An Evaluation of the U.S. Army Nurse Corps Patient Care Touch System


Name: Sara Breckridge-Sproat

Rank: COL

Organization: The Geneva Foundation

Performance Site: Tripler Army Medical Center, HI; Madigan Army Medical Center, Fort Lewis, WA

Year Published: 2013

Abstract Status: Project Completed


In 2008, US Army Nurse Corps (ANC) leaders committed to reduce variance and improve outcomes across all Army Nursing. From workgroup discussions, reviews of evidence, and discussions with civilian hospitals, the Patient CaringTouch System (PCTS) was created and implementation began in 2011.The PCTS is not only a model of care delivery, nor a change in the contextual features of patient care; it is comprehensive framework and strategic plan for nursing practice in the Army. It has five elements: enhanced communication, capacity building, evidence-based practice, healthy work environments, and patient advocacy. These five elements in combination are thought to produce the best patient, nurse, and system outcomes. Besides a defined care delivery model, PCTS has standards to refocus on professional practice with core values, practice reflection with peer feedback, skill building, a self governance model (shared accountability), and optimized performance (10 metrics measured at the unit level). Innovations such as the PCTS require significant attention and resources to implement and sustain. Although the PCTS has been implemented and measured with 10 nursing sensitive priority metrics, the degree to which it has been institutionalized and sustained is unknown. Moreover, the process, context and outcome changes that the PCTS espouses to improve have not been systematically studied and quantified. Army Nursing can learn a great deal from "best practice" PCTS sites. 

This study will evaluate certain aspects of the PCTS using retrospective data to compare pre-implementation, implementation, and post-implementation processes (patient pain reassessment), context (the nursing practice environment), and nurse (job satisfaction and intent to leave the job) and patient outcomes (falls, medication errors, and patient satisfaction) in Army hospitals. Data on practice environments, job satisfaction, intent to leave, patient pain reassessment, falls, medication errors and patient satisfaction are available from the ANC data repository for 2010-2013 and from the Military Nursing Outcomes Database for 2003-2006. The degree and quality of  spread and sustainment of the PCTS will aslo be evaluated by  collection of data on key system elements during site visits. Longitudinal, nested data analysis techniques such as generalized estimating equations will be employed.


Final Report is available on NTRL: