Operational Healthcare: Ready to Care for Our Warriors

The events of September 11 and the onset of military operations in support of OPERATION Enduring Freedom/Iraqi Freedom propelled readiness training to provide operationally relevant health care center stage. The unique characteristics of the casualties seen during wartime, which include victims of bomb blasts, gun shot wounds and severe blunt trauma from motor vehicle and helicopter crashes, are seldom seen during peacetime missions. Over 87% of the Air Force Medical System (AFMS) medical treatment facilities have 100 beds or less. The only Level I trauma center, which routinely cares for victims of trauma is Wilford Hall Medical Center (WHMC). Thus, nurses in all other smaller facilities must find alternative methods to ensure their readiness to care for these casualties.

This study seeks to replicate a TSNRP funded study previously conducted at WHMC (N99-P04) at an AF community-sized hospital (10th Medical Group - US Air Force Academy) to determine the readiness of AF clinical nurses to provide deployment health care to these unique casualties. The replication of this study is imperative as the distinctive care environment at WHMC limits the generalizability of the findings of the previous study to the remainder of the AFMS. The study will use a state-of-the-art simulation facility along with previously validated simulation teaching and evaluation instruments, cognitive exam and self-assessment tools. The participants will receive instruction and will be evaluated on their ability to care for patients with the most common injury patterns observed during military operations (bomb blast victims, patients with severe orthopedic and neurological injuries, burns and airway compromise).

Using a pretest-posttest experimental design the study will determine if an educational intervention improves the readiness of Air Force active duty nurses (46N3) as demonstrated by their performance in the simulation lag, cognitive evaluation and self-assessment. Study aims include determination of (1) differences in performance, cognitive knowledge, and self-assessment of the ability to provide care between baseline and immediately after the educational intervention and (2) the sustainment of those skills and knowledge one month after the intervention. The study results will inform future readiness training for the entire AFMS.