Medical journal (Fort Sam Houston, Tex.)最新文献

{"title":"66C Psychiatric/Behavioral Health Nurse Specialty in Military Medicine.","authors":"Caleb Manning, Marlene Arias-Reynoso, Amy Brzuchalski, Lutisha Crawford, Shaina Escribano, LaKisha Wright","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Abstract: </strong>The 66C, psychiatric/behavioral health nurse, provides expert psychiatric care to warfighters and their families across various settings for wartime, peacetime and humanitarian aid. As a specialized nursing field, the 66C focuses on three key areas: prevention through behavioral health promotion, intervention for addressing emerging concerns, and stabilization to support post-crisis recovery. Psychiatric nurses empower individuals to regain optimal functioning and wellbeing by addressing behavioral health needs in diverse environments.</p>","PeriodicalId":74148,"journal":{"name":"Medical journal (Fort Sam Houston, Tex.)","volume":"108 1","pages":"47-48"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of the Brigade Nurse.","authors":"Jill K Jackson","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Abstract: </strong>Brigade nursing is a unique opportunity for motivated, competent, and autonomous Army Nurses who want to expand their skills and experiences in an operational unit. There is only one nurse assigned to a brigade of up to 5,000 Soldiers. The primary role of the brigade nurse is to set up and maintain the patient hold section within the Role II medical treatment facility. The patient hold section can hold up to 20 patients who are expected to return to duty within 72 hours. This capability improves overall mission effectiveness and readiness in a field/deployed environment. Brigade nurses work hand and hand with other medical professionals in a deployed environment, while also providing life-saving care in garrison environments especially during events like the COVID-19 pandemic. Brigade nursing can pave the way for other strategic Army nursing positions such as division nurse.</p>","PeriodicalId":74148,"journal":{"name":"Medical journal (Fort Sam Houston, Tex.)","volume":"108 1","pages":"135-136"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shaping Medical Excellence: The Enduring Impact of an Army Emergency Trauma Clinical Nurse Specialist in Kuwait.","authors":"Domingo Baez-Diaz","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Abstract: </strong>This article explores the essential role of the Clinical Nurse Specialist (CNS) in military healthcare, particularly during the deployment of a U.S. Army Emergency Trauma CNS in support of Operation Spartan Shield in Kuwait. It highlights the gap in existing literature regarding the unique contributions of CNSs in military settings, emphasizing the need for advanced practice competencies to navigate the complexities of deployed healthcare provision. The CNS's multifaceted impact is demonstrated through their educational initiatives aimed at ensuring clinical staff readiness, where they trained 140 clinical personnel, providing 24-hour care to a diverse population at the U.S. Military Hospital-Kuwait. The article underscores the CNS's influence in promoting quality improvement, interdisciplinary collaboration, and adherence to established competencies such as those outlined in the 2022 AACN Scope and Standards. Additionally, the CNS advanced medical education throughout the Central Command (CENTCOM) region by initiating accredited continuing education courses, significantly enhancing the skill sets of healthcare providers and contributing to over 1,200 accredited educational hours. These initiatives not only exemplify the CNS's commitment to lifelong learning and evidence-based practice but also underscore their critical leadership role in improving healthcare delivery in military contexts. The article concludes by advocating for increased recognition of the indispensable contributions of CNSs in military medicine and the importance of ongoing education and competency development.</p>","PeriodicalId":74148,"journal":{"name":"Medical journal (Fort Sam Houston, Tex.)","volume":"108 1","pages":"146-148"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148703009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standardizing Early Ambulation Practices to Improve Mobility across Military Treatment Facilities.","authors":"Nicholas A O'Neel, Wendy M Krull, Amber L Smith, Jason L Robinson, Nichole E Crouch, Kimberley C Holkup, Brian K Vanbeveren","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Abstract: </strong>Background: Hospital-acquired immobility contributes to functional decline, prolonged hospital stays, and preventable complications. Within the Military Health System (MHS), inconsistent mobility practices and lack of a standardized protocol hinder effective care. Purpose: This evidence-based practice project aimed to implement and evaluate the Johns Hopkins Activity and Mobility Promotion program across adult inpatient units at Tripler Army Medical Center to standardize mobility, improve outcomes, and enhance interdisciplinary collaboration. Methods: Using a four-phase approach-planning, education and training, implementation, and sustainment-an interdisciplinary team integrated mobility assessment tools (Activity Measure Post-Acute Care (AM-PAC) \"Six Clicks\" Score and Johns Hopkins Hospital - Highest Level of Mobility (JHH-HLM) into MHS GENESIS (the military-specific electronic health record) and established training and performance metrics. Data collection focused on