Combat Casualty Care: Integrative Review and Validation of Nursing Competencies

Operational clinical readiness is essential to ensure that the highest possible care is provided to our warriors. Operational nursing competencies provide a framework to ensure operational clinical readiness. Currently there are no standardized, evidence-based core operational nursing competency checklists to guide the readiness preparation of military nurses from all three services. A body of research exists from studies conducted by the TriService Nursing Research Program, extant literature and operational databases to describe the types of patients being cared for under current operational conditions. Several studies have focused on the validation of instruments to assess nurses' perceptions of their readiness to deploy. Research has also been conducted related to the effectiveness of education and training initiatives used to prepare nurses to deploy. Embedded in the latter research are the clinical competencies that served as the basis for blueprint for study. Despite this growing body of evidence, results from these studies, reports and other data sources have not been systematically reviewed and integrated to describe the characteristics of the patients or the operational nursing competencies required to care for them. The first phase of this study will be a systematic integrated review of the extant literature in order to describe the types of patients cared for and their care requirements under wartime operational conditions. This integrated review will be used to identify the core operational nursing competencies for military medical-surgical and and critical care nurses. A panel of expert military medical-surgical and critical care nurses with deployment experience representing all three services will identify the core competencies based on the integrated literature synthesis and representative cases drawn from two existing operational medical databases. These competencies will then be validated survey using a Delphi technique sent to a stratified sample of nurses representing all components of the service (Army, Navy, Air Force-active, Guard/Air National Guard, Reserves). This military unique proposal is in response to the Corps Chiefs directed initiative to identify operational nursing competencies and it addresses the TSNRP Priority: Developing and Sustaining Nursing Competencies.

Aim 1. Conduct an integrated review and synthesis of the literature to describe the characteristics and care requirements of wartime casualties (injury and disease) in operational military treatment facilities.

Aim 2. Define operational clinical nursing competencies for medical-surgical and critical care nurses.

Aim 3. Validate operational clinical nursing competencies for medical-surgical and critical care nurses.