Air Force Nurse Research Articles

Psychometric properties of the Thai Qualifications Framework for Higher Education instrument among Royal Thai Air Force nurse stakeholders.

The Thai Qualifications Framework for Higher Education (TQF: HEd) serves as a framework to enhance the quality of higher education in Thailand. However, no valid and reliable TQF: HEd instrument is available to measure the quality of graduates among Royal Thai Air Force Nurses. This study aimed to assess the psychometric properties of the TQF: HEd instrument among graduate nurses of the Royal Thai Air Force. Psychometric testing of the instrument was conducted. The instrument's validity was evaluated through a review by a panel of five experts, providing a content validity index (CVI). Construct validity was assessed using Confirmatory Factor Analysis (CFA) with a sample size of 308, and Cronbach's α coefficient was utilized to measure the scale's internal consistency. The Scale-Content Validity Index (S-CVI) was 0.88. CFA yielded the following fit indices: χ2 = 265.861, p = 0.068, df = 233, χ2/df ratio = 1.141, Comparative fit index (CFI) = 0.996, Tucker Lewis Index (TLI) = 0.993, Root Mean Square Error of Approximation (RMSEA) = 0.021, and Standardized Root Mean Square Residual (SRMR) = 0.033. The scale reliability was acceptable, with a Cronbach's alpha coefficient of 0.93 and 0.85-0.92 for the six factors. The TQF: HEd instrument demonstrates satisfactory psychometric properties, which will be valuable for those in charge of the curriculum in utilizing the instrument to measure graduate competency and guide curriculum development.

Clinical Inquiry in Nursing Readiness Fellowship: Increasing Air Force Nurse Corps Evidence-Based Practice Leadership Infrastructure.

Increasing demands to generate, translate, and implement evidence into practice in manpower and budget-constrained environments triggered innovative support for the nursing scientific community. The Clinical Inquiry in Nursing Readiness (CINR) fellowship is a solution to integrate readiness into clinical inquiry priorities and develop future experts in the field. This article describes the fellowship program structure, implementation, and contributions to nursing science, readiness, and professional development. We share specific recommendations based on our experiences to enhance and sustain this valuable fellowship program. Six fellows have completed the CINR fellowship since its launch in July 2019. Fellows garnered $40,000 in grant funds for five evidence-based practices, two research studies, and six clinical inquiry initiatives. So far, the fellows have produced 20 knowledge products: Three published manuscripts, three evidence-based resource toolkits, nine professional conference presentations (one international), five professional certifications, a variety of organization-wide leadership briefings, and two military decorations specific to the pandemic response. Establishing a fellowship program to develop a pipeline of readiness-focused nurse scientists and evidence-based practice experts builds future capacity for the enterprise while professionally developing individual nurses for advanced degrees and clinical inquiry leadership roles. Individuals and organizations aspiring to promote a culture of nursing inquiry may benefit from fellowships such as the CINR program.

A Dialogue with Dr. Marilyn A. Ray: Nurse Scholar and USAF Veteran.

Dr. Marilyn A. Ray, nurse scholar and retired United States Air Force (USAF) veteran and former flight nurse, began her nursing scholarship in Canada. She was influenced by the experiences and interprofessional scholarly ideas that she encountered along her career trajectory. Her early love of the air and space led her to the United States Air Force Nurse Corps, where she served as a flight nurse during the Vietnam war era, followed by leadership positions in nursing education, administration, practice, and research. Dr. Ray's contributions to nursing knowledge includes two nursing theories and a caring inquiry methodology. Dr. Ray is helping to create a new caring science certificate program at Florida Atlantic University, Christine E. Lynn College of Nursing. In this column, Dr. Ray shares the story of her scholarly influences and how they helped her care for her husband and gain insight into her contributions to nursing knowledge development.

Nurse Leader Breaks Through Glass Ceiling: Making History as First Air Force Nurse Major General (1999-2005).