documentation compliance and quality. Results: Across five adult inpatient units (n=11,565 patients), AM-PAC and JHH-HLM documentation compliance varied and was initially low across most units (0-22%), except for Medical Surgical Unit 1 (MS1) (49-60%), but generally increased over time. Initially, Intensive Care Unit (ICU) and Progressive Care Unit (PCU) AM-PAC compliance was 0% and 18%, respectively, but increased to >90% by month 12. Medical Surgical Unit 1 consistently maintained high AM-PAC compliance (89-99%). Medical Surgical Unit 2 (MS2) and Medical Surgical Unit 3 (MS3) also improved to >93% in the last five months. AM-PAC/JHH-HLM reconciliation improved across most units (15-22% increase), with MS1 showing minimal change (1% increase). Implications for Practice: This initiative illustrates the feasibility of implementing a scalable, interdisciplinary mobility program within a military hospital. Continued expansion across military healthcare treatment facilities and development of formal practice guidelines are recommended next steps.</p>","PeriodicalId":74148,"journal":{"name":"Medical journal (Fort Sam Houston, Tex.)","volume":"108 1","pages":"100-107"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148703055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Permethrin-Treated Army Combat Uniforms and Topical Application of N,N-diethyl-3-methylbenzamide (DEET) for Bite Protection from Aedes aegypti in a Semi-Field Setting.","authors":"Sierra M Schluep, Vanessa C Vinci, Mark A Mitola, Edward R Traczyk, Corey A Day","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Abstract: </strong>Service members are routinely deployed to geographical locations where arthropod-borne diseases are endemic. Force health protection relies on integrated vector management methods to reduce service member exposure to disease vectors. The United States Department of Defense relies heavily on personal protective measures that include proper uniform wear, on-skin application of topical repellents, and insecticidal treatment of working uniforms with permethrin. The objective of this study was to evaluate the effectiveness of topical N,N-diethyl-3-methylbenzamide (DEET) application, permethrin-treated U.S. Army Combat Uniforms (ACUs) with operational camouflage pattern, and their combination for protecting service members from the bite of Aedes aegypti (L.) mosquitoes in a semi-field environment. Volunteers wearing treated or untreated ACUs, with or without DEET on exposed skin, stood stationery in outdoor cages containing 100 unfed Ae. aegypti females. The data recorded included number of mosquito bites identified on the volunteer, the number of blood fed mosquitoes, and post-exposure mosquito mortality rates 24 hours following trials. Results demonstrated that properly worn ACUs prevented mosquito bites from occurring on covered body parts, even when untreated. However, bites were common on exposed skin when DEET was not applied. The combination of DEET and a properly worn uniform provided nearly 100% protection from bites. Permethrin-treated uniforms alone did not prevent mosquitoes from biting exposed skin but resulted in significant mosquito mortality 24 hours after exposure. These results show that the combination of proper uniform wear, uniform treatment, and use of topical repellent provides holistic protection including bite reduction and focal mortality of exposed mosquitoes.</p>","PeriodicalId":74148,"journal":{"name":"Medical journal (Fort Sam Houston, Tex.)","volume":"108 2","pages":"75-80"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148623044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The American Dream: Army Reserve Nurses.","authors":"Clarisa B Colchado, Maria O Cruz de Portillo","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":74148,"journal":{"name":"Medical journal (Fort Sam Houston, Tex.)","volume":"108 1","pages":"133"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Graphene-treated Fabrics as an Innovative Platform for Enhancing Soldier Protection from Arthropod Vectors.","authors":"Edmund J Norris, Melynda Perry, Greg Allen, Haley Dabbs, Jedidiah Kline, Robert L Aldridge, Nicole Hoffman, Michael Manser, Joseph Orlando, Thomas Tiano","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Abstract: </strong>Military personnel are highly vulnerable to arthropod-borne diseases, and current personal protective measures-especially pyrethroid-treated uniforms-have limitations in durability and efficacy against insecticide-resistant vectors. This study evaluated a novel non-insecticidal approach using graphene-treated fabrics to enhance soldier protection from mosquito bites. To evaluate the potential of graphene to prevent mosquito biting, Aedes aegypti and Anopheles albimanus biting rates were monitored on graphene-treated vs. control fabrics under an arm-in-cage protocol. Graphene was applied to military fabrics utilizing three distinct print patterns (thin lines, thick lines, and dots), which were then subjected to standard military wash protocols utilized for pyrethroid-treated fabrics (out to 50 wash cycles) prior to bite protection evaluations at four distinct wash levels (0X, 1X, 20X, and 50X). All graphene-infused fabrics produced a significant reduction in mosquito bites for at least one wash level against both mosquito species. Of the graphene print styles evaluated, the largest reduction in bites was observed in the thick lines at the 50X wash level (64.7% reduction in biting). This was followed by dot and thin line patterns, respectively (49.7% reduction and 39.8% reduction, respectively). Idiosyncratic effects were observed for specific mosquito species and print patterns, with An. albimanus bites being most significantly reduced by all graphene print patterns. These results demonstrated that graphene-treated fabrics could serve as a robust bite protective technology against host-seeking mosquitoes. This technology offers a promising supplement to existing pyrethroid-based defenses, potentially overcoming issues of chemical durability and insecticide resistance. In conjunction with pyrethroid treatment, integrating graphene into uniforms could provide soldiers with long-lasting protection against disease vectors.