On 2017 Mar 24, University of Kansas School of Nursing Journal Club commented:

Team Members: Maddie Ehlers, Britta Smith, Sameer Upadhyaya, Clarissa Negrete, Briginé Newman, Nadia Grayfer, Amy Barnes. [Class of 2017]

Background Introduction:

We chose this article because it elaborates on the effect of Magnet recognition in the workplace and addresses issues that students like us will likely be affected after graduation and begin our careers. The outcomes of this study show what nurses can do to create a better work environment and how they can make needed changes in both the unit and organization. The gap in knowledge the article intends to fill in this course is the differences in the work environment, staffing, and nursing outcomes between a Magnet and non-Magnet organization. The findings bridged the gap to whether Magnet versus non-Magnet designation impacts nursing dissatisfaction, burnout, and turnover. Since we are students about to begin our nursing careers, we would like to work for an organization which allows us to avoid these negative facets. Therefore, having evidence that demonstrate the benefits of Magnet hospital versus a non-Magnet hospital can impact our decision making when selecting future workplace.

Methods:

This article was found through the CINAHL database. The purpose of this study was to examine whether work environments, staffing and nurse outcomes differ between Magnet and non-Magnet hospitals. A secondary analysis was done on data from a study of hospitals in 4 states (California, Florida, Pennsylvania and New Jersey). Researchers had distributed surveys to homes of a random sample of RNs using the state licensure lists from 2006-2007. All nurses who completed the survey were asked to provide the name of their employer, allowing researchers to combine responses by hospital. The final sample consisted of 567 hospitals and 46 of them were ANCC Magnet recognized. Sample also included 4,562 nurses working in Magnet hospitals and 21,714 nurses working in non-Magnet hospitals (Kelly et al. 2012). The survey was designed to measure five different components of the workplace: (1) nurse characteristics, (2) nurse staffing, (3) work environment, (4) education and (5) hospital characteristics. Work environment was measured using the 31-item Practice Environment Scale of Nursing Workforce Index. For education, nurses were to report their highest education in nursing and they would then calculate the hospital-level measure of proportion of nurses with a baccalaureate degree or higher. For hospital characteristics, they looked into the hospital designations such as, teaching status, postgraduate trainees and whether the hospital was a high-technology facility or not (Kelly et al. 2012). For measurement of outcomes, specifically job related burnout, they used the emotional exhaustion subscale of the Maslach Burnout Inventory Human Services Survey or MBI-HSS. The instrument assessed 3 domains: emotional exhaustion, depersonalization, and personal accomplishment. For measurement of nurse satisfaction, they asked nurses a single-item question, “How satisfied are you with your current job?” Intent to leave was characterized by nurses answering yes, they intend to leave their current employer within 1 year (Kelly et al. 2012). Overall, they tested the differences between the groups at the hospital level to estimate differences between Magnet and non-Magnet organizations. A series of logistic regression models were implemented to completely estimate the differences in job dissatisfaction, burnout and intent to leave in Magnet versus non-Magnet hospitals. Of the many models, the final model estimated the effects of the Magnet status while taking into account the individual nurse factors, hospital characteristics and hospital-nursing characteristics. All analyses were conducted with STATA version 11 (Kelly et al. 2012).

Findings:

The key findings were that Magnet hospitals are more teaching oriented, have more technology, and are more non-profit based than non-magnet hospitals. They found no difference in staffing between Magnet and non-Magnet even though Magnet hospitals were a lot bigger in size. It was also noted that Magnet hospitals have more certified specific nurses on their units which leads to better work environments. In addition, in California, the patient workload is a lot less than in their Magnet hospitals than non-Magnet hospitals. Lastly, Magnet hospitals are less likely to have nurse burnout and have better overall nurse satisfaction (Kelly et al. 2012). Although this study was successful in proving the hypothesis, there were limitations that arose. It was a cross sectional study to only a little over twenty percent of the Magnet hospitals at that time (Kelly et al. 2012). Therefore, they cannot generalize these hospitals to the whole population of Magnet hospitals. However, if the study were redone and the percentage of Magnet hospitals examined was expanded, we believe the study could be more generalizable across the nation and have a phenomenal impact on the number of hospitals that strive towards Magnet status.

