324 results match your criteria: "Landstuhl Regional Medical Center[Affiliation]"

Military Nurses' Deployment Experiences: A Qualitative Metasynthesis.

Mil Med

December 2024

Palliative Care Nurse Practitioner, Associate Professor, University of Colorado Anschutz Medical Campus, College of Nursing, Aurora, CO 80045, USA.

Introduction: Military medical personnel, including nurses, face a wide array of emotional and psychological issues while deployed. Understanding the challenges military nurses face in the deployed setting may prove useful in effectively preparing nurse leaders for future disaster responses in the military and civilian sectors. The purpose of this metasynthesis is to answer the following research question: What are the experiences of U.

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Introduction: Musculoskeletal (MSK) injury can negatively affect service members by compromising job performance and readiness. These injuries can impact the service member's physical health, functional abilities, and quality of life (QoL). Rehabilitation therapies for MSK injuries can reduce these impacts.

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Article Synopsis
  • - The study analyzed the OXYGEN trial, which compared high levels of oxygen (80% FiO2) vs. lower levels (30% FiO2) for preventing infections in patients with specific types of fractures and aimed to see if using an "as-treated" approach changed the results compared to the "intention-to-treat" method.
  • - Conducted at 29 trauma centers, 1,231 patients with tibial plateau, tibial pilon, or calcaneus fractures were randomly assigned to either oxygen treatment; adherence was evaluated using two specific criteria based on the percentage of surgery time at different oxygen levels.
  • - Results showed no significant differences in primary and deep infection rates, but the treatment group had fewer
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Reducing Opioid Consumption and Length of Stay After Bariatric Surgery: A Nonpharmacologic ERAS Intervention Bundle.

J Perianesth Nurs

October 2024

Center for Nursing Science and Clinical Inquiry, Landstuhl Regional Medical Center, Landstuhl/Kirchberg, Rheinland-Pfalz, Germany.

Purpose: To reduce opioid consumption and decrease length of stay (LOS) in bariatric surgical patients by implementing an evidence-based, nonpharmacologic enhanced recovery after surgery (ERAS) intervention bundle.

Design: Evidence-based practice project.

Methods: We developed and implemented a nonpharmacologic ERAS bundle from existing American Society of PeriAnesthesia Nurses Standards and bariatric and subspecialty surgical ERAS protocols to standardize the postoperative nursing care of bariatric patients.

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Genomic surveillance detected clonal sequence type-361 isolates carrying , , , and from a patient in Ukraine and four wounded foreign soldiers evacuated to Germany. Isolates were non-susceptible to carbapenems, aminoglycosides, and cefiderocol and aztreonam/avibactam due to a PBP3 YRIN insertion and the AmpC β-lactamase. Coordinated surveillance efforts across civilian, military, and veteran healthcare systems are essential to prevent further spread as international volunteers return home after medical evacuation from Ukraine.

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Background: Extremity surgeons frequently operate on the preoperative stretcher rather than the operating room (OR) table. This study sought to identify differences between stretcher-based (SB) and OR table-based (TB) procedures with regard to time efficiency and OR team member preferences.

Methods: We conducted a prospective randomized controlled trial comparing the efficiency of SB vs OR TB foot and ankle procedures.

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Background: Post-COVID conditions (PCC) are difficult to characterize, diagnose, predict, and treat due to overlapping symptoms and poorly understood pathology. Identifying inflammatory profiles may improve clinical prognostication and trial endpoints.

Methods: 1,988 SARS-CoV-2 positive U.

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Background: Among combat injured, invasive fungal infections (IFIs) result in significant morbidity. Cultures and histopathology are the primary diagnostic methods for IFIs, but they have limitations. We previously evaluated a panfungal polymerase chain reaction assay, which was 83% sensitive and 99% specific for angioinvasive IFIs.

