Date of Graduation


Document Type



Mass Casualty Incident, Mass Casualty Event, disaster preparedness, patient identification, patient tracking, unidentified patient nomenclature, Mass Casualty Drills, Mass Casualty Exercise

Degree Name

Doctor of Nursing Practice (DNP)

Degree Level



Hope Ballentine

Committee Member

Susan Patton


A Mass Casualty Incident (MCI) describes any natural or manmade disaster that stresses a community beyond their normal resources (CMS, 2019). Across the globe, populations have grappled with an increased frequency of natural disasters and a surge of critically ill secondary to pandemic SARs-CoV-2 (Cavallo, Donoho, & Forman, 2020; Smith, 2020; US Global Change Research Program, 2018). In addition, the incidence and severity of mass shootings has risen in the United States with a reported 277 active shooter events between the years of 2000-2018 (Federal Bureau of Investigation, 2018; Smith et al., 2019). An Emergency Department (ED) in Northwest Arkansas (NWA) posed the question: In mock patients presenting to the ED during MCI simulations, how does electronic registration with a unique Patient Identification Packets (PIP), compared to manual registration with John/Jane Doe aliases, affect patient tracking errors within six months? This DNP project aims to increase staff confidence in knowing their role during an MCI, increase efficiency in patient processing, and decrease lost patients during MCI simulations. This quality improvement project looked to the revised Iowa Model for guidance in process development and implementation through a series of MCI drills followed by a final multidisciplinary exercise (Iowa Model Collaborative, 2017). Data collected in this quasi-experimental study was evaluated through descriptive statistics and noted a 16.6% increase in mean confidence level of PIP efficiency, a 2% increase in mean confidence level of MCI roles, and a 0% patient lost rate (Kaliyadan & Kulkarni, 2019).