Nurse outcomes in Magnet® and non-magnet hospitals

The important goals of Magnet hospitals are to create supportive professional nursing care environments. A recently published paper found little difference in work environments between Magnet and non-Magnet hospitals. The aim of this study was to determine whether work environments, staffing, and nurse outcomes differ between Magnet and non-Magnet hospitals. A secondary analysis of data from a 4-state survey of 26,276 nurses in 567 acute care hospitals to evaluate differences in work environments and nurse outcomes in Magnet and non-Magnet hospitals was conducted. Magnet hospitals had significantly better work environments (t = -5.29, P < .001) and more highly educated nurses (t = -2.27, P < .001). Magnet hospital nurses were 18% less likely to be dissatisfied with their job (P < .05) and 13% less likely to report high burnout (P < .05). Magnet hospitals have significantly better work environments than non-Magnet hospitals. The better work environments of Magnet hospitals are associated with lower levels of nurse job dissatisfaction and burnout.     

Revising the Essentials of Magnetism tool: there is more to adequate staffing than numbers

In the Essentials of Magnetism (EOM) study, staff nurses in 9 of 16 hospitals known to have excellent staffing structures, ie Magnet hospitals, perceived staffing on their units as less than adequate. These hospitals did not fit the Magnet profile when compared to 26 Magnet, Magnet-aspiring, and non-Magnet hospitals. In the EOM study, the process "perception of adequacy of staffing" (PAS) was measured with a single-item indicator. A multi-item scale incorporating the results of a delivery system survey reported here, as well as other factors known to affect PAS, was constructed and evaluated. Results indicate that the 6-item PAS Scale is valid and reliable and is a more accurate measure of PAS than is a single-item indicator. The Magnet hospitals scored significantly higher on all 6 items of the scale than did the comparison hospitals. The 2 Magnet hospitals that did not score in the Magnet profile in the EOM study scored similarly to the Magnet hospital that scored very high in the Magnet profile. Measurement of the PAS process indicates whether staffing structures are viable and enabling and may account for the mixed results seen in some studies assessing the impact of staffing structures on patient outcomes. Discussion includes suggestions on how to promote smooth handoffs and accountability with flex delivery models, and emphasizes the need to evaluate the relationship between staff nurses' perceptions of adequate staffing and patient outcomes.     

Further evidence on the Magnet Recognition program: implications for nursing leaders

Growing evidence indicates that the Magnet Recognition program fosters excellence in nursing services through the development of a professional nursing practice environment. This study of 470 staff nurses from both Magnet and non-Magnet settings supports other recent evidence that nurses in Magnet hospitals demonstrate significantly higher levels of job satisfaction. Findings in this study suggest that this degree of job satisfaction, along with higher levels of satisfaction with key elements in the Magnet work environment, have a positive link to retention. The findings of this study, along with recommendations for developing a professional nursing practice environment through use of the 14 Forces of Magnetism, are timely and applicable to nursing leaders seeking remedies to the national nursing shortage.     

Differences in nursing practice environment among US acute care unit types: A descriptive study

BackgroundThe hospital nursing practice environment has been found to be crucial for better nurse and patient outcomes. Yet little is known about the professional nursing practice environment at the unit level where nurses provide 24-hour bedside care to patients.ObjectivesTo examine differences in nursing practice environments among 11 unit types (critical care, step-down, medical, surgical, combined medical–surgical, obstetric, neonatal, pediatric, psychiatric, perioperative, and emergency) and by Magnet status overall, as well as four specific aspects of the practice environment.DesignCross-sectional study.Settings5322 nursing units in 519 US acute care hospitals.MethodsThe nursing practice environment was measured by the Practice Environment Scale of the Nursing Work Index. The Practice Environment Scale of the Nursing Work Index mean composite and four subscale scores were computed at the unit level. Two statistical approaches (one-way analysis of covariance and multivariate analysis of covariance analysis) were employed with a Tukey-Kramer post hoc test.ResultsIn general, the nursing practice environment was favorable in all unit types. There were significant differences in the nursing practice environment among the 11 unit types and by Magnet status. Pediatric units had the most favorable practice environment and medical–surgical units had the least favorable. A consistent finding across all unit types except neonatal units was that the staffing and resource adequacy subscale scored the lowest compared with all other Practice Environment Scale of the Nursing Work Index subscales (nursing foundations for quality of care, nurse manager ability, leadership, and support, and nurse–physician relations). Unit nursing practice environments were more favorable in Magnet than non-Magnet hospitals.ConclusionsFindings indicate that there are significant variations in unit nursing practice environments among 11 unit types and by hospital Magnet status. Both hospital-level and unit-specific strategies should be considered to achieve an excellent nursing practice environment in all hospital units.     