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Article Synopsis
  • * Post-2019 samples included 32 strains that carried new genetic features linked to resistance.
  • * Phylogenetic analysis showed three sub-lineages of carbapenem-resistant strains primarily from Ukraine and Georgia, including a significant epidemic clone with all three key resistance genes, highlighting the need for effective infection control and global monitoring.
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We present an infant referred to Developmental Paediatrics for delays, slow growth, hypotonia, esotropia and spasticity. Over the course of 2 months, the infant's exam progressed, demonstrating worsening spasticity and tonal changes in the setting of a normal brain MRI with acquired microcephaly. Genetic testing demonstrated a pathogenic nonsense mutation.

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The Department of Defense Global Respiratory Pathogen Surveillance Program conducts continuous surveillance for influenza, severe acute respiratory syndrome 2 (SARS-CoV-2), and other respiratory pathogens at 104 sentinel sites across the globe. These sites submitted 65,475 respiratory specimens for clinical diagnostic testing during the 2021-2022 surveillance season. The predominant influenza strain was influenza A(H3N2) (n=777), of which 99.

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The American Society of Addiction Medicine Clinical Practice Guideline Development Methodology.

J Addict Med

July 2024

From the Program in Addiction Medicine, Yale School of Medicine, New Haven, CT (MBW); American Society of Addiction Medicine, Rockville, MD (AD, TS, MPB); VA Portland Health Care System, Portland, OR (DK); Department of Medicine, Oregon Health and Science University, Portland, OR (DK, PTK); Gateway Recovery Center, Lake Elmo, MN (EB); USA Landstuhl Regional Medical Center, APO, AE (AS); Johns Hopkins University School of Medicine, Baltimore, MD (DAR); Rutgers New Jersey Medical School, Newark, NJ (LSN); and CARMA Health, Austin, TX (CFT).

The American Society of Addiction Medicine (ASAM) has published clinical practice guidelines (CPGs) since 2015. As ASAM's CPG work continues to develop, it maintains an organizational priority to establish rigorous standards for the trustworthy production of these important documents. In keeping with ASAM's mission to define and promote evidence-based best practices in addiction prevention, treatment, and recovery, ASAM has rigorously updated its CPG methodology to be in line with evolving international standards.

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Introduction: Extracorporeal life support, including extracorporeal membrane oxygenation (ECMO), is a potentially life-saving adjunct to therapy in patients experiencing pulmonary and/or cardiac failure. The U.S.

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Hospital Unit Type and Professional Roles as a Predictor of Relational Coordination in an Army Medical Center.

Qual Manag Health Care

December 2024

Author Affiliations: University of North Carolina at Greensboro School of Nursing (Dr House); The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts (Dr Naim Ali); and Center for Nursing Science and Clinical Inquiry (CNSCI), Landstuhl Regional Medical Center, Landstuhl, AE, Germany (Dr Stucky).

Background And Objectives: High-quality communication and relationships are associated with quality of care. Workflow differences across hospital units can impede communication and relationships among health care professionals. Relational coordination (RC) is a process of communication supported by shared goals, shared knowledge, and mutual respect and is associated with quality of care and better performance outcomes in civilian hospitals.

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Every drop counts: Providing lactation support to breastfeeding surgical patients.

Nursing

March 2024

At Landstuhl Regional Medical Center, Christopher Stucky is the Chief of Research and a Nurse Scientist, Michelle Stucky is a Women's Health Nurse Practitioner and Lactation Consultant, and Rebeccah Dindinger is a Perinatal Clinical Nurse Specialist.

Over half of surgeries in the US are conducted in physician-owned ambulatory surgery centers (ASCs). While ASCs provide cost-effective and quality healthcare comparable to inpatient hospitals, they often lack robust support services, including lactation support. This article presents key information on breastfeeding benefits, early weaning risks, and strategies for nurses in ASCs to educate and support patients who are breastfeeding.

