The evidence-based practice concept: engaging interest and participation.

The TriService Nursing Research Program was chartered in 1992 to advance the science of military nursing to support mission readiness, to provide optimal evidence-based healthcare in various military settings, and to improve the health and quality of life of military personnel. In 2002, the Tri-Service Nursing Research Program created the evidence-based practice initiative to foster excellence in military nursing care through the evidence-based practice in the military healthcare system. The evidence-based practice initiative has been coherently and successfully implemented throughout the military healthcare systems largely due to strong commitment and support from all management levels across services and across components.

Developing military nursing research priorities.

Congress established the TriService Nursing Research Program (TSNRP) in 1992 to serve the nursing research needs of the military. The TSNRP advances the science of military nursing to support mission readiness and deployment, improves the health and quality of life of military personnel, and provides optimal nursing care in settings worldwide. In 1995, the TSNRP Advisory Council commissioned the Institute of Medicine to make recommendations on management, research funding areas, resource allocation, and objectives. In 1996, the committee issued its report, The Program for Research in Military Nursing: Progress and Future Direction. A principal recommendation was that the TSNRP hold regular research priority-setting conferences. In response, since 2000, the TSNRP has held three conferences. This article follows up the Institute of Medicine report and summarizes the results of those conferences. The article describes conference processes, constituents, and conclusions and outlines future TSNRP research directions.

Cardiovascular risks in a military health care beneficiary population with high blood pressure.

Prevention strategies for coronary artery disease among hypertensive patients require assessment of other modifiable risk factors in the target population. In this article, we describe the prevalence of other cardiovascular risk factors in military beneficiaries with high blood pressure (HBP). Baseline data from an ongoing randomized clinical trial designed to test effectiveness of a comprehensive HBP intervention are used in the analysis. A total of 147 beneficiaries from a military health system participated in this study. Findings indicate that the rate of HBP control in this sample was suboptimal (32%: blood pressure < 140/90). Other prevalent cardiovascular risk factors include high cholesterol, obesity, and diabetes. Many of these patients (31.3%) are also in the moderate-to-high danger level of developing coronary artery disease in the near future. These findings warrant a regular assessment of cardiovascular risk factors and rigorous behavioral interventions for all beneficiaries of the military health care system.

Hypertension screening and cardiovascular risk profiling in Vietnam.

The purpose of the present descriptive study was to determine the risks associated with hypertension in Vietnamese communities around Ho Chi Minh City, Vietnam. The 357 volunteers for this health promotion screening consisted of 125 men and 232 women, 19-85 years of age. Participants completed surveys on their cardiovascular health history, health practices and hypertension knowledge. Nearly one-third of the sample was found to have systolic blood pressure (SBP) above 139 mmHg and/or diastolic blood pressure (DBP) above 89 mmHg. Fifteen participants had either SBP over 180 mmHg or DBP over 108 mmHg, nine of these 15 participants were taking antihypertensive drugs and 76 were taking other cardiac medications. The majority (98%) cooked with salt and 75% added salt when eating. Drinking alcohol (21%) and smoking (23%) were more common in male participants. Knowledge of cardiovascular risks was very low, indicating a need for community health promotion activities with educational campaigns and further screenings.

Care of the critically ill patient in a military unique environment: a program of research.

The goal of the Air Force Nursing Research Program at WHMC is to conduct research on topics unique to Air Force and military nursing. The nine stressors of flight and the military environment of care have been used as a conceptual model to guide the development of research studies. The studies conducted to date describe how the environment affects practice and when the environment directly affects the patient. The studies conducted are examples of the numerous military nursing research projects supported by funding from the TSNRP. The research funded by TSNRP contributes to the body of nursing knowledge by supporting scientific research, particularly knowledge that is unique to the military. As our nation faces the threat of chemical and biologic attacks, terrorism, and increased deployment of soldiers to battlefields in remote locations throughout the world, it is more important than ever that we ensure the advancement of military nursing research. Supporting research that advances healthcare in peace and in war is critical to the care of our military members and their families. This will require that research funds continue to be available to support military nursing research, that a strong infrastructure to provide resources in support of nursing research programs continues to exist, and that the military nursing corps continues to attract, train, and retain PhD prepared nurse researchers. Given the results of the research completed to date, the following evidence-based practice can be applied to the care of the patient described at the beginning of this article: The nurse positions the patient in the center of the cargo compartment, away from the bulkhead, toward the front of the aircraft, the warmest location during flight. While enroute, the patient will need to be positioned on an aerovac mattress, repositioned frequently, and have his/her heels elevated at all times. Additional padding may be needed for areas adjacent to the litter cross members to reduce pressure on the skin in areas prone to pressure ulcer formation. Should the patient need endotracheal suctioning, the nurse knows that hyperoxygenation-hyperinflation is effective in preventing suctioning-induced hypoxemia. In addition, the suction pressure will need to be increased to account for the effects of altitude without exceeding the pressure limits on the transport ventilator and causing catastrophic ventilator failure. Because there is not enough room on the litter for the chest tube drainage tubing to lay straight, it will be coiled and should dependent loops develop, they should be drained every 15 minutes. This is Air Force nursing research in practice.

The use of traditional and Western medicine among Korean American elderly.

With the current wave of Asian immigration to the United States, awareness of their use of traditional medicine, often in combination with Western medicine, is an increasingly salient issue for health care professionals. This paper describes the use of traditional and Western medicine by Korean American elderly and factors that are associated with their health-seeking behaviors and health service utilization. Data were obtained from a convenience sample of 205 Korean elderly immigrants through interview. The findings revealed that health service utilization among Korean American elderly covered a broad spectrum of health resources, including the use of Western medicine, the traditional Korean medicine (hanbang), or both Western and traditional clinics. In addition, health insurance status and the source of health care were found to relate to the types of health service that Korean American elderly chose to utilize. Better understanding of patterns of health service utilization may improve the quality of health care by increasing health providers' cultural sensitivity and facilitating adequate communication between Asian immigrant clients and their care providers. Implications for research and practice are discussed.