There is a gap in the nursing literature about the significant contributions of executive military nurse leaders to the advancement of nursing as a profession and into interprofessional leadership roles. Many executive military nurse leaders have demonstrated the value of nursing leadership in non-traditional roles and paved the way to expand the leadership opportunities for nurses who would follow. The purpose of this study is to explore the personal stories, experiences, leadership strategies, and lessons learned through the eyes of the first nurse to achieve the rank of Major General in the U.S. Air Force. The oral history method guided the exploration of participant memories and experiences. In compliance with the Oral History Association guidelines, the investigator obtained Institution Review Board permission, informed consent, and audiotaped interviews. An expert panel provided feedback on the appropriate language use in semi-structured interview questions with Air Force nurse executives. The oral history method provided a framework for the semi-structured interview and analysis. Active listening techniques such as exploration, clarifying, and paraphrasing helped foster deep listening. A graduate research assistant transcribed the 4-hour interview verbatim. The primary investigator emailed a copy of the transcript to the participant to verify accuracy and clarify content. Analysis involved examination and interpretation of the professional, military, nursing, and participant's personal perspective to enhance historical understanding. Three independent coders extracted prevalent themes and subthemes during analysis. Repetitive major themes of courage, figuring it out, and winning others over emerged during data analysis. The major theme of courage has corresponding subthemes of tenacity, risk-taking, and re-writing the narrative. The major theme of figuring it out has subthemes of optimism, creativity, connectedness, learning, and managing change. Lastly, the winning others over theme has subthemes of emotional intelligence, teamwork, role-model/mentor, and moving from outsider to insider. The leadership strategies of taking calculated risks while remaining calm, being open to opportunities that she had never considered, and spending time learning new skills contributed to repeated advancement into higher leadership positions not previously held by a nurse within the U.S. Air Force. The interview is packed full of leadership lessons that are just as relative today as 20 years ago. This presentation will conclude with a discussion of the most effective leadership strategies, the lasting impact of the leadership accomplishments, and current implications for nurse leaders today.

An Air Force Nurse Leader’s Impact: Brigadier General Goodwin, 10th Air Force Nurse Corps Chief

To pursue and fulfill the limitless potential of nursing, it is important to recognize and record the stories of previous leaders who helped to pave the way for advances in the nursing scope of practice, clinical expertise, and leadership opportunities. The purpose of this oral history research method study was to preserve and explore the impact and contributions of Brigadier General (Brig Gen) Barbara Goodwin during the evolutionary time from 1988 to 1991. In an extensive interview, Brig Gen Goodwin reflected on her leadership strategies to address the nurse shortage, the advancement of nurse leadership and educational opportunities, and crucial collaboration efforts contributing to the deployment of 40,000 women in support of war efforts. The findings section discusses the leadership themes identified, which included collaboration, prioritization, understanding the system, and a passion for clinical nursing. The conclusion summarizes her significant impact on military nursing.

Air Force Executive Nurse Leadership Impact: Brigadier General Diann Hale O’Connor, Air Force Nurse Corps Chief From 1982 to 1985

In the 1980s, nurses became more recognized as interprofessional healthcare partners who actively participated in the advancement of patient care and the nursing profession. There is a significant gap in the nursing literature about the significant contributions of executive military nurse leaders. The purpose of the interview with Brigadier General (Brig Gen) Hale O'Connor was to explore the personal stories, experiences, leadership strategies, lessons learned, and impact of her leadership on the future development of nursing as a profession. The oral history method provided a framework for the interview and the analysis. In compliance with the Oral History Association guidelines, the primary investigator obtained Institutional Review Board permission, participant informed consent, and an audiotaped interview. A graduate research assistant transcribed the 3-hour audiotaped interview verbatim. The participant reviewed the transcription, provided clarification, and validated accuracy. Three independent coders extracted prevalent themes and subthemes during analysis. Researchers compared findings and reached a consensus when resolving minor discrepancies. Two broad thematic qualities, commitment to duty and fairness, emerged from the data with their respective subthemes. Subthemes of trust, patriotism, loyalty, and assiduousness supported the main theme of commitment to duty. Pillars of alignment, equality, and advocacy supported the broad theme of fairness. Although the team did not use the Reina Trust Model as a framework, the trust-building behaviors emerged from the transcribed interview during the analysis. Surprisingly, many of the leadership strategies utilized by Brig Gen Hale O'Connor fit well into the Reina Trust Model, published 25 years following O'Connor's tenure as Chief, Air Force Nurse Corps. In addition, several of Brig Gen Hale O'Connor's leadership accomplishments are still relevant today, solidifying the observation that the foresight of Brig Gen Hale O'Connor was fundamental to the advancement of nursing during her tenure and for those who followed.

Deployment Stressors in United States Air Force Nurses Associated with the Experience of Moral Distress

Deployment stressors among military service members are well-documented in the literature such as those related to the horrific experiences often encountered in a war setting. However, less known are the implications of military healthcare professionals providing clinical care in a deployed setting. Previously conducted research examined the experience of moral distress in U.S. Air Force Critical Care Air Transport (CCAT) nurses. A secondary analysis was completed to identify the deployment stressors which affected the nurses' experiences of moral distress. Utilizing an explanatory narrative qualitative approach, 15 previously transcribed interviews were analyzed to identify and describe stressors associated with moral distress experiences told by CCAT nurses in the earlier research study. While the identified stressors cannot be referred to as moral distress, the situation were precipitated or exacerbated by the deployment stressors. Eight themes, with descriptors, resulted from the analysis of interviews. Mitigating strategies to target deployment stressors related to the experience of moral distress may equip healthcare providers to better manage the encounters that arise in the deployed environment, thereby reducing its negative impact.