</p>","PeriodicalId":74148,"journal":{"name":"Medical journal (Fort Sam Houston, Tex.)","volume":"108 2","pages":"15-23"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148623093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"66H In Every Era, in Every Fight: The Medical-Surgical Nurse's Enduring Reach.","authors":"Hanna Betts, Danielle M Garcia, Nicole M Fuss, Maria T Pescatore","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":74148,"journal":{"name":"Medical journal (Fort Sam Houston, Tex.)","volume":"108 1","pages":"59-60"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"66E U.S. Army Perioperative Nursing: Foundation, Function, and Future in Military Healthcare.","authors":"Kenneth Romito, Kristine D Lee, Christopher H Stucky","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Abstract: </strong>The U.S. Army perioperative nurse (66E) plays a pivotal role in delivering surgical care that directly influences battlefield survivability, operational readiness, and overall force health. Rooted in a legacy dating back to the American Revolutionary War, Army perioperative nurses embody a unique blend of clinical precision, operational agility, and leadership excellence. These nurses serve as circulating or scrub personnel in operating rooms, managing sterile technique, surgical equipment, implants, and intraoperative imaging, while coordinating preoperative and postoperative care in both domestic and deployed settings. Their responsibilities extend beyond the surgical suite, encompassing trauma response, setting up field hospitals, managing mass casualties, and providing surgical logistics in austere environments. Specialization in perioperative nursing offers distinct career advancement opportunities and aligns with the Military Health System's goals of maintaining a medically ready force. Through training, mentorship, research dissemination, and advanced academic programs such as the Doctor of Nursing Practice Adult-Gerontology Clinical Nurse Specialist with a perioperative focus at USUHS, 66Es contribute to surgical innovation and quality improvement across the continuum of care. In 2024, 66Es demonstrated significant impact through leadership roles, global deployments, scholarly achievements, and clinical education initiatives. Looking forward, strategic efforts to reintegrate 66Es into forward surgical units and expand CNS authorizations will further strengthen the specialty's influence. Army perioperative nurses remain essential to military surgical capability, shaping the future of combat care and enhancing patient outcomes across operational and humanitarian missions.</p>","PeriodicalId":74148,"journal":{"name":"Medical journal (Fort Sam Houston, Tex.)","volume":"108 1","pages":"49-52"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Bedside to Blueprint: The Role of the Public Health Nurse in Strategic Military Health Facility Planning.","authors":"Jasmin A Gregory","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Abstract: </strong>Public health nurses are often associated with disease prevention and community-based health education. Yet their contributions extend far beyond clinical and community interactions. In the context of military healthcare, public health nurses bring a systems-oriented perspective that supports long-range strategic planning, readiness, and resilience. This article offers a firsthand account of how nursing experience, rooted in frontline outbreak response and humanitarian missions, evolved into strategic leadership within the U.S. Army Health Facility Planning Agency (HFPA). HFPA is charged with designing and modernizing healthcare delivery systems across the Department of Defense, integrating clinical operations with infrastructure planning to support military operations worldwide. Public health nurses are uniquely qualified to contribute to this mission. Their training in prevention, population health, epidemiology, and health equity informs facility design that not only meets immediate clinical needs but anticipates long-term shifts in disease burden, demographic changes, and emerging health threats. This article explores the intersection of public health nursing, strategic planning, and military health systems through the example of a hospital redevelopment project in Chuuk State, Federated States of Micronesia. It underscores how public health insights can strengthen healthcare access and reinforce global health partnerships that align with operational readiness. By embedding nursing expertise into the fabric of infrastructure design, the future of military healthcare can be proactive and responsive.</p>","PeriodicalId":74148,"journal":{"name":"Medical journal (Fort Sam Houston, Tex.)","volume":"108 1","pages":"139-141"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148703062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}