ABOUT
TSNRP solves challenges to ensure every warfighters' ability to survive, thrive, and remain fit for duty.
Military nursing research finds solutions for:
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Challenging healthcare delivery settings, like austere environments, extreme temperatures, ground warfare, maritime operations, airborne missions, natural disasters, and pandemics.
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Mission operational readiness and performance of service members, before, during, and after active conflicts.
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Cost-effective delivery of high-quality, evidence-based healthcare for military personnel and their families worldwide.
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Occupational and environmental hazards that affect the physical and mental health and readiness of service members such as chemical, biological or nuclear exposures.
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Illness, stress, and injury resulting from large scale combat operations, humanitarian missions, and other deployments.
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Innovations to improve clinical outcomes and evidence-based practice across the military healthcare system.
Military nursing science is also being used in the civilian health system. For example, the Maryland Department of State Police adopted a blood administration course and toolkit created as a result of a TSNRP-funded evidence-based practice project led by an Air Force nurse. As a result, Maryland administers life-saving blood products during helicopter rescues.
For the Department of Defense, TSNRP identifies the most innovative military nursing research that promises significant, positive impacts on military warfighters and their families so they receive the best evidence-based care on the frontline and at home. Since 2019, TSNRP research has been conducted at more than 30 sites in 23 states, and in collaboration with 35 public universities.
TSNRP-funded military nursing research includes studies such as these:
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Infection Control in Tomorrow's Battlefield
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Anticipating Future Combat Needs: Radiation Burn Training for Nurses
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Development of a BioChip for Rapid Detection of Urinary Tract Infection in Combat Settings
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Effects of Temperature Extremes on Medications in an Austere Environment
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Severe Burn Nursing Care in Large Scale Combat Operations
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Prevention of Pressure Injuries During Aeromedical Evacuation
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Effect of Epinephrine Sequestration on the Return of Spontaneous Circulation
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Battlefield Acupuncture for the Treatment of Low Back Pain
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Effects of Sleep Deficiency on National Guard Personnel Responding to Disasters
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Home Therapies for Musculoskeletal Injuries in Active Duty
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Exertional Heat Illness: Deployability, Risk Assessment, and Clinical Management
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Effect of Intraosseous vs. Intravenous Lidocaine in a Cardiac, Hypovolemic Arrest Model (to address battlefield hemorrhage)
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Identifying Infectious Contamination of Military Uniform in a Hospital Setting
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Sleep, Mental Disorders, and Traumatic Brain Injury in Deployed Military Members
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Improving Resiliency in U.S. Armed Forces Personnel
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Non-pharmacologic Interventions for Sleep and Back Pain for Military Personnel
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Military Unique Competencies for Combat Palliative and End-Of-Life Care
Mission
To facilitate nursing research to optimize the health of military members and their beneficiaries.
Vision
Be a thought leader to foster innovative research, support partnerships, inform leaders, and support operationally relevant research and Evidence-Based Practice.
Strategic Goals
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Develop nurse scholars and facilitate TriService scholarly collaboration.
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Provide a TriService infrastructure to enhance military nursing research and advance Evidence-Based Practice.
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Support research and Evidence-Based Practice projects on areas relevant to military readiness and military nursing practice.
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Enhance strategic communication to TSNRP stakeholders to increase awareness and relevance of military nursing research and Evidence-Based Practice.
Executive Director
Lt Col Cubby Gardner, PhD, FNP-C, NC, USAF
Lt Col Cubby Gardner is the Executive Director of TriService Nursing Research Program, the only Department of Defense (DoD) program dedicated to military nursing research.
During his military career spanning 40 years, Lt Col Gardner has served as a chief of EnRoute Care for the Combat Casualty Care Research Program, Senior Scientist with the 59th Medical Wing, and an assistant professor at the Graduate School of Nursing at the Uniformed Services University.
Lt Col Gardner is a published military nurse researcher who also serves as an expert reviewer of manuscripts, texts, monographs, and proposals. He is an ex officio member representing the Department of Defense Nursing on the National Advisory Council for Nursing Research at the National Institute of Nursing Research, contributing to national research priorities in nursing science.
Lt Col Gardner received a direct commission into the Air Force Medical Service in August 2008, after a cold-war era enlistment as a medical services specialist, followed by a civilian career in Texas local public health. While working as a paramedic, he earned an Associate Degree in Nursing from North Central Texas College in 1995. During his tenure with Denton County Health Department, he earned a Bachelor of Science Degree with a major in Nursing from Texas Woman’s University in 2005, and a Master of Science Degree with a major in Family Nurse Practitioner studies from Texas Woman’s University in 2006.
After returning to active duty and supporting contingency operations in Afghanistan, he was competitively selected and earned a Doctorate from the Graduate School of Nursing, Uniformed Services University of the Health Sciences, for research in clinical informatics in 2015. Lt Col Gardner is board certified by the American Academy of Nurse Practitioners and is a member of American Medical Informatics Association.
Lt Col Cubby Gardner, PhD, FNP-C, NC, USAF
Executive Board of Directors
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BG James (Jamie) D. Burk, USA
FORSCOM Surgeon
Chief, Army Nurse Corps
BG James (Jamie) D. Burk received his commission in 1995 from the Reserve Officer Training Corps (ROTC) after graduating from East Tennessee State University with a BS in Nursing. Past staff assignments include an Emergency Nurse with the 86th Combat Support Hospital, Ft. Campbell, KY. He served as an emergency nurse and Head Nurse at Leonard Wood Army Community Hospital, Ft. Leonard Wood, MO. In 2001, BG Burk was assigned to the 3rd Brigade 4th Region ROTC Headquarters at the Presidio of Monterey, CA as a Brigade Nurse Recruiting Officer. He was later assigned to Fort Bragg in May 2003 serving as the Medical Operations Officer for the 261st ASMB and later as the HHD, 261st ASMB Commander.
