Running head: Impact of Magnet Hospitals 1

Impact of Magnet Hospitals: Patient safety, Nurse Satisfaction, and Work Environment in

Hospital Setting

Tara Amero, Katrina Larson, Nicolette Merlo, Danielle Snovak

Youngstown State University

Running head: Impact of Magnet Hospitals

Abstract

Magnet status is given by the American Nurses Credentialing Center to evaluate

a hospitals environment and strength of nursing care. Magnet hospitals can be found in

five different countries, with the first accredited hospital being recognized in 1994.

Hospitals must meet a set of criteria in order to meet Magnet status and have to reapply

every four years. Magnet hospitals have become increasingly popular over the years.

These hospitals have shown to positively improve work environments and staff

satisfaction compared to non-magnet hospitals. The purpose of this paper is to compare

patient safety between Magnet and non-Magnet hospitals with regards to nurse

satisfaction and work environments.

Running head: Impact of Magnet Hospital 3

Introduction

As nursing students, we are taught that safety and quality are two of the highest

concerns of patient care. Students are always being taught ways to keep their patients

safe from falls, hospital related injuries, and other infections. In the hospital setting, it is

challenging to provide this type of care for every patient. Nurses get overwhelmed with

the amount of work, and it can sometimes interfere with their quality of care, which can

results in these misfortunes. When quality of care is compressed, it results in decreased

patient safety. One of the ways hospitals are improving work and safety is through the

Magnet recognition program.

Many people may not know what it means to be a Magnet hospital. The term was

created in the 1980s when there was a nursing shortage. 41 hospitals and long term care

facilities were chosen to be a part of the study to have work environments, job

satisfaction, recruitment, and retention rates analyzed. There was a positive link found

between all hospitals and the four characteristics. This study helped coin the term

Magnet status (Smith, 2014).

Magnet hospitals recognize health care organizations for quality patient care,

nursing excellence, innovations and professional nursing practice (American Nurses

Credentialing Center, 2016). Magnet status is based off of the Magnet Model

Components. If hospitals meet criteria in five areas and pass a site visit, they are award

the Magnet title for four years. These areas are: transformational leadership, structural

empowerment, exemplary professional practice, new knowledge, innovation, and

improvements, and empirical quality results. These five areas also contain subcategories

called the 14 Forces of Magnetism.

Running head: Impact of Magnet Hospital 4

There are currently 430 accredited Magnet hospitals, which counts for 7% of all

hospitals in the United States (ANCC, 2016). The Magnet hospitals have been related to

higher nurse retention rates, patient safety and better work environments. Once these

goals are met, Magnet hospital qualifications are achieved.

Review of Literature

Many articles on Magnet hospitals, regarding patient safety, nurse satisfaction,

and work environments, have been published in the recent years. These three areas are a

large concern for patients, their families, and hospitals Not only does it benefit patient

care, Magnet status has positive effects financially. Improving safety and eliminating

errors decreases extraneous costs hospitals have throughout the year. Although many

studies have shown the benefits being a Magnet hospital, there are some that show no

difference between non-Magnet hospitals. In this review, we have chosen three categories

regarding Magnet while comparing them to non-Magnet hospitals.

Patient Safety
According to the World Health Organization, patient safety is the prevention of

errors and adverse effects to patients associated with health care. Patient safety is one of

the highest concerns for nurses. When comparing Magnet hospitals to non-Magnet,

studies have shown a great significance in patient safety. Dariel and Regnaux (2013) state

that there is a positive relationship between Magnet status hospitals and patient outcomes.

Mortality rates, patient falls, and readmission rates were all lower in Magnet hospitals

compared to non-Magnet. The Cedar Sinai Medical Center (CSMC), a Magnet hospital in

Los Angeles, did a study that showed a 19% decrease in patient falls at their hospital.

They credit this decrease in falls to the emphasis on patient safety and communication, as

seen in the exemplary professional practice component of the Magnet Model (Swanson
Running head: Impact of Magnet Hospital 5

and Tidwell, 2011). Fewer falls can lead to cost savings, shorter hospital stays, and

preventing patients from pain.

Also, Ma and Park (2015) reported a 21% lower HAPU rate in Magnet hospitals.

The pressure ulcer data was collected through direct inspection of patients skin. Pressure

ulcers are defined as a localized lesion of the skin and/or underlying tissue resulting from

pressure or pressure combined with shear according to the National Database of Nursing

Quality Indicators. They reported that an average of 2.5 million pressure ulcers occur

each year, and can cost an upward of $11.6 billion dollars. Keeping patients safe and

preventing pressure ulcers can positively affect the hospital as a whole by saving money

and better patient satisfaction.

