# Disaster preparedness in hospices and specialized home palliative care services in Germany: a cross-sectional survey of team-leading nurses

## TL;DR

This study explores how hospices and palliative care services in Germany prepare for disasters, finding that many lack proper plans and need better preparation.

## Contribution

The study provides new insights into disaster preparedness in hospices and specialized palliative home care services in Germany.

## Key findings

- 62% of respondents reported no business continuity plan in their service.
- 70% of respondents agreed that further disaster preparation is necessary.
- Leadership nurses are seen as key to improving disaster readiness.

## Abstract

Hospices and specialized palliative home care services provide care for people with serious, life-threatening illnesses and those at the end of their lives. Disasters cause severe disruptions that exceed the capacity of structures and processes in a society. Given the increasing frequency and impact of disasters, it is crucial that these services maintain their functions for as long as possible, even under adverse conditions, to protect the people entrusted to their care. The aim of this research was therefore to examine whether and to what extent hospices and specialized palliative home care services in Germany are already prepared for disasters.

We used an explorative, quantitative cross-sectional design. The intention was to conduct a full nationwide survey among nurses in team-leading roles in all hospices and specialized palliative home care services in Germany. A self-developed semi-standardized online questionnaire assessed perceived disaster awareness, organizational preparedness, and staff preparation. Descriptive statistics were used to analyze the survey data.

A total of 189 nurses in team-leading roles from all parts of Germany responded to the online survey (29% response rate). Overall, respondents considered disaster preparedness to be an important topic, but this has rarely been reflected in corresponding initiatives. 62% of respondents stated that their service does not have a business continuity plan, or that they were unaware of such a plan. An above-average share of respondents expressed the view that the nursing staff of these services should fulfil additional tasks before, during, and after disasters to ensure the safety of those in their care. Although nurses were generally considered competent to carry out these tasks, 70% of respondents agreed that further preparation for disasters was necessary.

Our survey data suggest that hospices and specialized palliative home care services in Germany need to improve their disaster preparedness to ensure they can continue to provide specialized hospice and palliative care in times of adversity. This requires organizational initiatives in collaboration with other healthcare and civil protection services, as well as personnel development measures. Nurses in leadership positions could play a key role in this.

The online version contains supplementary material available at 10.1186/s12912-026-04456-8.