During this command, BG Burk deployed the detachment in support of OIF 04-06. Upon redeployment, he transferred to Womack Army Medical Center where he served as the
Head Nurse in the Emergency Department from 2006-2009. BG Burk later deployed with the 274th Forward Surgical Team as an emergency nurse in support of OIF and OEF. In
April 2011, BG Burk served at the US Army Human Resource Command as an Assignments Officer for the Army Nurse Branch.
Brig Gen Gwendolyn Foster, USAF
Commander, 59th Medical Wing
Director, San Antonio MHS
Chief, Air Force Nurse Corps
Brig. Gen. Gwendolyn A. Foster is the Commander of the 59th Medical Wing (MDW), and Director, San Antonio Military Health System, Joint Base San Antonio-Lackland, Texas. She commands the Air Force Medical Service's largest healthcare, medical education, and readiness platform comprising six groups with a staff of 5,600 personnel executing a $270 million budget. The wing conducts 900,000 clinic visits, performs 19,000 surgical procedures, and supports more than 300 worldwide deployments annually. Additionally, the 59th MDW staff at Brooke Army Medical Center supports 2.5 million patient visits, and 19,000 admissions per year.
As the Director for the San Antonio Military Health System, Brig. Gen. Foster directs and manages the overall operations and resources of an integrated, joint-services health system with a collective operating budger of $1.2 billion. The Market provides high-quality, safe, and reliable health care to more than 255,000 local beneficiaries.
Brig. Gen. Foster also services as the 19th Chief Nurse of the Air Force, responsible for establishing policies and maintaining programs for 19,000 active duty, Guard, and Reserve nursing personnel. She coordinates with Air Staff, Joint Staff, Department of Defense, Department of Veterans Affairs, and civilian health care organizations to develop the highest caliber of nursing personnal ensuring truly reliable care to the the Military Health System's 9.6 million beneficiaries worldwide.
RDML Robert J. Hawkins, USN
Director, J5/5/7, Defense Health Agency
Chief, U.S. Navy Nurse Corps
RDML Robert J. Hawkins enlisted in the Navy in 1983 and completed the Nuclear Power Training Program before serving on two submarines. He earned a BS in Nursing from the Medical University of South Carolina and was commissioned as an Ensign in 1993. He completed an MBA from Webster University, a Master of Science from Georgetown University, and a Master of Arts in Defense and Strategic Studies at the Navy War College.
He holds a Doctor of Nursing Practice from the College of Nursing at Rush University and a PhD from the Rush University Graduate College. Hawkins completed a Graduate Certificate in Global Health from the University of Massachusetts-Amherst and a Master of Public Health.
He served wartime deployments as a nurse anesthetist as part of Fleet Surgical Team Eight and as director of the graduate Nurse Anesthesia Program at the Uniformed Services University.
Research Interest Groups
RIGs are teams that connect multidisciplinary researchers, clinical nurses, and graduate students with common interests for knowledge sharing and mentoring. Members gain opportunities to join research projects, step into leadership, and network with colleagues across service branches. RIGs are organized around the following priorities in military nursing. Recent studies and evidence-based practice projects are noted for each RIG:
Anesthesia
This team’s recent pilot project demonstrated endotracheal tube (ETT) reusability feasibility in operational settings challenged by short supplies, and stability of ketamine. Another innovative research study investigated the effects of heat and cold exposure on medications in an austere environment to determine if there is a negative impact on effectiveness. To date, this study is the first to examine multiple freeze-thaw cycles on medications commonly used by anesthesia providers.
Biobehavioral Health
A recent scoping review identified eight research and critical training gaps to address combat stress and psychological support and optimal transport interventions for warriors. (Military Medicine, 186(9-10), e932-e942). This RIG also developed the COVID-19 Palliative Care Toolkit, which was adopted by the Defense Health Agency as practical guidance for the delivery of palliative care during the COVID-19 pandemic.
Expeditionary Care
Because nursing care under military operational conditions is complex and unique, this team created the widely used TSNRP Battlefield and Disaster Nursing Pocket Guide to put new and emerging evidence-based operational research by military nursing scientists into the hands of frontline nurses and first responders. More than 8000 copies of the second edition were distributed to the Army, Navy, and Air Force. This RIG has also conducted 10 studies related to nursing skill readiness for large scale combat operations, aeromedical transport, pressure injury prevention, and infection control in operational settings.
Health Systems/Informatics
Via four research studies, this RIG contributed to increased readiness of roles in operational settings, improved data analytics on military healthcare, and reduction of horizontal violence in the workplace. Most recently, TSNRP funded an evidence-based practice (EBP) project titled Developing an Evidence-Based Joint Military Nursing Professional Practice Model. The National Defense Authorization Act 702 of 2017 mandated the transfer of the administration of Service-specific Military Treatment Facilities to the Defense Health Agency. This transition created an opportunity to develop a joint professional practice model (JPPM) to shape and align Joint Service nursing care. The JPPM outlines standards for: Operational Readiness, Quality & Safety, EBP, Healthy Work Environment, and Leadership. (2023, Hodson P, Swiger PA, Campbell CM, et al.)
Military Family Care
Sixteen research studies conducted by this team contributed significantly to a growing body of evidence that support development of strategies to ensure the health, well-being, and readiness of military families prior to a service member’s deployment, as well as reintegration of service members post-deployment.
Military Women’s Health
This team conducted research addressing readiness and resilience of service members in operational and combat settings. In 2021, evidence on seven topics pertinent to the health of active duty military females was published in Science Direct.