By Deborah Lucas
UAB School of Nursing PhD student Pauline Swiger was inspired by her research experience while deployed to the Middle East and is now part of a team evaluating an Army initiative that could impact the care of U.S. servicemen and women around the world.
Swiger, a U.S. Army major, is one year into her studies and has joined a team working on an evaluation of the Army’s innovative Patient CaringTouch System, which was initiated by Lt. Gen. Patricia Horoho, who is now the U.S. Army Surgeon General. This new framework for nursing care is expected to decrease variance in patient care across military hospitals and clinics by adopting evidence-based strategies that improve quality care. In addition, a major component of the Patient CaringTouch System is the accountability of nurses and other personnel who provide direct care to patients from injury through recovery.
“Because of their continuous 24-hour presence, nurses tend to have the most contact and develop the strongest bonds with patients, whether the care is delivered in theater, overseas or within the United States,” Swiger said. “They are best able to evaluate care at the micro-system level and identify processes that will improve patient outcomes. The Patient CaringTouch System provides a framework for identifying areas needing improvement, as well as the structure to implement change across the enterprise.”
Data from military hospitals around the world is being evaluated to identify top-performing hospitals in hopes of capitalizing on their successes. Spreading best practices and decreasing variance across the enterprise has the potential to impact not only patient care, but also the job satisfaction and work environments of 12,000 military and civilian nurses who deliver that care in the U.S. Army.
Swiger, MSN, RN, CMSRN, CNL, has been deployed twice, most recently to Baghdad, Iraq, as part of a Deployed Combat Casualty Research Team, collecting trauma data in the ER. She was inspired by the teamwork she saw in the field — medics, doctors, nurses and other caregivers working in close concert to provide care.
“When you are in the field, everyone is 100 percent concentrated on the most important component of their job, caring for the patient. Every decision is made by first considering what is best for the patient,” she said. “You can see positive impact of teamwork and communication. In my opinion, the Patient CaringTouch System is a way to build that sharp patient focus into all aspects of the military healthcare system.”
The U.S. Army Nurse Corps is a highly educated workforce. All Army nurses must have at least a BSN to join, and 35 percent have master’s degrees. In addition, the Army selects two to four nurses annually to obtain a doctoral degree. As one of the Army nurses selected, Swiger is putting her experience to work with the help of her mentor and Donna Brown Banton Endowed Professor at the UAB School of Nursing, Patricia A. Patrician, PhD, RN, FAAN. Patrician is an internationally renowned scholar and researcher in the areas of nurse staffing, the nurse practice environment, and patient and nurse outcomes.
“I’ve known of Dr. Patrician’s work for many years, and I was thrilled to come to UAB and learn from her,” Swiger said.
“This is a very unique opportunity to partner with the U.S. military and for Maj. Swiger to work with Dr. Patricia Patrician, who has extensive experience with the military and has been acknowledged for her work with students with the 2015 AcademyHealth Interdisciplinary Research Group on Nursing Issues (IRGNI) Mentorship Award,” said Associate Professor Karen Heaton, PhD, CRNP, FNP-BC, FAAN, Director of the PhD Program.
“This project is evaluating and analyzing large data sets, translating them for analysis and scholarly use. The results will be used at the point of care and provide policy change recommendations that could translate into the civilian world.”
Patrician, herself a 26-year veteran of the U.S. Army Nurse Corps, said she has been most impressed with Swiger’s ability to take information provided in differing formats and prepare a single analytic data set.
“Suggestions made by Pauline and our team may one day lead to a more uniform data collection and extraction methods throughout the military health system,” Patrician said. “Preliminary results have demonstrated positive changes over time in the work environments within the study hospitals. Changes recommended by the research team include more directly measuring patient satisfaction with aspects of nursing care; exploring the validity of the current measures of nurse staffing; and adapting the instruments to nursing care in the military.”
Patrician continued: “The Patient CaringTouch System is about listening to the people who provide care and interact with patients and providing a framework for them to work as a team in which the voice of every member is not just valued, but vital. The teamwork and camaraderie in the military extends from the providers to the patients and helps caregivers along the line of recovery provide the best care, counseling and guidance to both the patient and their families.”
The program evaluation team has applied for a one-year extension to the $300,000 TriService Nursing Research Program grant to continue the evaluation into the next year.
The value of this team’s work is already proving itself through the feedback gathered from participants. Identifying aspects of the system that work well and those that need improvement are vital to the success and sustainment of this system of care. It is expected that when the evaluation is complete, it will help improve the Patient CaringTouch System so that it may serve as an exemplar for other large hospital systems that aim to improve patient care.
“Our whole motivation is finding ways to make nursing care the best it can be,” Patrician said.
Student's doctoral research is U.S. Army's patient CaringTouch system
Swiger's work was inspired by the teamwork she saw when she was in Baghdad, Iraq, as part of a Deployed Combat Casualty Research Team