2023
ANNUAL REPORT
Expanding Impact
The TriService Nursing Research Program enables the operational readiness, health, and care of warfighters by advancing military nurse scholars, nursing research, and Evidence-Based Practice in the Military Healthcare System.
11
Research
Awards
5
Mini-EBP
Awards
$3,769,286
Total
Awards
226
Posters & Presentations
32
Journals & Books
Research & Dissemination
Evidence-Based Practice
4 Facilitators
Full Time EBP Experts Who Teach & Mentor
21 Consults
For Military Treatment Facilities (MTFs)
47 Projects
Mentored at 15 MTFs
23 Workshops
Nearly 1000 Attendees
5 Webinars
Care of the Family
Women in Combat
7 CE Courses
122.91 Nursing Contact Hours
$12.5K
For 13 Resource Requests
8 Rounds
Nursing Grand Rounds
123 Attendees
Resource Center
6 RIGs
Research Interest Groups
6 Fellows
Post Doctoral Nursing Research Fellows
9 Early Career
Investigators
Junior Officers & Cadets
11 Mentors
Scientific Research Mentors
Scientific Mentorship
700
DHA
Facilities
13
Executive
Leadership
Briefings
17
DoD
Partners
15
Civilian
Universities
Collaborations
Value to U.S. National Defense
TSNRP is Congressionally authorized to fund scientific research by military nurses (S.R. 107-732) in support of American warfighters and their families on the battlefield and at home. TSNRP is the only program to fund rigorous military nursing research and EBP projects that saves lives, solves complex problems, and improves healthcare in collaboration with the Army, Navy and Air Force. In addition to contributing to the national defense, findings of funded research ultimately benefits healthcare outcomes for all Americans.
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Military nursing research solves challenges such as:​
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Unique operational settings for healthcare delivery, including disasters and operational environments
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Mission readiness and performance of Service members
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Patterns of illness, stress, and injury
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Occupational and environmental hazards that affect health and readiness
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Cost-effective delivery of high-quality, evidence-based healthcare
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Innovation to improve medical outcomes
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Improvement of delivery systems and processes to enhance warfighters’ ability to survive, thrive, and remain fit for duty.
As a partner to the Department of Defense, centered at the Uniformed Services University, TSNRP identifies the most innovative and collaborative research that promises significant, positive impact on the lives of military personnel and their families. Plus, the program produces education to advance military nurses’ knowledge, networks, and capacity to provide Evidence-Based nursing care at home and on the frontline.
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5 Funded Studies
$2,537,933
FY23 Funded Studies By Service
3 Funded Studies
$816,353
3 Funded Studies
$415,000
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Funding by Research Priorities
Aligned with U.S. Defense Strategy
In FY2023, the number of awards issued were 7x greater than 2022. Focused on the pursuit of excellence in military nursing, and aligned with the Surgeons General from each military service and the Defense Health Agency, research priorities are approved by the TSNRP Executive Board which is comprised of the Nurse Corps Chiefs from the Army, Navy, and Air Force. Quantitative and qualitative studies are supported on operational and deployment health topics in the following strategic areas:
Force Health Protection
• Fit and ready force
• Deploy with & care for warrior
• Care for all entrusted to our care
Nursing Competencies & Practice
• Patient outcomes
• Quality and safety
• Translate research into Evidence-Based Practice
• Clinical excellence
• Knowledge management
• Education and training
Leadership, Ethics, & Mentoring
• Patient outcomes
• Quality and safety
• Translate research into Evidence-Based Practice
• Clinical excellence
• Knowledge management
• Education and training
8 FY23 Research Projects (72%)
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2 FY23 Research Projects (18%)
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1 FY23 Research Projects (9%)
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Executive Director Letter
One constant is our unwavering commitment to advance nursing science to ensure
better healthcare for service members and their families. TSNRP supported the Defense Health Agency’s mission to promote the adoption and integration of evidence-based practices (EBP) across the Military Healthcare System (MHS) by mentoring 47 projects at military treatment facilities (MTFs) and educating nearly 1000 military nurses on EBP at more than 23 MTFs. In addition, funded research will address topics such as post-COVID-19 syndrome, vitamin k2 and readiness, effects of ketamine on synaptic density following mild TBI, increasing resiliency, virtual nursing with patients on continuous remote monitoring, pain reduction via spinal and opioid receptor heteromers, musculoskeletal training for infantry trainees, data-driven healthcare decision-making, and military nurse retention.
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As a community of military nurse scholars, we translate science into clinical guidelines that elevate healthcare for service members and inspire nursing colleagues to pursue adoption of research findings into routine clinical care for the benefit of our patients. We launched a pilot program to extend eligibility for TSNRP funding to DoD nurses with veteran status in order to foster more research and EBP projects that support readiness and care of the warfighter. When surplus funding became available, funds were immediately directed toward high priority research and EBP awards.
Young J. Yauger
PhD, CRNA, FAANA
COL, AN
Executive Director
Scientific mentorship is an important benefit the TSNRP community offers military nurses. This year we honored Col (ret) Laurie Migliore with the TSNRP Scientific Mentor Award, recognizing her efforts to champion EBP and research across the Joint Base San Antonio clinical inquiry communities, as well as providing guidance on the future alignment of Air Force nurse scientist positions.
To prepare the next generation of military nurse scientists, TSNRP launched the first cohort of the Early Career Investigator Coaching program where junior nurse officers and cadets from the Army, Navy, and Air Force are mentored to advance their military careers as effective researchers. The TSNRP Fellowship program was expanded to include master’s and doctoral nurses, and integrated an online Critical Thought and Leadership certificate for emerging nurse scientists to assume leadership positions in military treatment facilities, operational settings, and global disasters. In partnership with Cornell University's elearning platform and the USUHS Griffith Center for Military Medical Professionalism, nursing fellows learn advanced critical thinking, decision-making, strategic planning, and strategic change management for comprehensive patient care in the rapidly evolving combat and operational nursing environments plus earn an Executive Leadership Certificate from Cornell University.
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We expanded awareness and impact of nursing science in the U.S. and abroad by actively briefing leaders of nonprofits, hospitals, and universities about the essential mission of TSNRP and its contributions to healthcare. From introducing TSNRP to nursing leaders at Massachusetts General Hospital, the original and largest teaching hospital of Harvard Medical School, to presenting at the LTC Juanita Warman Conference, and from briefing the U.S. Army, Navy, and Air Force Nurse Corps to educating military nursing leaders in Allied countries, TSNRP leadership continued to grow recognition and understanding of the key role military nurse scientists play in securing operational readiness.
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TSNRP will continue to educate, mentor, and elevate military nurse scientists as they transition from academics through their military career and into retirement, growing a community of healthcare professionals skilled in EBP projects, research, and translation of key findings into relevant clinical guidance that ensures operational readiness and quality healthcare for service members and their families.
Research Interest Groups
"Think Tanks" for Innovation
TSNRP Research Interest Groups initiate research, Evidence-Based practice, and education projects that support operational readiness in their areas of expertise. Here is a sampling of RIG projects advanced in FY2023:
Military Women's Health RIG
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Leaders:
Maj Angela K. Phillips, PhD, APRN, WHNP-BC, Leader
COL Lana J. Bernat, DNP, CNM, CPHQ, Deputy
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Key Contributors:
Leilani Siaki, LTC(ret), PhD, ANP, FAAN
Pedro Oblea, LTC (ret), PhD
Jennifer Buechel, CAPT, PhD, FAAN
Candy Wilson, COL(ret); PhD, WHNP-BC, FAAN
Dawnkimberly Hopkins, Lt Col(ret), PhD, WHNP-BC
Lori Trego, COL, PhD, APN, FAAN
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Project: Women in Combat
The Military Women’s Health RIG sponsored Women in Combat, a 3-day virtual continuing education event via the AMSUS elearning platform. COL Young Yauger, PhD, RN, CRNA, TSNRP executive director, served as the emcee introducing keynote speakers such as COL Hope Williamson-Younce, DNP, ACNP-BC, CCNS, CEN who spoke on diversity, equity, and inclusion in the military health system; and BG Katherine Simonson, MS, BS, RN who discussed innovation in healthcare and the importance of nursing. Day 1 also featured topics on gender-based stigma among US military officers, and how lean mass predicts lower body power and upper body strength in US Marine women.
