Central Asia Regional Health Security Workshop George C. Marshall European Center for Security Studies 17-19 April 2012, Garmisch-Partenkirchen, Germany - PowerPoint PPT Presentation

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Central Asia Regional Health Security Workshop George C. Marshall European Center for Security Studies 17-19 April 2012, Garmisch-Partenkirchen, Germany

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Title: Central Asia Regional Health Security Workshop George C. Marshall European Center for Security Studies 17-19 April 2012, Garmisch-Partenkirchen, Germany


1
Central Asia Regional Health Security
WorkshopGeorge C. Marshall European Center for
Security Studies 17-19 April 2012,
Garmisch-Partenkirchen, Germany
Technicians, Nurses and Physician Assistants in
the United States Department of Defense
  • Major Robin Ducker
  • International Health Specialist
  • Headquarters Air Forces Central Command
  • 18 April 2012

2
Introduction
  • Enlisted Medical Technician Training
  • Medical Education and Training Center
  • Licensed Practical Nurse
  • Registered Nurses
  • Nurse Transition Program/Nurse Residency Program
  • Nursing Specialties
  • Advance Practice Nurses
  • Advanced Academic Degrees
  • Physician Associates/Physician Assistants

3
Who Are They?
  • Privileged Providers Physicians, Nurse
    Practitioners, Physician Assistants
  • Remote location/Limited Providers Independent
    Duty Technicians (Air Force), Independent Duty
    Corpsman (Navy)
  • Nurses (All have Baccalaureate of Science
    degrees)
  • Licensed Practical Nurses (Army)
  • Medical Technicians (Air Force), Hospital
    Corpsman (Navy), Health Care Specialist Combat
    Medic (Army)

4
Enlisted Technicians
  • High School (Secondary/12 years school total)
    graduates
  • Perform all of the functions in the military
    hospital that do not require a Baccalaureate
    degree (4 years of college)

5
Tri-Service Enlisted Medical Training at the
Medical Education and Training Campus
  • New school fully operational just last year
  • Originated by advice of Presidential Commission
    formed and tasked to reduce Department of Defense
    expenditures and increase efficiencies
  • Forms the largest medical education and training
    institution in the U.S.
  • Trains 25,000 students every year (About 8,000
    students at any point in time)

6
  • Public Health Services
  • Animal Care (Army) 11 weeks
  • Veterinary Food Inspection (Army) 8 weeks
  • Health Physics (Army) 12 weeks
  • Behavioral Health Air Force 13 weeks, Navy 17
    weeks, Army 17 weeks
  • Preventive Medicine Army 15 weeks, Navy 24 weeks
  • Dental Training
  • Dental Specialist (Army) 7 weeks 23 weeks in
    hospital
  • Dental Assistant (Air Force/Navy) 8 weeks
  • Dental Lab (basic) 23-25 weeks
  • Dental Lab (Advanced) (Navy) 24 weeks
  • Preventive Dental (Army) 12 weeks
  • Advanced Porcelain Techniques 3 weeks
  • Removable Prosthodontics (Navy/Air Force) 3
    weeks

7
  • Orthotics (Air Force) 29 weeks
  • Otolaryngology Army 6 weeks, Air Force 12 weeks
  • Practical Nurse (Army) 8 weeks
  • Respiratory Therapy 30 weeks
  • Surgical Tech (Army/Air Force) 10 weeks
  • Surgical Tech (Navy) 23 weeks
  • Urology (Navy/Air Force) 15 weeks
  • Combat Medic (Army) 14 weeks
  • Medical Technician (Air Force)/Hospital Corpsman
    (Navy) 20 weeks
  • NURSING SPECIALTY
  • MEDICAL TRAINING
  • Allergy/Immunization 5 weeks
  • Cardiopulmonary (Air Force) 14 weeks
  • Cardiovascular (Army/Navy) 20 weeks
  • Hemodialysis Army 14wks, Navy 20 weeks
  • Ophthalmic Tech Army 6 wks, Air Force 10 weeks
  • Optician (Army/Navy) 23 weeks
  • Orthopedics Army 6 weeks, Navy/Air Force 12
    weeks

8
Surgical Technician Training
9
Combat Medic/Medical Technician/Hospital Corpsman
  • Air Force Medical Technician
  • 9 weeks Basic Training
  • 20 weeks at Medical Education and Training Campus
  • Hospital training 45 days
  • Usually dont further specialize right away like
    the Army and Navy do
  • Can later go for 12 weeks further training as an
    Independent Duty Medical Technician
  • Army Combat Medic
  • 10 weeks Basic Training
  • 8 weeks training at Medical Education and
    Training Campus
  • Often go on to further training such as
    orthopedics and optometry
  • Navy Hospital Corpsman
  • 7-9 weeks Basic training
  • 20 weeks training at Medical Education and
    Training Campus
  • Many go on to further training such as radiology
    and laboratory technology
  • 7 weeks Field Medical Service School will qualify
    them to serve with Marines
  • Are often called Doc by fellow Navy and Marine
    personnel as a term of respect

