Running head: A LITERATURE REVIEW ON MAGNET HOSPITALS AND PROFESSIONAL NURSING
A Literature Review on Magnet Hospitals and Professional Nursing
Jenny Parish
Ferris State University
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A LITERATURE REVIEW ON MAGNET HOSPITALS AND PROFESSIONAL NURSING
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A Literature Review on Magnet Hospitals and Professional Nursing
The concept of a “magnet” work environment originated from a 1980’s study to explore what
was a successful setting for nursing practice. Today, magnet recognition is one of the most
important efforts in healthcare to recognize a positive work environment (McClure, 2005).
“Magnet recognition is awarded by the American Nurses’ Credentialing Center (ANCC) to
hospitals that satisfy a set of criteria designed to measure the strength and quality of their
professional nursing practice” (Kaplow, 2008). According to a study by Abraham (2011),
magnet hospital recognition has gained popularity within the professional community. This
article states that as of 2011 approximately 8% of U.S. hospitals are magnet recognized.
The articles within this review discuss the concept, history and characteristics of a magnet
work environment. These articles were used to examine the impact work environment has on
nursing outcomes and the quality of patient care. Within the body of this paper there are four
main sections. The first section of this review focuses on the history behind the magnet concept.
The second section explores common characteristics within magnet recognized work
environments. The third section discusses nursing outcomes associated within these work
environments. The fourth section, titled “Nursing Assessment of Patient Care Outcomes”,
discusses the nurses’ perception of quality patient care in a magnet environment. Scholarly
articles used in this literature review were from online nursing journals retrieved through the
Ferris State University library database and Google search engine.
History
In the early 1980’s the American Academy of Nursing (AAN) organized a task force to
explain how during a time of nursing shortage were some hospitals able to recruit and retain
A LITERATURE REVIEW ON MAGNET HOSPITALS AND PROFESSIONAL NURSING
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nurses (Upenieks, 2003). Research from this original study of 41 hospitals led to the
development of the American Nurses’ Credentialing Center’s (ANCC) Magnet Hospital
Recognition Program for Excellence in Nursing (ANCC, 2011). McClure, a researcher on the
original task force, has published multiple articles in magnet research. McClure’s 2002 article,
“Magnet Hospitals: Attraction Retention of Professional Nurses”, discusses the ongoing trend to
attract and retain nurses in a magnet environment.
In 2008, Lundmark published “Patient safety and quality: An evidence-based handbook for
nurses. In chapter 46, “Magnet Environments for Professional Nursing Practice”, Lundmark
describes the history of the magnet concept and recognition program. This article describes a
magnet hospital as an organization and practice environment supportive to nursing excellence
(Lundmark, 2008). In Abraham’s 2011 article, “The diffusion of magnet hospital recognition”, it
suggests magnet recognition is now recognized as the gold standard in quality care. This article
makes the assumption that more hospitals will seek magnet recognition in the future. These
articles include over thirty years of research examining the work environments impact on nursing
and patient care.
Characteristics of Magnetism
Research articles in this section identify the common characteristics within a work
environment that makes it “magnet”. This research began in 1983, when McClure and others set
out to observe commonalities within certain corporations that were referred to as magnet forces.
McClure’s original research demonstrated that these “magnet” corporations proved a
commitment to quality and lived up to it daily through patient care and support to nurses. The
studies of both McClure (1983) and Laschinger (2003) suggest that empowering work
environments can influence professionalism and excellence in the quality of patient care. These
A LITERATURE REVIEW ON MAGNET HOSPITALS AND PROFESSIONAL NURSING
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studies demonstrated evidence suggesting magnet hospital characteristics are correlated with a
nurses increased satisfaction on the job. It is the characteristics of an organization that makes it
possible to attract and retain valuable employees. Upenieks (2003) article, “What’s the attraction
to magnet hospitals”, agrees with McClure and Laschinger’s findings.
Karen Drenkard (2010), the director of the American Nurses Magnet Recognition Program,
published the article “Going for gold: the value of attaining magnet recognition”. This article
also identifies characteristics of a magnet environment. These characteristics include increased
nurse autonomy, improved physician/nurse relationship, decreased nurse turnover rate, and better
economic performance. This article also gives the reader a clearly stated overview of the benefits
associated with magnet recognized hospitals. Drenkard’s article would be useful to researchers
because it is written from the perspective of the director of the recognizing organization.
Nursing Outcomes
This section focuses on the impact magnet environments have on a positive nursing
experience. Articles in this section support a healthy work environment increases nursing
satisfaction on the job. In fact, magnet studies over the past thirty years demonstrate a positive
relationship between a work environment and nursing job satisfaction.
The article “Nursing Outcomes in Magnet and Non-Magnet Hospitals” was published in 2011
in the Journal of Nursing Administration. This article analyzes secondary data from a four-state
survey of 26,276 nurses in 567 acute care hospitals to evaluate environment in nursing outcomes.
Research from this study found a positive relationship in work environment and nursing job
satisfaction. The study revealed nurses in magnet hospitals reported greater job satisfaction than
those non-magnet hospitals (Kelly, 2011). In 2011, Hess also published an article in the Journal
of Nursing Administration. This article “Perceptions of nurses in magnet hospitals, non-magnet
A LITERATURE REVIEW ON MAGNET HOSPITALS AND PROFESSIONAL NURSING
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hospitals, and hospitals pursuing magnet status” was developed from the study of data collected
from the 2010 National Survey of Registered Nurses (NSRN). This study analyzed standardized
surveys from nurses within different work environments. Research found that nurses working
within hospitals with magnet identified characteristics had the most job satisfaction. This
research suggests a hospital did not necessarily have to be magnet recognized but did have to
possess these values (Hess, 2011). Research from this article is useful because it validates
previous research findings on the relationship of nursing satisfaction and a positive work
environment.
