Clinical Knowledge Development: Continuity of Care for War Injured Service Member


Name: Patricia Kelley


Organization: The Henry M. Jackson Foundation

Performance Site: National Naval Medical Center, Bethesda, MD; Naval Medical Center, San Diego, CA; Brooke Army Medical Center, Fort Sam Houston, TX; Walter Reed Army Medical Center, Washington, DC; Landstuhl Regional Medical Center, Landstuhl, Germany; Wilford Hall Medical Center, Lackland AFB, TX; Veterans Administration Medical Center, Washington, DC; Veterans Administration Medical Center of Palo Alto, CA

Year Published: 2008

Abstract Status: Final


The Purpose of this research is to gather first person experience-near accounts of experiential learning of nurses caring for wounded service members and first accounts of service members' memories of all levels of care and transition from point of injury in the combat zone into the Military Health Care System, in order to develop and sustain nursing competencies, and examine the rehabilitative factors (recovery, rehabilitation and reintegration) (DoDI, 2006).Specific Aim 1: To capture experiential learning regarding medical and nursing care for returning wounded service members in order to evaluate and extend knowledge for clinical competence;Specific Aim 2: To provide narratives of rehabilitative care from the perspective of nurses and returning service members requiring extensive rehabilitation that could assist in the design and teaching of clinical competencies in rehabilitative health care;Specific Aim 3: To obtain accounts of service members' memories of all levels of care and transitions from the combat zone to rehabilitation in order to provide evaluative data from service members about their experience with recently developed innovations in combat health care delivery, e.g., embedded and more portable immediate rescue care in the combat arena and the staged model of care using rapid transport from the field;Specific Aim 4: To create a collection of narratives around practice topics or issues that can be published as a learning resource for nurses providing acute and rehabilitative care.Design: qualitative research study that will employ an ethnographic methodology.Sample and Method: Narrative interviews will be obtained from nurses (n=240-320) and injured service members (n= 48-60) at designated Military and Veterans Administration Medical Centers.Data Analysis: Utilization of experts, identification of major themes/exemplars, review, coding and classification of the interviews according to the primary concern or nature of the incident described.Findings: It is anticipated that a picture of the service members "Injured Journey"- will now include "Phase II" -the Rehabilitation Phase of the patient through the integrated healthcare delivery system which will serve as a guide for training requirements and competency proficiency for nurses.Implications: The knowledge gained will expand the discipline of nursing's understanding of care for the wounded warrior during the rehabilitative phases of the service members' journey and support future nurses' rehabilitative acumen and skill development necessary for provision of competent care.


Final Report available on NTRL at: