BETHESDA, Md.  –   After training over 250 medical-surgical nursing personnel, the Directorate for Professional Practice and Clinical Excellence plans to offer its Nursing Care After Trauma course on a quarterly basis to enhance readiness.

“This course is about ensuring our nurses are prepared for the patients we may receive and the mission we are called to support,” said U.S. Army Col. Rene Key, director for Professional Practice and Clinical Excellence. 

“Our medical-surgical nurses play a critical role in the recovery of trauma patients, and this training gives them the tools and confidence to provide that care safely and effectively,” Key, DNP, added.

Walter Reed Clinical Nurse Specialist Manny Santiago, DNP, agreed with Key and said that Walter Reed’s investment in NCAT is worth it because of what the training delivers: increased operational readiness, reduced complications and cost burden, standardized high-reliability care, stronger workforce performance and retention, and improved patient outcomes.

With Walter Reed’s primary mission as a casualty receiving platform and its day-to-day health care mission, U.S. Army Col. Canisha Martin, chief nursing officer, saw an opportunity to strengthen her nursing teams’ skills and enhance readiness. Key communicated that vision to her team. From there, Santiago and U.S. Navy Lt. Shawn Holdsworth, two Walter Reed clinical nurse specialists, spearheaded development and execution of the course with support from other Walter Reed teammates and departments. 

“NCAT is not just a training course — it is a force multiplier for Walter Reed’s mission,” Holdsworth said. 

He added that the training initiative directly supports readiness, safety and quality, education, and patient outcomes by preparing nurses for combat casualty care, providing standardized trauma practices, developing clinical excellence and improving post-trauma care.

The inaugural course ran weekly for eight weeks, from March to May, and was designed to strengthen nursing staff readiness by investing in their ability to provide effective and safe care after traumatic incidents. Medical-surgical staff, which included military and civilian registered nurses, licensed practical nurses and military paraprofessionals — U.S. Army medics, U.S. Navy hospital corpsman and U.S. Air Force medical technicians — working on Walter Reed’s inpatient wards participated in the training.

“We’ll be ready by design, not by accident,” Santiago said after referring to a quote by Keith Bass, assistant secretary of war for health affairs. Earlier this year, Bass said “None of this happens by accident — it happens by design,” when discussing the future of federal health care. 

The resulting NCAT program consisted of three parts: virtual, classroom and Just-in-Time training. Prior to the classroom component, participating staff were required to complete 31 online modules to establish a foundation for the training. 

The classroom component consisted of 2 1/2 in-person days. While in the classroom, staff listened to lectures, engaged in hands-on training and participated in simulated trauma scenarios. This area focused on preparing the medical-surgical nurses to care for their patients that were recovering from combat-related injuries. 

Their training was reinforced through Just-in-Time training. This third component ran parallel to the classroom training and served to actively reinforce the critical skills taught and expand clinical reach across the medical-surgical units.

During the training, the team focused on two areas: complex trauma management and clinical bedside interventions. Complex trauma management involves traumatic brain injuries and spinal cord injuries; amputations, acute burn care and septic shock management; and early sepsis recognition and clinical protocol execution. Clinical bedside interventions include chest tube management and troubleshooting, advanced wound care and dressing techniques, and tracheostomy care and emergency airway management. 

“NCAT bridges the gap between resuscitation and definitive care,” Holdsworth said. “It prepares nurses for med-surg level trauma management, emphasizes long-term recovery priorities and provides seamless transition across the continuum of care.”

So, in addition to its readiness value, the NCAT’s focus on complex trauma management and clinical bedside interventions also benefits medical-surgical inpatients. Santiago said that some of those benefits for patients include being able to recognize when something is wrong sooner; assess and not just react; provide more consistent and safer care by using a standardized, structured approach; provide better pain and wound care management; and be a stronger advocate.

Whether from a readiness aspect or patient care, the decision to continue offering NCAT enhances Walter Reed’s “why.” 

“Walter Reed does not exist to treat patients only — it exists to sustain the fighting force,” Santiago said. “Training reduces preventable complications. … Trained staff don’t hesitate to act. 

“If Walter Reed sets the standard, NCAT helps define it.”