Nursing Assessment of Patient Care Outcomes
This section contains articles that demonstrate association between magnet status and nursing
assessment of quality patient care. Kramer (2005) published the article “Best quality patient
care; a historical perspective on magnet hospitals. This article describes the development of the
association between recognition for nursing excellence and improved patient outcomes.
Research in this article proves that the quality of patient care relates to the care the nurse is able
to provide. The article suggests nursing job satisfaction and ability to provide quality patient care
is improved in a magnet environment. In 2008, Linda Aiken published the article
“Transformative Impact of Magnet Designation: England case study”. This article discusses a
hospitals journey to magnetism and the impact of preparing and achieving magnet status. The
research in this article also supports the nurses’ assessment of an improved quality of patient care
within a “magnet” environment (Aiken, 2008). These articles stimulate further research into
expanding the magnet concept to include all aspects of patient care delivery while in the hospital,
not limited to excellence in nursing care.
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Conclusion
In the 15 scholarly articles I reviewed for this paper, all research studies suggests a positive
trend in quality patient care and nursing satisfaction in magnet vs. non-magnet hospitals. These
scholarly articles provide research based evidence. This research proves a relationship work
environments possessing magnet characteristics and increased job satisfaction in nursing.
Magnet work environments also promote an improved delivery of patient care. For further
insight into magnet recognition, Sherman’s (2010) article, “Growing future nurse leaders to build
and sustain healthy work environments at the unit level” can be considered. This article reviews
literature on what is necessary to build a successful magnet environment. This article also
identifies the role nurse leaders have in promotion of a healthy work environment for the future.
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References
Abraham, J., Jerome-D’Emilia, B., Begun, J.W., (2011). The diffusion of magnet hospital
recognition. Health Care Management Review, 36(4), 306-14. Retrieved from
http://www.ncbi.nlm.nih.gov/pubmed/21691211
Aiken, L.H., Buchan J., Ball, J., Rafferty, A.M., (2008). Transformative impact of magnet
designation: England case study. Journal of Clinical Nursing, 17(24), 3330-3337.
doi:10.1111/j.1365.2702.2008.02640.x
American Nurses Credentialing Center. (2011). History of the magnet program. Retrieved from
http://www.nursecredentialing.org/MagnetHistory.aspx
American Nurses Credentialing Center. (2011). Magnet Recognition Program Model. Retrieved
from http://www.nursecredentialing.org/Magnet/NewMagnetModel.aspx
Drenkard, K., (2010). Going for the gold: The value of attaining magnet recognition. American
Nurse Today, Vol.5. No. Retrieved from
http://www.americannursetoday.com/article.aspx?id=6378&fid=6276
Hess, R., Desroches, C., Donelan, K., Norman, L., Buerhaus, P.I., (2011). Perceptions of nurses
in magnet hospitals, non-magnet hospitals, and hospitals pursuing magnet status. Journal
of Nursing Administration, 41(7-8), 315-23. doi: 10.1097/NNA.0b013e31822509e2
Kaplow, R., Reed, K.D., (2008). The AACN synergy model for patient care: A nursing model as
a force of magnetism. Nursing Economics. 26(1). 17-25. Abstract retrieved from
http://www.medscape.com/viewarticle/572309
Kelly, L.A., McHugh, M.D., Aiken, L.H., (2011). Nurse outcomes in magnet and non-magnet
hospitals. Journal of Nursing Administration, 41(10). 428-33. Abstract retrieved from
http://www.ncbi.nlm.nih.gov/pubmed/21934430
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Kramer, M., Schmalenburg, C.E. (2005). Best quality patient care: A historical perspective on
magnet hospitals. Nursing Administration Quarterly, (3), 275-87. Retrieved from http://0www.ncbi.nlm.nih.gov.libcat.ferris.edu/pubmed/16056163
Laschinger, H.K., Almost, J., Tuer-Hodes, D., (2003). Workplace empowerment and magnet
hospital characteristics: making the link. Journal of Nursing Administration. 33(7-8).
410-22. Abstract retrieved from http://www.ncbi.nlm.nih.gov/pubmed/12909793
Lundmark, V.A., (2008). Magnet environments for professional nursing practice. Patient Safety
and Quality: An Evidence-Based Handbook for Nurses (Ch. 46). Retrieved from
http://www.ncbi.nlm.nih.gov/books/NBK2667/
McClure, M.L., Poulin, M.A., Sovie, M.D. (2002). Magnet hospital: Attraction and retention of
professional nurses. Nursing Administration Journal. Retrieved from
http://www.http://hrsa.gjhost.com/documents/magnet
McClure, M.L., (2005). Magnet hospitals: Insights and issues. Nursing Administration Journal.
Vol. 29. No. 3. 198-201. Retrieved from
www.http://hrsa.gjhost.com/documents/magnet_insights_McClure.pdf
Sherman, R., Pross, E., (2010). Growing Future Nurse Leaders to Build and Sustain Healthy
Work Environments at the Unit Level. The Online Journal of Issues in Nursing, Vol. 15,
No. 1, Retrieved from http://www.nursingworld.org/MainMenuCategories/ANA
Upenieks, V.V., (2003). What’s the attraction to magnet hospitals? Nursing Management.
Volume. 34. No. 2. 43-44. Retrieved from
http://www.nursingcenter.com/library/journalarticleprint.asp?Article_ID=402847