Maj Jennifer L. Armon, USAF, NC, is pursuing a doctorate of nursing practice at the University of Nevada, Reno.
Capt Yvette Lucca, USAF, NC, is pursuing a doctorate of nursing practice at the University of Maryland, Baltimore.
Crit Care Nurse. 2024 Oct 1;44(5):13-19. doi: 10.4037/ccn2024428.
Decreases in size, capability, clinical volumes, case mixes, and complex care opportunities in military treatment facilities contribute to the atrophy of clinical skills among medical professionals in these facilities.
The COVID-19 pandemic resulted in a 39% decline in admissions to a military critical care unit. The decrease in patient census contributed to skill sustainment challenges.
To identify methods to combat skill atrophy, the CINAHL and PubMed databases were searched using the terms peacetime effect, military-civilian partnership, and skill sustainment. Active-duty critical care nurses stationed at a military treatment facility implemented a military-civilian partnership with a civilian medical facility for clinical skill sustainment.
One year after implementation, 39 critical care nurses had completed 511 shifts, gaining clinical experiences seldom achieved at the military facility. A survey of these nurses demonstrated that 8 of 17 (47%) gained experience treating patients requiring intra-aortic balloon pumps or continuous renal replacement therapy, 6 of 17 (36%) gained experience with patients requiring a ventricular assist device, 12 of 17 (71%) acquired hands-on experience with intracranial pressure monitoring, and 14 of 17 (82%) reported vasoactive intravenous infusion manipulation.
This article highlights the importance of evaluating clinical practice within the military health system, developing military-civilian partnerships, and removing military-civilian partnership barriers for nurses and other health care professionals. Failure to implement military-civilian partnerships may adversely affect the clinical competency of the military nurse force.
军事医疗机构的规模、能力、临床量、病例组合和复杂护理机会减少，导致这些医疗机构的医疗专业人员的临床技能萎缩。
COVID-19 大流行导致军事重症监护病房的入院人数下降了 39%。患者人数的减少导致了技能维持的挑战。
为了确定对抗技能萎缩的方法，使用了“和平时期效应”、“军民合作”和“技能维持”等术语，在 CINAHL 和 PubMed 数据库中进行了搜索。驻扎在军事治疗设施的现役重症监护护士与一家民用医疗机构建立了军民合作关系，以维持临床技能。
实施一年后，39 名重症监护护士完成了 511 次轮班，获得了在军事设施很少能获得的临床经验。对这些护士的调查显示，8 名（47%）护士获得了治疗需要主动脉内球囊泵或连续肾脏替代治疗的患者的经验，6 名（36%）护士获得了需要心室辅助装置的患者的经验，12 名（71%）护士获得了颅内压监测的实践经验，14 名（82%）护士报告了血管活性静脉输注操作。
本文强调了评估军事卫生系统内临床实践、发展军民伙伴关系以及为护士和其他卫生保健专业人员消除军民伙伴关系障碍的重要性。如果不实施军民伙伴关系，可能会对军事护士队伍的临床能力产生不利影响。
