Evaluating Nursing Knowledge and Readiness to Provide Care for Post-9/11 Veterans in Civilian Healthcare Settings: A Quality Improvement Project

Over three-million military service members deployed overseas in support of the post-9/11 Global War on Terror since 2001. Of those, 7,057 have been killed in action, 30,177 have committed suicide, 279,652 died from ill-defined and unknown medical causes, and 520,966 have been diagnosed with cancer. Post-9/11 veterans are 192.75% more likely to be diagnosed with cancer when compared to their civilian counterparts and are more likely to utilize civilian providers (75%) than the Department of Veterans Affairs for health care concerns. The purpose of this quality improvement project is to investigate the level of nurse knowledge, beliefs, and perceptions related to providing health care to post-9/11 veterans in civilian care settings. A descriptive project design with a 15-question survey was implemented. The survey was sent to registered nurses practicing in civilian care settings. A sample of 537 registered nurses practicing in civilian care settings responded. Findings included that 93% incorrectly chose mental health conditions as the most likely occurring condition in post-9/11 veterans, while 7% correctly chose medical illnesses as most prevalent. Nurse respondents reported perceived prevalence of post-traumatic stress occurring more often than cancer and malignancies at a ratio of 19:1. These findings highlight the high potential for cognitive biases which may lead to misdiagnoses and delayed diagnoses in post-9/11 veterans presenting for care with medical symptoms, furthering the need for education. This quality improvement project revealed significant gaps in civilian nurses’ clinical knowledge in screening, assessing, identifying, treating, and recommending resources for post-9/11 veterans and medical related conditions