Magnet status and registered nurse views of the work environment and nursing as a career

OBJECTIVES: To compare how registered nurses view the work environment and the nursing shortage based on the Magnet status of their organizations. BACKGROUND: The upsurge in organizations pursuing and obtaining Magnet recognition provides increased opportunities to investigate whether and how registered nurses who are employed in Magnet organizations and organizations pursuing Magnet status perceive differences in the nursing shortage, hospitals' responses to the shortage, characteristics of the work environment, and professional relationships. METHODS: A nationally representative sample of registered nurses licensed to practice in the United States was surveyed. The views of registered nurses who worked in Magnet organizations, organizations in the process of applying for Magnet status, and non-Magnet organizations were analyzed as independent groups. RESULTS: Significant differences were found. Although there is a clear Magnet difference, there are also identifiable differences that occur during the pursuit of Magnet recognition. CONCLUSION: Many organizations in the process of applying for Magnet status rated higher than Magnet organizations, indicating that there is much to do to maintain the comparative advantages for Magnet hospitals.     

Nurses' work environment perceptions when employed in states with and without mandatory staffing ratios and/or mandatory staffing plans

Multiple stakeholders have sought regulatory and nonregulatory strategies to address nursing workforce and patient safety concerns. This study examines differences in nurses' work environment perceptions. Approximately 4,000 nurses employed in 10 states provided their perceptions of key characteristics of their work environment using the Individual Workload Perception Scale. Univariate statistics were used to characterize mean values of the nurses' work environment perceptions by state of employment and whether these perceptions changed if employed in states with versus without mandatory staffing ratios and/or mandatory staffing plans. This study provides preliminary evidence that mandatory staffing plan legislation may be linked with the most positive nurse work environment perceptions when compared with implementation of mandatory staffing ratios or no workforce regulation. Based on this preliminary observation, further analysis comparing the relative benefits and costs of workforce regulation may be warranted.     

新入职护理人员职业生涯规划辅导效果研究

目的 探讨职业生涯规划辅导对新入职护理人员自我职业生涯管理状况和职业认同的影响,探索新入职护理人员职业生涯规划辅导的有效途径.方法 从太原市某三级甲等医院选取40名新入职护理人员作为研究对象,按照设计的方案对其进行系统的职业生涯规划辅导,采用“自我职业生涯管理问卷”和“护士职业认同问卷”进行评估.结果 干预后新入职护理人员自我职业生涯管理状况和职业认同得分均较干预前提高(P＜0.05).结论 对新入职护理人员进行针对性的职业生涯规划辅导能有效提高其自我职业生涯管理水平及职业认同感,可以作为有效的辅导方法为护理管理者和教育者所用.     

传染病专科医院与综合医院护士职业认同、工作压力源的比较研究

目的比较传染病专科医院与综合医院护士在工作压力源、职业认同水平上的差异,为护理管理者和教育者提升护士职业认同水平提供指导和参考。方法采用护士职业认同量表与护士工作压力源量表,对天津市1所传染病专科医院、5所综合医院共87名护士进行问卷调查。结果传染病专科医院护士的工作压力高于综合医院护士,尤其在护理专业及工作方面、工作量及时间分配、工作环境及其资源、管理及人际关系4个因子方面(P均<0.05);但与综合医院护士在职业认同各维度与量表总得分上的差异均无统计学意义;职业认同与工作压力源呈负相关。结论传染病专科医院护士工作压力高于综合医院护士,工作压力对职业认同有负性影响。     

Implementation of an intravenous medication infusion pump system: implications for nursing

AIM: To assess perceptions of nurses regarding the implementation of intravenous medication infusion system technology and its impact on nursing care, reporting of medication errors and job satisfaction. BACKGROUND: Medication errors are placing patients at high risk and creating an economic burden for hospitals and health care providers. Infusion pumps are available to decrease errors and promote safety. METHODS: Survey of 1056 nurses in a tertiary care Magnet hospital, using the Infusion System Perception Scale. Response rate was 65.43%. RESULTS: Nurses perceived the system would enhance their ability to provide quality nursing care, reduce medication errors. Job satisfaction was related to higher ratings of the management team and nursing staff. Perceptions verified the pump was designed to promote safe nursing practices. CONCLUSIONS: It is important to consider relationships with job satisfaction, safe nursing practice and the importance of ratings of nursing staff and management teams when implementing infusion technology. IMPLICATIONS FOR NURSING MANAGEMENT: Infusion pumps are perceived by nurses to enhance safe nursing practice. Results stress the importance of management teams in sociotechnological transformations and their impact on job satisfaction among nurses.     

Nurses report a healthy culture: results of the Practice Environment Scale (Australia) in an Australian hospital seeking Magnet recognition

The Magnet Recognition Program requires evidence that the nursing practice environment supports staff to provide optimal care, access professional development opportunities and participate in hospital affairs. This research aimed to assess clinical nurses' work environment at a leading private hospital in Sydney, Australia using a version of the Practice Environment Scale of the Nursing Work Index modified for the Australian context. Our results were comparable to Magnet hospitals for two subscales and significantly higher than Magnet results for the remaining three subscales and the composite scale. This was especially pleasing in relation to the hospital's preparation for Magnet recognition. Hospitals across Australasia might find administration of the Practice Environment Scale (modified for use in the Australian context) a useful exercise both as a stimulus to preparation and an indicator of readiness for Magnet recognition.     