Living up to the job: Confessions of a Brigadier General on the lived experiences of becoming a leader in the Air Force Nurse Corps

Today, nurse leadership positions are more and more common. However, there have been many exemplary Nurse Leaders in the past whose contributions and sacrifices enabled nursing to transform to the leadership position it is today but have not been documented. It is important to recover and record this history so that future generations of nurses can learn from past examples in a way they cannot learn with current nursing education alone. This article examines the development of the professional nurse through the lens of the service of Brigadier General Sue Ellen Turner. The oral history method guided the exploration of memories and experiences. The recurring characteristics of discernment, reflection, and ability to break barriers/build relationships contributed most to the general's success in restructuring organizational systems to optimize leadership opportunities for nurses. The conclusion discusses the lasting impact and future implications of Turner's work on the profession of nursing.

Air Force Nursing Executive leadership impact on health care 2004–2008

Recorded history allows us to recognize our past and can contribute to the present and future nursing practice. The purpose of this study is to examine the impact of the United States Air Force Nursing Executive leadership on military health care transformation, through Major General (Retired) Melissa A. Rank's personal stories and experiences. This study explores the development and impact of Air Force nursing in its historical, social, and global context between the years of 2004–2008. The oral history method was used to explore and record the professional life experiences of a great military nurse leader. The United States Air Force Nurse Corps has contributed to global healthcare via humanitarian medical support, medical disaster relief, aeromedical patient transport, development of best practices, advances in technology, education programs, and transformation in deployed medical care during times of war, peace, and natural disasters.

An Interview with Major General (Retired) Melissa Rank: The Evolution of Air Force Nurse Corps Leaders.

An Interview with Major General (Retired) Melissa Rank: The Evolution of Air Force Nurse Corps Leaders.

Becoming an Air Force Nurse: The Experience of Transition A New Perspective of a Known Phenomenon.

Transitions in nursing have consistently been described as complex and stressful. While the literature is replete with studies investigating role transitions in civilian healthcare settings, there is no known research that explores the role transition of experienced nurses who move from civilian to military nursing practice. Using nurses in the U.S. Air Force as an exemplar, this study serves as a starting point to understand the transition process and challenges likely encountered by nurses new to the military. The outcomes of this study could influence future efforts to recruit and retain qualified nurses. A hermeneutic, phenomenologic approach was used to explore and describe the lived experience of transition from civilian staff nurse to Air Force staff nurse. The results indicated that new Air Force nurses encounter challenges related to a lack of knowledge and role preparedness, which led to feelings of stress and frustration. Support from peers, mentors, and managers helped the new Air Force nurses bridge the gap in knowledge and successfully integrate into the military culture. Efforts to reduce the perceived lack of knowledge through improvements to the Commissioned Officer Training program and the clinical orientation period are recommended.

Implementing Nursing Professional Development.

Sandra Bruce is the Nurse Education Program Manager, Air Force Personnel Center, Joint Base San Antonio-Randolph in Texas, and is responsible for the Air Force Continuing Nursing Education program and facilitation of selection boards for graduate education and fellowship programs. She served as editor for the third and fourth editions of the Association for Nursing Professional Development (ANPD) Core Curriculums for Nursing Professional Development. Sandy previously served as the Education Consultant to the Air Force Surgeon General for Nursing Education programs for over 3,000 Air Force Nurse Corps members. She received her BSN from Mercy College of Detroit in 1976 and entered the Air Force in 1982. The Air Force sponsored her Master's Degree in Nursing as a Clinical Nurse Specialist.

7000 Miles and 7 Days From the Battlefield

Critically injured combat casualties are rapidly evacuated from the battlefield, and within hours of their injuries they begin a 7000-mile journey home, often arriving in the United States within 7 days. National Naval Medical Center in Bethesda, Maryland, is a major facility for wounded warrior care in the Military Health System. Throughout the facility, the staff from a variety of disciplines and all military services provides care for military personnel with injuries and illnesses, with the goal of optimizing recovery and quality of life. The foundational evidence for select aspects of this care is discussed. Innovations in training and care delivery include the Air Force Nurse Corps’ Critical Care Fellowship, the new inpatient Traumatic Brain Injury Unit, and the National Intrepid Center for Excellence for Traumatic Brain Injury and Psychological Health. The future of the Medical Center includes a new name, expanded staff, and newly constructed space by Department of Defense Base Realignment and Closure activities.

7000 Miles and 7 Days From the Battlefield

Critically injured combat casualties are rapidly evacuated from the battlefield, and within hours of their injuries they begin a 7000-mile journey home, often arriving in the United States within 7 days. National Naval Medical Center in Bethesda, Maryland, is a major facility for wounded warrior care in the Military Health System. Throughout the facility, the staff from a variety of disciplines and all military services provides care for military personnel with injuries and illnesses, with the goal of optimizing recovery and quality of life. The foundational evidence for select aspects of this care is discussed. Innovations in training and care delivery include the Air Force Nurse Corps' Critical Care Fellowship, the new inpatient Traumatic Brain Injury Unit, and the National Intrepid Center for Excellence for Traumatic Brain Injury and Psychological Health. The future of the Medical Center includes a new name, expanded staff, and newly constructed space by Department of Defense Base Realignment and Closure activities.

