/1748-5908-6-42

Ogrinc, G., Davies, L., Goodman, D., Batalden, P., Davidoff, F., & Stevens, D. (2016). SQUIRE 2.0 (Standards for QUality Improvement Reporting Excellence): Revised publication guidelines from a detailed consensus process. BMJ Quality & Safety, 25(12), 986-992. https://doi.org/10.1136/bmjqs-2015-004411