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Introduction: Active-duty servicewomen and veterans make up nearly 20% of the United States military and may experience trauma specific to military service. Military-specific trauma includes combat deployment and military sexual trauma, exposure to which may result in posttraumatic stress disorder (PTSD). The purpose of this scoping review is to examine the extent to which military trauma exposures impact the pregnancy outcomes of active-duty servicewomen and women veterans.

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Skin Antisepsis before Surgical Fixation of Extremity Fractures.

N Engl J Med

February 2024

From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.).

Article Synopsis
  • A study conducted at 25 hospitals compared the effectiveness of two antiseptic solutions (iodine povacrylex and chlorhexidine gluconate) in preventing surgical-site infections during extremity fracture surgeries.
  • Results showed that iodine povacrylex led to a lower rate of infections in patients with closed fractures (2.4% vs. 3.3%) but did not show a significant difference for open fractures (6.5% vs. 7.3%).
  • Ultimately, the study concluded that iodine povacrylex is a more effective skin antiseptic for closed extremity fractures, resulting in fewer infections compared to chlorhexidine, though both had similar outcomes for reoperations and adverse events.
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Treatment and Current Policies on Pseudofolliculitis Barbae in the US Military.

Cutis

December 2023

Injae Jung and Dr. Cho are from Uniformed Services University, Bethesda, Maryland. Injae Jung is from the School of Medicine, and Dr. Cho is from the Department of Dermatology. Dr. Lannan is from the Department of Dermatology, Landstuhl Regional Medical Center, Germany. Dr. Weiss is from the Department of Dermatology, Wilford Hall Medical Center, Lackland Air Force Base, Texas.

Article Synopsis
  • * These grooming standards exist to ensure a proper fit of protective equipment like gas masks, emphasizing the importance of facial hair restrictions for safety.
  • * The text reviews the treatment options for PFB and the different guidelines in place for each branch of the US Military, highlighting the need for dermatologists to be informed about these policies.
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Objectives: Cognitive load is postulated to be a significant factor in clinical reasoning performance. Monitoring physiologic measures, such as heart rate variability (HRV) may serve as a way to monitor changes in cognitive load. The pathophysiology of why HRV has a relationship to cognitive load is unclear, but it may be related to blood pressure changes that occur in a response to mental stress.

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Acromioclavicular joint injuries are common in young active patients. A wide variety of surgical techniques exist to address specific complications associated with surgery. Complications after surgery include loss of reduction, fracture of the clavicle or coracoid, failure of fixation, and prominent and symptomatic hardware.

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Background: Plantar fasciitis (PF) results in pain-related disability and excessive healthcare costs. Photobiomodulation therapy (PBMT) has shown promise for decreasing both pain and disability related to PF.

Purpose: The purpose was to assess the clinical impact of PBMT on pain and function in people with PF.

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Impact of the primary care nurse manager on nurse intent to leave and staff perception of patient safety.

Nurs Manage

January 2024

Melissa J. Miller is a nurse scientist and Chief, Center for Nursing Science and Clinical Inquiry, Tripler Army Medical Center in Honolulu, Hawaii. Mary L. Johansen is a clinical professor at Rutgers, The State University of New Jersey in Newark, N.J., and a member of the Nursing Management Editorial Advisory Board. Pamela B. de Cordova is an associate professor at Rutgers, The State University of New Jersey in Newark, N.J. Pauline A. Swiger is a nurse scientist and CNO for the Defense Health Agency in Falls Church, Va. Christopher H. Stucky is a nurse scientist and Chief, Center for Nursing Science and Clinical Inquiry, Landstuhl Regional Medical Center in Landstuhl, Germany.

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Background: Foot and ankle surgeons often perform minor surgeries on the preoperative stretcher instead of the operating room table. We examined whether stretcher-based and operating room table-based procedures differed with respect to operating room efficiency and staff perceptions.

Methods: We retrospectively reviewed medical records of patients undergoing minor foot and ankle surgery at an ambulatory surgery centre.

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