Research Program Results in Service-Wide Nursing Standards of Care

By Lauren Bigge
NMHM Public Affairs Coordinator

Contemporary military nurses have domestic and deployment professional skill set standards thanks to research and collaboration on common interest topics among the Army, Navy and Air Force Nurse Corps. U.S. Air Force Lt. Col. Jennifer Hatzfeld, PhD, RN, Executive Director of the TriService Nursing Research Program (TSNRP), shared the story of how some of those standards were defined and developed with the Medical Museum Science Café audience at the National Museum of Health and Medicine (NMHM) on July 25.

The story, according to Hatzfeld, begins with the creation of TSNRP. "The program started as a way to ensure excellence in military nursing care," she said.

Sen. Daniel Inouye of Hawaii advocated for the development of the National Center for Nursing Research in 1986. "He really believed in the power of nursing," Hatzfeld said. She noted that just a few years later, Inouye fully supported the development of a TriService Nursing Research Program. In fact, he was instrumental in the 1992 commitment of $1 million, the initial appropriation for the TSNRP, which was established at the Uniformed Services University of the Health Sciences.

The Patient CaringTouch System (PCTS) is a nursing practice model intended to improve the quality of care provided to patients and their families, which resulted from the TSNRP-funded study Military Nursing Outcomes Database. "As they developed this database, they were able to look at patterns and trends they could see that were associated with good patient outcomes or good outcomes for nurses," she said, adding that the Army implemented PCTS in 2011. "This model has had a great impact, on both patients and nurses in the Army." Army nurses fill out a survey annually; the data is useful for guiding policy and procedure.

Air Force Col. Elizabeth Bridges led another study, which developed operational nursing competencies and was intended to help military nurses prepare for deployments. Medical-surgical and critical care readiness skills checklists were created, then divided into those needed for clinical work in U.S. hospital settings or those needed for deployed settings abroad. The research results formed the outline of the TSNRP Battlefield and Disaster Nursing Pocket Guide, published in 2009. Nurses in all services use it. "This resource has impacted thousands of military nurses," Hatzfeld said.

A recent Global Health Engagement study led by Cmdr. Heather King, a Navy nurse scientist, focused on clinical experiences and lessons learned from hospital ships. King and her team identified interview-based themes: cultural competence, teamwork, communication, and preparation of patients for transport from ship to land. The data are still being analyzed.

"I can see that it's already starting to inform clinical practice, education, and some of the policy decisions that are being made," Hatzfeld said.

"One of the roles of the museum is to share the stories of the triumphs and challenges of military medicine," said Andrea Schierkolk, NMHM public programs manager. "Nurses play a vital role in the care of our service members and their families. This program shared how research by military nurse scientists leads to innovative practices, improvements in technologies and better-prepared nurses."

NMHM's Medical Museum Science Cafes are a regular series of informal talks that connect the mission of the Department of Defense museum with the public. NMHM was founded as the Army Medical Museum in 1862 and moved to its current location in Silver Spring, Maryland, in 2012. NMHM is an element of the Defense Health Agency. For more information on upcoming events, please call 301-319-3303 or visit