Nurse communication is a vital part in patient safety. Many Magnet hospitals use

the Situation-Background-Assessment- Recommendation (SBAR) communication tool

for nurse-to-nurse reporting. Drenkard (2011) reports that some Magnet hospitals have

mentors, or safety coaches, to work with staff to teach proper reporting and informing

about the risks of error reporting. The proper reporting helps nurses communicate better

and keep the staff well informed. Proper reporting can eliminate medication errors,

patient falls, and errors in nursing care. These mentors have helped cause a 37% decrease

in adverse events and medication errors. Preventing these errors and events play a vital

role in patient safety.

Nursing Staff Satisfaction

Does job satisfaction have an affect on patient care? Most studies show that

higher staff satisfaction results in higher patient outcomes. One important indicator of

staff satisfaction is the turnover rate. The average turnover rate in non-Magnet hospitals

is 15%-36% (Dariel and Reganux, 2013). The American Nurses Credentialing Center

reports the average RN turnover in Magnet hospitals is only 10.72%. A heavy workload,
Running head: Impact of Magnet Hospital 6

too many hours, and other stressors that come with nursing cause many turnovers. Higher

turnover rates can cause organizational dysfunction, which can affect patient outcomes.

With high turnover rates, hospitals may be short staffed while trying to replace nurses.

Being short staffed can cause the need for temporary agencies and staff overtime.. The

constant rehiring and training new employees creates more costs for the hospital. Always

having new employees can negatively affect the work environment and quality of care.

Research has shown that Magnet hospitals have a 13% less chance of nurse burnout

(Kelly & McHugh, 2011). Structural empowerment, increased autonomy, and positive

work environment are three components of Magnet status that help hospitals have a better

moral. The requirements of being a Magnet hospital create a more satisfying work

environment, which positively affects the staffs well being.

Nurse Satisfaction and Work Environment
Work environment plays a large part of nurse satisfaction, which can affect patient

care. According to Dariel and Regnaux (2013), a positive relationship was found between

working environment and job satisfaction. Horizontal management, communication, staff

recognition programs, and creating a culture of safety and quality care are recognized as

factors creating the positive relationship. Kelly and McHugh (2011) state that the goal of

Magnet hospitals is to create a supportive, professional nurse care environment. This

professional environment has helped cause an 18% lower dissatisfaction rate than non-

Magnet hospitals. Magnet hospitals focus more on patient care and educational

advancements compared to non-Magnet. Magnet hospitals have a higher proportion of

nurses with a BSN or higher education compared to non-Magnet (Kelly & McHugh,

2011). Focusing on these two issues have shown better effects on their nurses, which in
Running head: Impact of Magnet Hospital 7

return, have better effects on patients. Lower burnout rates, staff satisfaction, and less

intent to leave from nurses have all been attributed to Magnet status hospitals.
Conclusion
Throughout our research, the positives of Magnet status outweighed non-Magnet

hospitals. Work environments, nurse satisfaction, and patient care are all important

characteristics seen in Magnet hospitals. Smith (2014) reports that it can cost a hospital

up to $100,000 to obtain Magnet status. As this seems like a large cost, many hospitals

see it as an investment. Having higher patient safety saves hospitals hundreds of

thousands of dollars in the long run.

While having the Magnet status may give the hospital a good reputation, it is not

without flaws. Many hospitals may have been given the status for meeting the standards

on inspection; however, it does not mean they are following these standards year round.

Since hospitals are not inspected regularly, there is room for error. Hospitals may have

this status, but are not up to par. On the other hand, there are hospitals without this status

that are trying to do their best, but are not given national recognition. In summary,

Magnet status hospitals have been proven to deliver an overall better performance

regarding patient care and nurse satisfaction.

Running head: Impact of Magnet Hospital

References

Drenkard, Karen. "Magnet Momentum: Creating A Culture Of Safety". Nurse Leader 9.4
(2011): 28-46. Web.

Kelly, Lesly A., Matthew D. McHugh, and Linda H. Aiken. "Nurse Outcomes In
Magnet And Non-Magnet Hospitals". JONA: The Journal of Nursing
Administration 41.10 (2011): 428-433. Web. 29 Mar. 2016.

Ma, Chenjuan, and Shin Hye Park. "Hospital Magnet Status, Unit Work Environment,
And Pressure Ulcers". Journal of Nursing Scholarship 47.6 (2015): 565-573. Web.
29 Mar. 2016.

Petit dit Dariel, Odessa, and Jean-Philippe Regnaux. "Do Magnet-Accredited Hospitals
Show Improvements In Nurse And Patient Outcomes Compared To Non-Magnet
Hospitals: A Systematic Review Protocol". JBI DB Syst Rev Impl Reps 11.11 (2013):
125. Web. 29 Mar. 2016.

Smith, S. A. "Magnet Hospitals: Higher Rates Of Patient Satisfaction". Policy, Politics,

& Nursing Practice 15.1-2 (2014): 30-41. Web. 29 Mar. 2016.

Swanson, J., Tidwell, C., (September 30,2011), Improving the Culture of Patient Safety
Through the Magnet Journey OJIN: The Online Journel of Issues in Nursing Vol.
16, No. 3, Manuscript 1. Web. 29 March 2016.