Military medicine
-
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.
-
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.
-
Patients with the medical diagnosis of obstructive sleep apnea (OSA) and those with undiagnosed OSA have greater chances for adverse events during surgical procedures related to their medical condition. Early identification of at-risk OSA patients can help mitigate associated adverse events. The purpose of this project was to implement a preoperative process to provide early identification of at-risk OSA patients in the preadmission unit, at a large military level I trauma center in central Texas. ⋯ Early identification of OSA has an impact on the decisions made to augment and enhance the patient-specific tailored care for each at-risk OSA surgical patient. Potential adverse events may be diminished or eliminated with the early identification of OSA patients. Preoperative policies that support the utilization of preoperative screening for OSA will improve the overall quality and safety of care provided to surgical patients.
-
Scant research has examined mental health treatment utilization and barriers to care in deployed U.S. soldiers. This study aims to assess mental health treatment utilization in deployed soldiers, including providers used and barriers to care. ⋯ Prevalence of common psychopathology and receipt of care in a combat environment was similar to previous reports from postdeployment settings. Nonprovider sources of care were more frequently utilized as compared to an in-Garrison report. Findings suggest important differences exist in sources of help and barriers to care in deployed vs. postdeployment environments. The hypothesized barriers to care did not preclude receiving any help, however, less than one-half of soldiers at mental health risk received help. Thus, future research should identify factors that have the greatest influence on help seeking behavior in both deployed and Garrison settings.