Nurse Patient Care Color Tubing
Standardized use of a color coded triple IV port system as shown here, helps reduce medication submission errors for Carl R. Darnall Army Medical Center Labor and Delivery patients. The policy to standardize the use of the color tubing is one example... (Photo Credit: U.S. Army) VIEW ORIGINAL

FORT HOOD, Texas (Feb. 14, 2012) -- Since implementing a new approach to its system of care last year, Carl R. Darnall Army Medical Center, or CRDAMC, nursing professionals boast to having successfully created a positive culture change, resulting in improved patient satisfaction.

The Army rolled out the Patient Care Touch System, or PCTS, throughout all Army medical treatment facilities in April 2011. The five-element model was developed after a multi-year study which reviewed best practices for health care delivery in the civilian and military sectors, and combined those best-practices to form a patient-driven and family-centered care system.

"Any time you initiate change in an organization, you will meet with some resistance. But the concept has gone over well at Darnall. We've had some really positive outcomes - improvements for patients and staff, and only expect more good things to happen," said James McPherren, CRDAMC nursing supervisor and PCTS ambassador. "With improved working conditions, you have a happier staff. A happier staff means happier patients."

Changes and policies that have been developed through PCTS have helped improve patient care and reduce wait times, resulting in an increase in the number of positive Interactive Customer Evaluation, or ICE, comments and Army Provider Level Satisfaction Surveys, also known as APLSS, for the hospital.

All clinics and departments have been empowered to bring about positive changes through the shared governance component of PCTS, which establishes formal nursing practice councils at unit, facility, region, and Army Nurse Corps levels. Unit Practice Councils, or UPC, consist of elected representatives from within a unit and include all staff from the front desk clerk, staff nurses, to doctors to technicians. All issues that affect a unit's operations are addressed and shared across the board.

"The best thing about the UPC is that everyone at the unit has a voice in the way they care for patients and how staff is treated," said McPherren. "UPC meetings are more than gripe fests and comments don't just get lost in a suggestion box. The council considers all input and keeps the unit and higher levels informed as to what they're working on."

Many clinics have already achieved positive outcomes, or "quick-wins", according to McPherren.

Labor and Delivery's "quick-win" was implementing a policy to use color-coded triple lumbar tubing to reduce potential for medication submission errors.

"Our patients may receive different medications intravenously, typically magnesium and pitocin, in addition to their main-line fluids. Now that we consistently use a specific color tube to identify the medications, any nurse can check a patient and know at a glance what specific medicine that patient is receiving. It saves time and eliminates any confusion," said Jennifer Irby, nurse and UPC member.

She added that since instituting this policy, there have been zero medication errors with patients receiving infusions amongst patients utilizing the color coded tubing system.

Bennett Health Clinic's "quick-win" resulted in an improved check-in process for its patients. The UPC initiated a new procedure that reduces the amount of paper documentation required for each patient at check-in.

"It was really a simple change, but really effective. Patients are checked-in quicker and there's an increase in the face time between patient and provider," stated Angela Jones, registered nurse at the clinic. "Plus, we have the added benefit of less infection control issues, as there's less paperwork passed from hand-to-hand."

Other "quick-wins" recently recorded include providing viable lunch options for Thomas Moore Health Clinic staff and an improved means of internal communications at Troop Medical Clinic 12.

"The wheels are in motion now and that momentum will carry on. Darnall is among the first of the military treatment facilities to successfully complete the implementation phase and move into the sustainment phase," he said. "We've embraced the concept, and have truly succeeded in putting the patient as the 'center' of care."

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