U.S. Army Professional Filler System Nursing Personnel: Do They Possess Competency Needed for Deployment?

Military Medicine, Feb 2006 by Rivers, Felecia M, Wertenberger, Dana H, Lindgren, Katherine

One-way analysis of variance (ANOVA) was used to test for statistical significance. The data were statistically analyzed at a confidence interval of 95%. Because this research study surveyed both enlisted and officer PROFIS personnel, the data are presented in group format, as 66XXX (registered nurse), 91C/ 91M6 (licensed practical nurse), and a third group composed of 91D (mental health specialist), 91X (operating room specialist), and other military occupational specialties. In the 91B/91W (certified nursing assistant) group, only five individuals completed the survey. Therefore, the results for this group might not be a fair representation of their skill levels; results are not displayed in the panoramic graph but are included in the tables and ANOVAs for review. Significant differences were noted between the groups throughout the six dimensions of the READI.

The READI uses a 5-point scale, as follows: 1, not competent; 2, slightly competent; 3, somewhat competent; 4, competent; 5, totally competent. After review of the data analysis, we thought the results of the research could be more clearly displayed if the 5-point scale was collapsed into three categories, i.e., not competent, moderately competent, and totally competent. Table FV provides an ANOVA of a portion of the clinical nursing competency results. Figure 1 and Tables V to VIII illustrate the means and SDs for the different subsets.

Clinical Nursing Competency

Participants reported low levels of competency for more than one-half of the clinical competency skills, including caring for patients in hemorrhagic shock, implementing documentation in a field environment, reconstituting medications, performing in a code situation, implementing Advanced Cardiac Life Support protocols without a physician, caring for life-threatening injuries, and implementing triage categories. Moderate to high levels of competency were noted in areas such as following standing orders, responding to code situations, and deciding who would be treated first in a shock scenario. None of the participants reported the highest level of competency in this category.

Operational Nursing Competency

All groups reported moderately high competency in field sanitation and hygiene and deployable medical systems proficiency. Slightly low competency means were reported for evacuation procedures, reporting unlawful acts, and echelon of care. Very low means were noted for use of the 12-lead electrocardiograph and the suction apparatus. The same results were noted in previous studies.6

Soldier/Survival Skills

The results were fairly consistent across the three groups, with means varying from 2.25 to 3.43 for perceived competency in soldier and survival skills. The lowest item score among all three groups was for competency in the ability to resist the enemy if captured. The highest rated item was the ability to navigate using a map and a compass. The enlisted soldiers reported greater competency in using the Army communications equipment than did the officers. All groups rated moderately in the ability to defend themselves and their patients and in using the M40 mask and protective gear during a nuclear/ biological/chemical attack.