10
Navy Corpsman Training
11
Independent Duty Corpsman / Independent Duty
Medical Technician
  • Scope The training program includes (but is not
    limited to)
  • medical history taking
  • physical examination techniques and procedures
  • advanced medical and surgical procedures
  • environmental sanitation and preventive medicine
  • pharmaceutical mathematics
  • clerical procedures
  • fiscal and supply management
  • Often is the sole provider for a particular
    location, a role that finds them stitching
    wounds, dispensing medicine, performing dental
    care, and treating injuries and illnesses.

12
What is a Practical Nurse or Licensed Practical
Nurse?
  • Has undergone approximately 12 months of
    intensive study and hospital experience
  • Has passed a state licensure examination in
    Practical Nursing
  • The Practical Nurse is similar to the now defunct
    State Enrolled Nurse in Great Britain (Level 2
    Nurse)
  • Always works under the supervision of a
    Registered Nurse
  • Unable to administer many intravenous medications
    and blood products in most states
  • Are only utilized in the civilian sector and in
    the Army

13
Does the Military Train Licensed Practical Nurses?
  • Yes!
  • The Army Combat Medic applies to the program with
    letters of recommendation and evidence of ability
    to complete the program
  • The LPN program consists of 8 weeks at the
    Medical Education and Training Center and 44
    weeks of hospital training
  • At the completion of the training, the soldier is
    qualified to take the National Practical Nurse
    exam

14
  • HEALTH SERVICES MANAGEMENT
  • Biomedical Equipment Army/Air Force 41 weeks,
    Navy 54 weeks
  • Medical Material Supervisor (Air Force) 3 weeks
  • Medical Expense Performance Reporting System (Air
    Force) 2 weeks
  • Medical Logistics Army 6 weeks, Air Force 5
    weeks
  • Patient Administration Army 6 weeks, Air Force
    7 weeks
  • DIAGNOSTIC TRAINING
  • Cytotechnology 50 weeks
  • Electroneurdiagnostic Navy/Air Force 26 weeks
  • Histopathology Navy/Air Force 36 weeks
  • Medical Lab (Air Force) 17 weeks
  • Medical Lab (Air Force/Navy) 26 weeks
  • Nuclear Medicine 19 weeks
  • Radiology/Radiography Air Force 19 weeks, Navy
    21 weeks, Army 24 weeks
  • Diagnostic Medical Sonography (Advanced Course)
    1 week
  • Mammography (Air Force) 12 weeks

15
  • Additional Biomedical Equipment Technician
    Courses (Advanced Training)
  • Computer Based Medical Systems 4 weeks
  • Computed Tomography 2 weeks
  • Mammography Imaging 1 week
  • Radiographic/Fluoroscopic Imaging 3 weeks
  • Radiographic Acceptance Procedures 2 weeks
  • Telemedicine 3 weeks
  • Ultrasound Imaging Systems 1 week
  • Advanced Field Medical Systems 2 weeks
  • Advanced Sterilization Systems 4 days
  • Biomedical Equipment Management 4 days
  • ANCILLARY TRAINING
  • Nutrition/Diet Therapy Army/Air Force 7 weeks
  • Occupational Therapy Army 19 weeks, Navy 35
    weeks
  • Pharmacy (Air Force) 14 weeks
  • Pharmacy Army 22 weeks, Navy 23 weeks
  • Physical Therapy 16-25 weeks

16
Sample Curriculum Pharmacy Technician Course
  • Program Model
  • Phase I (didactic/laboratory training)
  • 12 weeks long (all 3 services together)
  • After 12 week(Phase I) program
  • AF students go directly to Phase II (experiential
    training)
  • Army and Navy continue for 3 more weeks of
    advanced training (didactic/laboratory), then go
    to Phase II (experiential training)

17
Pharmacy Technician Training Phase I Breakdown
  • Students must complete 11 courses
  • Pharm 101(Intro to Pharmacy)/Service Specific
    Training
  • Pharm 102 (Admin/Supply)
  • Pharm 103 (Intro to Therapeutics)
  • Pharm 104 (Therapeutics 2)
  • Pharm 106 (Therapeutics 3)
  • Pharm 110 (Outpatient Operations)
  • Pharm 120 (Pharmacy Compounding)
  • Pharm 111 (Inpatient Operations)
  • Math 102 (Pharmacy Calculations)
  • Math 103 (Compounding Calculations)
  • Math 201 (Inpatient Calculations)

