Military medicine
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In 2017, the TriService Nursing Research Program completed a strategic planning session, which identified key barriers to implementing evidence-based practice (EBP) within the U.S. Military Health System (MHS) including a focus on readiness training and deployments, frequent staff moves for military members, and relatively junior nurses in clinical roles. To facilitate EBP at individual military treatment facilities (MTFs), an EPB Facilitator role was developed using an evidence-based model and based on validated EBP competencies. ⋯ As EBP efforts continue and the program matures, it is anticipated that the outcomes from the individually completed projects, to include decreases in safety events, fiscal savings, and other improvements in organizational metrics, can be compiled to demonstrate the collective impact of these roles within the MHS.
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Falls during hospitalizations can increase the length and cost of a hospital stay. Review of patient safety reports on a 26-bed medical-surgical telemetry unit revealed that the number of falls went from 6 in 2015 to 12 in 2016. The reports identified a knowledge gap in the patient population and nursing staff related to high fall risk interventions. A literature review suggests that patient-staff safety agreements, in combination with proper implementation of Clinical Practice Guidelines, can successfully increase education and adherence to fall prevention measures and reduce the number of inpatient falls. ⋯ One of the largest obstacles to this project was staff and leadership turnover. However, the project found that patient fall safety agreements facilitate a dialogue among staff and patients as well as encourage patients to take ownership of their own care. They improve the safety of patients and create a collaborative environment for nurses to conduct safe, quality patient care.
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Care under operational conditions is complex and unique. Although there is a growing body of evidence to inform this care, very few resources address operational nursing care. To address this issue and the lack of a compilation of relevant studies and evidence-based guidelines, the TriService Nursing Research Program Battlefield and Disaster Nursing Pocket Guide was created. ⋯ Military nurse scientists and multidisciplinary clinical experts contributed to the guide, with the content undergoing critical review by experts in operational care. This article summarizes the development of the pocket guide, summarizes some of the updates from the first edition, and demonstrates the integration of the guide into the major phases of evidence translation: knowledge, creation, and distillation; diffusion and dissemination; and adoption, implementation, and institutionalization. The incorporation of the pocket guide into readiness training reflects a goal of TriService Nursing Research Program to "develop and strengthen the Triservice community of nurse scholars to generate new knowledge in military nursing and translate it into practice" and an unending commitment to bring world class care to those in harm's way.