Celebrating certification in nursing: forces of magnetism in action

Professional certification in nursing is a measure of distinctive nursing practice. The rise in consumerism in the face of a compelling nursing shortage and the profession's movement to elevate nursing as a career option has given prominence to the value of certification in nursing. The value of certification is not only significant for nursing practice rather the focus on professional certification is also essential to meet multiple standards within the American Nurses Credentialing Center's Magnet Recognition Program for excellence in nursing services. This article describes one hospital's success with a critical care nurse certification drive. The article identifies ways in which an organization can take elements of a professional certification drive to show-case the forces of magnetism and to provide evidence that a Magnet-aspiring organization meets required Magnet standards.     

护士人文执业能力与护理执业环境现状及相关性研究

目的:了解乌鲁木齐市三级甲等医院护理执业环境和护士人文执业能力现状及其相关性,为提高护士人文执业能力提供理论依据。方法:采用便利抽样法抽取乌鲁木齐市三级甲等医5所三级甲等医院的2376名临床护士,应用一般资料调查表、护士人文执业能力量表、医院护士执业环境量表进行问卷调查和统计分析。结果:医院护士人文执业能力与护理执业环境总分分别为(82.20±12.81)分、(72.81±27.65)分,人文执业能力及各维度与护理执业环境及各维度呈正相关(r为0.201~0.649,均P<0.05)。回归分析结果显示,年龄、性别、职称及工作年限对人文执业能力有预测作用;护理执业环境对护士人文执业能力有一定影响因素,共解释25.7%的变异量。结论:乌鲁木齐市三级甲等医院护理执业环境及护士人文执业能力处于一般水平,医院管理者应继续深化优质护理服务,加强医护合作,保证充足人力、物力,营造和谐向上的团队氛围,以此来提高护士的人文执业能力,使医患关系更加和谐。     

急诊护士职业认同、工作满意度与离职倾向关系的研究

目的 探索适合急诊护士的职业认同、工作满意度与离职倾向的作用方武模型.方法 抽取辽宁省11所三级甲等医院急诊科的402名护士作为调查对象.应用职业认同量表、护士工作满意度量表和离职倾向量表进行调查,获得有效问卷346份.应用SPSS 17.0和Lisrel 8.7统计软件对结果进行分析.结果 急诊护士职业认同与工作满意度9个维度呈显著正相关,与离职倾向呈显著负相关,工作满意度各维度与离职倾向呈显著负相关;急诊护士职业认同对离职倾向直接影响为-0.392,急诊护士工作满意度对离职倾向直接影响为-0.375,工作满意度在职业认同与离职倾向间的中介效应为-0.09.结论 急诊护士职业认同直接影响离职倾向,同时通过工作满意度间接影响离职倾向.     

Evaluation of a gerontological nursing continuing education programme: effect on nurses'' knowledge and attitudes and on patients'' perceptions and satisfaction

The purpose of this study was to evaluate the effects of a four-session (8-hour) gerontological nursing continuing education (CE) programme on nurses' knowlege of and attitudes towards the elderly. The study also sought to ascertain the effects of the CE programme on patient satisfaction with and perceptions of nursing care. Seventy-six nurses completed the Miller-Dodder Revision of the Palmore Facts on Ageing Quiz and the Kogan Attitudes Towards Old People Scale before and after participating in the CE programme. Post-test scores on both measures were slightly but significantly higher than pretest scores. Thirty hospitalized elderly patients were interviewed before and 33 were interviewed after the CE programme was offered to the nurses on their hospital units, using the LaMonica-Oberst Patient Satisfaction Scale and the Harrison-Novak Patient Perception Scale. Post-test measures of patient satisfaction and perception were not significantly different from pretest scores. Patients were generally satisfied with their nursing care, but perceived that nurses did not focus on health promotion activities. In addition, 59% of the patients indicated that they were unable to distinguish nurses from other health care providers. The article identifies implications of the study for nursing education, practice and research.     

护士长倾听日在儿科护士中的应用效果研究

目的 探讨“护士长倾听日”在儿科护士中的应用效果,以寻求科学合理的干预方法提高儿科护士心理弹性水平,改善护士组织气氛,降低隐性缺勤的发生。方法 2018年该院开展精益化10S管理,采用整群随机抽样法选取该院收治慢性病患儿的神经内科、血液内科和康复科共87名护士作为研究对象,随机分为试验组42名和对照组45名。2018年1月—12月成立“护士长倾听日”小组,开展以倾听-减压-互动为主要环节的“护士长倾听日”活动。干预前后采用心理弹性量表（Connor-Davidson Resilience Scale,CD-RISC）、护士组织气氛感知量表、斯坦福隐性缺勤量表（Stanford Presenteeism Scale,SPS-6）对研究对象进行调查。结果 干预前后CD-RISC得分与护士组织气氛感知量表得分呈正相关,与SPS-6得分呈负相关,SPS-6得分与护士组织气氛感知量表得分呈负相关,差异均有统计学意义（P<0.05）。干预后CD-RISC和护士组织气氛感知量表得分均优于干预前,SPS-6得分低于干预前,差异均有统计学意义（P<0.05）。结论 “护士长倾听日”的开展能提高儿科护士的心理弹性水平,改善护士组织气氛,降低隐性缺勤的发生。