18
Phase 1 Course Matrix
19
Pharmacy Technician Training Phase II
  • Phase II (Experiential Training)
  • Air Force (3 weeks)
  • Army (5 weeks)
  • Navy (5 weeks)(1 week prior math refresher)
  • Total Training Lengths
  • Air Force (15 weeks)
  • Army (22 weeks)
  • Navy (23 weeks)

20
  • Enlisted Training
  • Aerospace Evacuation Technician 21 days
  • Aerospace Physiology Apprentice 45 days
  • Bioenvironmental Engineering Apprentice 68 days
  • Bioenvironmental Engineering Craftsman 5 days
  • Public Health Apprentice 67 days

21
What is a Registered Nurse?
  • Has had two to four years of college education in
    Nursing
  • Has passed a nationally administered licensure
    exam
  • Is unable to make medical diagnoses and prescribe
    medication
  • Army, Navy and Air Force all require their Active
    Duty Nurses to have 4 year Nursing Degrees (The
    Army Reserves still allow nurses in with less
    than 4 year degrees)

22
Registered Nurses
  • The Air Force gets most of its new nurses every
    (about 60) from the civilian health care sector.
  • The other 40 of the new nurses have no
    experience. They have just graduated from college.

23
New Nurse at Graduation
24
Air Force Nurse Transition Program/Nurse
Residency Program (Novice Nurse)
  • 4 Centers of Excellence for training
  • National Council of State Boards of Nursing
  • Transition To Practice Model
  • Recognize value of evidence-based models in
    public protection
  • Phase 2 Training
  • Phase 2 Training
  • Continues the Phase I Nurse Transition Program
    through transition in a military facility

25
Novice Nurse Transition Year
Month 1-2 Commissioned Officer Training,
Communication, Team-Work
Enrolls in Program
New Graduate Nurse Recruited
Month 2-3 (Nurse Transition Program) Clinical
Skills, Critical Thinking,
Problem Solving
Month 4-7 Hospital and Unit Orientation
Month 7-12 (Air Force Nurse Residency
Program) Evidence Based Practice,
Communication, Quality, Informatics
Month 12 (Graduate) Submit paperwork, Upgrade
to full RN categorization
26
Army Nurse Specialties
After one year of service, Army Nurses attend a
clinical specialty course
27
What is a Nurse Practitioner or Advanced Practice
Nurse or Advanced Registered Nurse Practitioner?
  • Usually are graduates of a Masters degree
    granting program (Bachelors degree plus two
    years Masters level study)
  • Require licensure by national exam
  • Usually work in a clinic setting but some have
    hospital privileges
  • Can practice independent of a physician
  • Can prescribe most medications
  • All services use nurse anesthetists

28
Does the U.S. Department of Defense train
Advanced Practice Nurses?
  • Yes!
  • Critical Care Clinical Nurse Specialist (CNS)
  • Emergency/Trauma CNS
  • Flight Nursing CNS
  • Medical-Surgical CNS (Adult Health)
  • Perioperative CNS
  • Nurse Anesthesia
  • Womens Health Nurse Practitioner
  • Pediatric CNS
  • Family Nurse Practitioner

29
Advanced Academic Degrees (contd)
  • Psychiatric Mental Health Nurse Practitioner
  • Community Health
  • Masters in Health Administration
  • Masters in Business Administration/Masters in
    Nursing
  • Nurse Midwifery
  • Perinatal CNS
  • Pediatric Nurse Practitioner
  • Neonatal Intensive Care CNS
  • Masters in Public Health
  • PhD Nursing Science

30
Uniformed Services University of the Health
Sciences
  • Graduate School of Nursing Masters of Science
    in Nursing (MSN)
  • Family Nurse Practitioner
  • Nurse Practitioner
  • Perioperative Clinical Nurse
  • Psychiatric Mental Health Nurse Practitioner
  • Doctorate of Philosophy (PhD) Program in Nursing
    Science

31
What is a Physician Assistant or Physician
Associate?
  • Usually are graduates of a Masters degree
    granting program (Bachelors degree plus two
    years Masters level study)
  • Require licensure by national exam
  • Usually works in a clinic setting
  • May sometimes be unable to prescribe narcotics
  • Always work under the supervision of a physician

32
Does the Military Train Physician
Assistants/Physician Associates?
  • Yes!
  • Inter-service Physician Assistant Program
  • Medics with a bachelors degree can apply for the
    program
  • Program is 2 years in length (1 year of training
    at the Medical Education and training center and
    1 year of training at a military hospital)
  • Approximately 180 students are trained each year
  • Graduates are commissioned and can sit for
    national certification
  • 4 year service obligation

33
Questions?
34
  • Major Robin Ducker
  • International Health Specialist
  • Robin.ducker_at_afcent.af.mil
  • 803-895-3024
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