In 2011, Army Medicine introduced the Patient CaringTouch System, a product of the Army Nurse Corps. The aim of the Patient CaringTouch System is to ensure nurses deliver quality care to patients in accordance with evidence-based nursing practice.
An evaluation of the impacts of the Patient CaringTouch System found that ratings of the professional practice environment exceed those of healthcare organizations distinguished by another widely recognized standard for excellence -- the "Magnet" hospital designation of the American Nurses Credentialing Center (ANCC). (Magnet is a registered trademark of the American Nurses Credentialing Center)
To obtain Magnet recognition, a hospital must satisfy a set of performance-driven criteria that examine nursing excellence and innovations in professional nursing practice. In short, hospitals can only achieve the Magnet designation after demonstrating excellence in patient care.
A team, led by Col. Sara Breckenridge-Sproat from Regional Health Command Europe, has been collecting data since 2011 on the effectiveness of the Patient CaringTouch System.
Col. Breckenridge-Sproat and team used the Practice Environment Scale of the Nursing Work Index (PES-NWI) to assess the hospital and unit nursing practice environment; it is the most commonly used tool to measure the professional nursing practice environment. The PES-NWI has been shown previously to be a useful tool to examine differences in the practice environments for nurses. The Army Nurse Corps conducts an annual nursing survey as part of the sustainment strategy for the Patient CaringTouch System, and much of the data collected are items from the PES-NWI. The PES-NWI allows for comparison of the nursing practice environment between Military Treatment Facilities and civilian facilities, both Magnet and non- Magnet.
Congruent with research findings in the civilian sector, previous research in military hospitals has led to the awareness that the nursing practice environment has substantial positive associations with nurses' job satisfaction and ratings of care quality, and inverse relationships with intent to leave the job. By measuring the performance and perceptions of high-quality nursing staff, we are better able to identify strategies necessary to recruit and retain the best nurses, and enhance patient safety and satisfaction.
An Army-wide PES-NWI survey conducted from 2002 to 2003 resulted in a composite score of 2.71. At the time, that score was higher than the score of non- Magnet civilian medical facilities (2.65), although lower than Magnet facilities score of 2.95.
By 2011, however, during the implementation of the Patient CaringTouch System, 88 percent of Army MTFs scored above non- Magnet facilities, and 63 percent scored above civilian Magnet facilities on the PES-NWI.
In 2014, following the implementation of Patient CaringTouch System and additional data collection, 100 percent of the Army MTFs included in the Patient CaringTouch System evaluation scored higher on the PES-NWI when compared to civilian non- Magnet facilities and 90 percent of these same Army MTFs scored higher on the PES-NWI than Magnet facilities.
The Patient CaringTouch System is helping to create the requisite nurse staff environment for optimal care of patients. A favorable practice environment includes a collaborative culture that shares decision-making and teamwork. Professionally satisfying work environments are associated with a better patient safety climate, lower mortality, higher patient satisfaction, and fewer patient falls. The relationship is clear; a favorable practice environment is linked to improved overall patient outcomes and higher nurse-reported quality-of-care ratings.
Nurses are "the glue that holds hospitals together"; they function as the vigilant surveillance system in the hospital 24-hours a day and the first responders when problems do occur. At the front line of care, nurses ensure patient safety and health care quality standards are being met.
The Patient CaringTouch System is a critical tool for the Army Nurse Corps to transform military health care into high reliability organizations that are responsive and reliable in the delivery of health services across the military medical enterprise. The Patient CaringTouch System is an essential part of the effort for continuous improvement of clinical care for servicemembers and their families, patient safety, and quality outcomes.
This project is funded by the TriService Nursing Research Program (Grant #N13-P13).
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