Don't throw in the towel

Lori Flori, a member of the U.S. Air Force Nurse Corp., is an emergency department nurse at Elmendorf Air Force Base near Anchorage, Alaska. The views expressed in this article are those of the author and do not reflect the official policy or position of the U.S. Air Force, Department of Defense, or the U.S. Government.

Readiness Estimate and Deployability Index for Air Force Nurse Anesthetists

Air Force (AF)-certified registered nurse anesthetists (CRNAs) play an important role in the support of the global war on terror. The purpose of the investigation was to use an AF CRNA-specific modification of the Readiness Estimate and Deployability Index Revised for AF Nurses to assess readiness for deployment. Dimensions included clinical competency, operational competency, soldier/survival skills, personal/psychosocial/physical readiness, leadership and administrative support, and group integration/identification. Readiness skills verification for AF CRNAs was used to develop clinical competency questions. Validity was assessed by two experts, and internal consistency reliability was evaluated by using Cronbach's alpha. Available stateside AF CRNAs (n=105) were surveyed, with a 60% response rate. Descriptive statistics were used to describe the sample, providing a mean score for each variable. Using a 5-point scale, participants rated themselves with an overall readiness score of 4.09, which suggests that AF CRNAs perceive themselves as ready to deploy.

Reliability and Validity Testing of a Short Form of the Readiness Estimate and Deployability Index Revised for Air Force Nurses

The purpose of this study was to test the reliability and validity of the Readiness Estimate and Deployability Index Revised for Air Force Nurses Short Form, with a sample of 205 Air Force nurses. Participants were mostly female (70%), 36.31 +/- 9.3 years of age, with 11.52 +/- 7.17 years of nursing experience. With structural equation modeling, the initial model did not fit the data (chi2/df = 5.45) and was revised. Revisions based on modification indices provided evidence of reliability (alpha coefficients of 0.70-0.94; the majority of R2 values were >0.50) and improved the fit of the model (chi2 difference, 35.54; df difference, 3.76; p < 0.05). Hypothesis testing provided evidence of construct validity. The 40-item Readiness Estimate and Deployability Index Revised for Air Force Nurses Short Form provides evidence of reliability and validity as a self-assessment measure of deployment preparedness.

Communication to Facilitate Care of the Obstetric Surgical Patient in a Postanesthesia Care Setting

Perinatal clientele have become more complex in their presentation and care today than ever before, requiring care in units other than the traditional obstetric or perinatal unit. Therefore, it is extremely important that the nurses caring for these patients know the associated standards of care, understand the importance of communication, and work to ensure the safety of the patient. This article provides an overview of the standards of ASPAN and the Association of Women's Health, Obstetrics, and Neonatal Nurses (AWHONN), guidance on initial and ongoing assessments of this population, and emphasizes the importance of all forms of communication during the care of the obstetric patient.

Pilot testing the Readiness Estimate and Deployability Index Revised for Air Force Nurses.

The Readiness Estimate and Deployability Index Revised for Air Force Nurses (READI-R-AFN) was derived from modifications of Reineck's Readiness Instrument. Reliability and validity of the READI-R-AFN was estimated on completed questionnaires of 181 active duty Air Force nurses. The READI-R-AFN was evaluated based on item analysis, internal consistency (alpha coefficient, >0.70), confirmatory factor analysis with structural equation modeling, and hypothesis testing. The findings were supported by Flannery's model of stress resistance. There was evidence of reliability and validity of the 83-item READI-R-AFN based on internal consistency (alpha, 0.80-0.96), structural equation modeling, and hypothesis testing. The original hypothesized six dimensions were retained.

A Delphi Study to Validate Competencies Required of Air Force Medical Surgical (46N3) Nurses in Mobilized Environments

The objectives of this study were to develop competencies for wartime and operations other than war for 46N3 Medical/Surgical Air Force nurses and to validate those competencies among a group of experts in the field. The sample consisted of 109 nurses with mobilization experiences. A Delphi consensus technique was used to validate both the importance of competencies required in a mobilization environment and to determine the level at which those competencies should be practiced. A web-based questionnaire was used to collect responses during three rounds of data collection. At the end of round 3, 83% of the importance statements achieved consensus whereas 67% of the level of practice statements achieved consensus. Those importance items validated were traditional assessment and interventions skills that represented noncontroversial practices. Those items not validated were either controversial or perceived as not pertinent in an austere mobilization environment.