Implications:

This literature selected is important to nursing because it shows evidence on the benefits of being involved with a Magnet institution. The main aspects this article looked at were dissatisfaction, burnout, and the intent to leave between current employed nurses at Magnet and non-Magnet organizations. Any nurse does not want to lose their drive for nursing and quality patient care. By providing facts on the benefits of Magnet institutions we can help prevent nursing dissatisfaction. The findings of the article are important to us in regard to the study of the health care microsystem. Since this article looked at patient workload, staffing issues, and work environments, this can lead to the determination of a healthy/positive work environment which can ultimately determine if a nurse remains satisfied in their area of practice. Furthermore, nurse satisfaction levels will ultimately affect turnover rates and prevent nurses from leaving the profession altogether. On a personal level, as we strive to enter in the nursing profession, we want to be in an institution where we are satisfied with our careers, so it is important for us as new grad nurses to find a work environment in which we can develop and thrive. Based on the results of this study, we are best suited to thrive and develop within a Magnet organization. In addition, we will be able to further develop as nurse leaders within a Magnet organizations. The study relates to the future of nursing practice because as future nurses want to find a way to stay satisfied in our practice, and the article demonstrates the importance of Magnet organizations in nurse job satisfaction. The article acts as reinforcement for us to be the change in the workplace. It also creates awareness as we are making decisions for our future careers, and to remember to consider the benefits of a Magnet versus non-Magnet hospital. As we know, increased nurse satisfaction creates a better work environment which ultimately increases patient outcomes.

References:

Kelly, L. A., McHugh, M. D., & Aiken, L. H. (2012). Nurse outcomes in magnet and non- magnet hospitals. Journal Of Nursing Administration, 42(10), S44-9. doi:10.1097/NNA.0b013e31822eddbc

On 2017 Mar 24, University of Kansas School of Nursing Journal Club commented:

Team Members: Maddie Ehlers, Britta Smith, Sameer Upadhyaya, Clarissa Negrete, Briginé Newman, Nadia Grayfer, Amy Barnes. [Class of 2017]

Background Introduction:

We chose this article because it elaborates on the effect of Magnet recognition in the workplace and addresses issues that students like us will likely be affected after graduation and begin our careers. The outcomes of this study show what nurses can do to create a better work environment and how they can make needed changes in both the unit and organization. The gap in knowledge the article intends to fill in this course is the differences in the work environment, staffing, and nursing outcomes between a Magnet and non-Magnet organization. The findings bridged the gap to whether Magnet versus non-Magnet designation impacts nursing dissatisfaction, burnout, and turnover. Since we are students about to begin our nursing careers, we would like to work for an organization which allows us to avoid these negative facets. Therefore, having evidence that demonstrate the benefits of Magnet hospital versus a non-Magnet hospital can impact our decision making when selecting future workplace.

Methods:

