Clinical Nurse Specialists in Action: Air Force and Army collaboration at Fort Carson

  • Published
  • By Lt. Col. Kathy Savell and Maj. Yetta Lewis
  • U.S. Air Force Academy Public Affairs
U.S. AIR FORCE ACADEMY, Colo. --  The mission of the Colorado Springs Military Health System here is to facilitate patient centered care through the optimization of the Direct Care System for over 172,000 beneficiaries served by the six Military Treatment Facilities in the Colorado Springs service area.

Col. Kathy Prue-Owens, Deputy Commander for Nursing, Evans Army Community Hospital and Col. Iris Reedom, Chief Nurse with the 10th Medical Group, U.S. Air Force Academy, are recent arrivals to this system.

Experienced nurse leaders who meet monthly to discuss individual and market issues, concerns and resources, they initiated a collaborative effort to optimize the direct care system at Evans Army Community Hospital at Fort Carson, Colo. and the market. Nursing leadership is proactive with talent management to address the facility's clinical needs.

Additionally, this strategy allows the Advance Practice nurses to maintain their certification.

Maj. Yetta Lewis, Army nurse, and Lt. Col. Kathy Savell, Nursing Commander, are two master's prepared Clinical Nurse Specialists in acute and critical care adult nursing, with over 35 years of experience in adult and pediatric in and outpatient settings.

They have combined efforts to improve patient care at EACH using the Army's framework for nursing practice, the Patient Caring Touch System.

The PCTS is depicted as a star with the patient and family at the center. The five star points name the elements of nursing best practice realized at the unit level, and radiating from the points are the ten components of organizational best practice such as care teams, core values, skill building and standardized documentation.

These 10 components are where leaders provide the needed framework to assist the clinical staff, who then directly impact the patient and family.

Lewis and Savell are currently working on the Family Care Ward, a 24-bed inpatient unit that cares for newborn to geriatrics patients with medical and surgical needs.

Each of the CNS's projects on the Family Care Ward is aligned to achieve one or more of the PCTS components, thereby improving patient outcomes.

Standardizing practice by reducing variability is the goal of PCTS. Prue-Owens and Reedom realized the value of the CNSs' training in-system, and aligned it under their direct purview.

This strategic approach has advantages over CNSs assigned to individual departments in effecting system-wide operations.

After spending time learning the FCW's day-to-day practices, attending staff meetings and reviewing current measures, they formulated a list of projects for the FCW and organization leaders to review.

They are piloting several projects with the plan to concurrently implement standardized practices hospital-wide as outcomes are evaluated.

The projects relate to standardized documentation, care teams, enhanced communication and optimized performance measured by documentation audits, patient satisfaction surveys and educational presentations to build capability.

1st Lt. Evan Kohoutek, a staff nurse at the FCW, said, "It's good to have the CNSs on the floor. We can let them know about things we can change to improve patient outcomes and nurse job satisfaction."

Capt. Abigail Kassulke, Charge Nurse at the FCW, said, "The CNSs bring clinical expertise to a floor of relatively new nurses. Having experienced nurses available as references helps increase optimal patient care, decreases errors and brings policies to the forefront of our practice."

Amy Stoner, a civilian registered Staff Nurse at the Family Care Ward, said, "Having CNSs on the floor will help the floor nurses with expertise on things like policies, education and new floor implementations."

CNSs work in collaboration with floor nurses and multidisciplinary teams to create, gather, synthesize and implement clinically-relevant evidence into nursing practice. They provide ongoing decision support to the nursing leadership, with the aim of enhancing the quality and efficiency of nursing care provided within the organization and the Colorado Springs Military Health System.