On Day 2 Dr. Holly Hoffmeyer, PhD, MPH, MSN, MFA, CNM, AFN-BC presented on gender-sensitive care, and CPT Celeste Chavez, MS, BS highlighted trauma informed care. Intimate partner violence and its impact on service members was addressed by MAJ Rebeccah Dindinger, DNP, RNC-OB, IBCLC followed by a robust panel of experts on sexual assault, prevention, and response.
On Day 3, attendees enjoyed a briefing from Ms. Seileen Mullen, BA, principal deputy assistant secretary of defense for health affairs followed by presentations by Dr. Jacqueline Killian, PhD, MHR, MSN, NPDc, LYTc on alternative methods to promote health and wellness for women in and out of uniform; Dr. Kristin Popp, MS, BS on the suppression of the hypothalamic-pituitary-ovarian axis in women during Army t combat Training; and Dr. DawnKimberly Hopkins, PhD, WHNP-BC, Lt Col USAF (ret) on living with polycystic ovary syndrome (PCOS) in the military. Ms. Amelia Barrett, MS, ATC provided an overview of the Initiation of Marine Physiological Assessment of Combat Training (IMPACT) study.
Expeditionary Care RIG
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Leaders:
Lt Col Tonya White, PhD, USAF, NC, Leader
MAJ Angela Samorsorn, PhD, AN, Deputy
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Project: Lessons Learned from World War II Webinar
Moderators: EXRIG Leader and Deputy
Expert Panelists:
COL Christopher Van Fosson, PhD
Col Darren Domiami, PhD
Lt Col Sarah Huffman, PhD
COL Young "John" Yauger, PhD
Ms. Tamara “AB” Averett-Brauer, MN, RN, DR-III, DAF
Lt Col Theresa Bedford, PhD
At the 2023 Research & EBP Dissemination Course, author Rosemary Neidel-Greenlee shared nursing stories from her book And If I Perish: Frontline U.S. Army Nurses in World War II. Inspired by Rosemary's narrative, the EXRIG assembled military nursing experts from the Army, Navy, and Air Force to conduct a roundtable discussion via the AMSUS elearning platform on lessons learned and how to apply that wisdom for today's operational environments.
Anesthesia RIG
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Leaders:
LTC John Reed CRNA MBA PhD, Leader
CDR Justin Hefley, DNP, CRNA, Deputy
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Project: An Evaluation of the Thermal Stability of Two Propofol Formulations
CDR Justin Hefley, DNP, CRNA
Dr. Sanjiv Kumar Ph.D. MAJ(P)
Laura E. Riddle DVM, MPH, DACVPM, DACLAM
MAJ Stephanie K. Parks, DNP, CRNA
Dr. Donald J. Vallier DNP, CRNA
LTC Michael A. Washington PhD, M(ASCP)
LTC John R. Reed, PhD, MSN, MBA, CR
Military medical personnel often operate under difficult conditions in austere environments. In these situations, medical urgency coupled with equipment and supply constraints can require the use of materials that are less than ideal. It is therefore important to understand the properties of commonly utilized pharmaceutical formulations when refrigeration is unavailable and storage conditions cannot not be optimized. This study aims to analyze the effects of freeze-thaw (FT) cycles on propofol, a frequently used anesthetic, to simulate the austere environments where conventional medication storage conditions are unavailable.