This article was found through the CINAHL database. The purpose of this study was to examine whether work environments, staffing and nurse outcomes differ between Magnet and non-Magnet hospitals. A secondary analysis was done on data from a study of hospitals in 4 states (California, Florida, Pennsylvania and New Jersey). Researchers had distributed surveys to homes of a random sample of RNs using the state licensure lists from 2006-2007. All nurses who completed the survey were asked to provide the name of their employer, allowing researchers to combine responses by hospital. The final sample consisted of 567 hospitals and 46 of them were ANCC Magnet recognized. Sample also included 4,562 nurses working in Magnet hospitals and 21,714 nurses working in non-Magnet hospitals (Kelly et al. 2012). The survey was designed to measure five different components of the workplace: (1) nurse characteristics, (2) nurse staffing, (3) work environment, (4) education and (5) hospital characteristics. Work environment was measured using the 31-item Practice Environment Scale of Nursing Workforce Index. For education, nurses were to report their highest education in nursing and they would then calculate the hospital-level measure of proportion of nurses with a baccalaureate degree or higher. For hospital characteristics, they looked into the hospital designations such as, teaching status, postgraduate trainees and whether the hospital was a high-technology facility or not (Kelly et al. 2012). For measurement of outcomes, specifically job related burnout, they used the emotional exhaustion subscale of the Maslach Burnout Inventory Human Services Survey or MBI-HSS. The instrument assessed 3 domains: emotional exhaustion, depersonalization, and personal accomplishment. For measurement of nurse satisfaction, they asked nurses a single-item question, “How satisfied are you with your current job?” Intent to leave was characterized by nurses answering yes, they intend to leave their current employer within 1 year (Kelly et al. 2012). Overall, they tested the differences between the groups at the hospital level to estimate differences between Magnet and non-Magnet organizations. A series of logistic regression models were implemented to completely estimate the differences in job dissatisfaction, burnout and intent to leave in Magnet versus non-Magnet hospitals. Of the many models, the final model estimated the effects of the Magnet status while taking into account the individual nurse factors, hospital characteristics and hospital-nursing characteristics. All analyses were conducted with STATA version 11 (Kelly et al. 2012).

Findings:

The key findings were that Magnet hospitals are more teaching oriented, have more technology, and are more non-profit based than non-magnet hospitals. They found no difference in staffing between Magnet and non-Magnet even though Magnet hospitals were a lot bigger in size. It was also noted that Magnet hospitals have more certified specific nurses on their units which leads to better work environments. In addition, in California, the patient workload is a lot less than in their Magnet hospitals than non-Magnet hospitals. Lastly, Magnet hospitals are less likely to have nurse burnout and have better overall nurse satisfaction (Kelly et al. 2012). Although this study was successful in proving the hypothesis, there were limitations that arose. It was a cross sectional study to only a little over twenty percent of the Magnet hospitals at that time (Kelly et al. 2012). Therefore, they cannot generalize these hospitals to the whole population of Magnet hospitals. However, if the study were redone and the percentage of Magnet hospitals examined was expanded, we believe the study could be more generalizable across the nation and have a phenomenal impact on the number of hospitals that strive towards Magnet status.

Implications:

This literature selected is important to nursing because it shows evidence on the benefits of being involved with a Magnet institution. The main aspects this article looked at were dissatisfaction, burnout, and the intent to leave between current employed nurses at Magnet and non-Magnet organizations. Any nurse does not want to lose their drive for nursing and quality patient care. By providing facts on the benefits of Magnet institutions we can help prevent nursing dissatisfaction. The findings of the article are important to us in regard to the study of the health care microsystem. Since this article looked at patient workload, staffing issues, and work environments, this can lead to the determination of a healthy/positive work environment which can ultimately determine if a nurse remains satisfied in their area of practice. Furthermore, nurse satisfaction levels will ultimately affect turnover rates and prevent nurses from leaving the profession altogether. On a personal level, as we strive to enter in the nursing profession, we want to be in an institution where we are satisfied with our careers, so it is important for us as new grad nurses to find a work environment in which we can develop and thrive. Based on the results of this study, we are best suited to thrive and develop within a Magnet organization. In addition, we will be able to further develop as nurse leaders within a Magnet organizations. The study relates to the future of nursing practice because as future nurses want to find a way to stay satisfied in our practice, and the article demonstrates the importance of Magnet organizations in nurse job satisfaction. The article acts as reinforcement for us to be the change in the workplace. It also creates awareness as we are making decisions for our future careers, and to remember to consider the benefits of a Magnet versus non-Magnet hospital. As we know, increased nurse satisfaction creates a better work environment which ultimately increases patient outcomes.

References:

Kelly, L. A., McHugh, M. D., & Aiken, L. H. (2012). Nurse outcomes in magnet and non- magnet hospitals. Journal Of Nursing Administration, 42(10), S44-9. doi:10.1097/NNA.0b013e31822eddbc