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By Linda H. Aiken, PhD, RN, FRCN, FAAN, Donna S. Havens, PhD, RN, and Douglas M. Sloane, PhD - page 3 / 10





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Nurses’ Levels of Education in the Two Groups of Hospitals

ANCC Magnet Hospitals

Original Magnet Hospitals 4.9%








    • 27.8


    • 9.7




The chi-square value testing the independence of education across the two hospital settings is 16.5 with three degrees of freedom (p < 0.001).

hospitals. While magnet hospitals were found to have higher nurse-to-patient ratios than other hospitals, the cost of more nurses was more than offset by sig- nificantly shorter lengths of stay and lower utilization of ICU days. Overall, multiple studies point to signif- icantly better outcomes in magnet hospitals, as com- pared with nonmagnet hospitals.

In the early 1990s, the ANA, through the ANCC—the organization that certifies registered nurses in clinical specialties—established a formal magnet hospital program to recognize excellence in nursing services.16, 17 The Magnet Nursing Services Recognition Program is a voluntary form of exter- nal professional nurse peer review available to all hospitals (and more recently to nursing homes). ANCC magnet hospital designation is based on a hospital’s ability to meet 14 standards of nursing care evaluated in a multistage process of written documentation and on-site evaluation by nurse experts—a process similar to JCAHO accreditation. The ANCC magnet hospital recognition program is similar in objectives and design to the original AAN magnet hospital program, except that the ANCC program involves a voluntary application process and requires hospital recertification every four years. Because the ANCC magnet hospital recogni- tion program is available to all hospitals, it’s a vehi- cle for providing information to consumers about the quality of nursing care in local hospitals.

The purpose of this study was to examine whether ANCC-recognized magnet hospitals had the same organizational attributes responsible for excellent nursing care as the original magnet hospi- tals did and whether they had high rates of nurse satisfaction and the same quality of care (as assessed by nurses) and thus offered evidence that the good

outcomes shown to exist in the original magnet hos- pitals can be expected to exist in those selected through the newer ANCC Magnet Nursing Services Recognition Program.

METHODS In the present study, seven ANCC magnet hospitals were compared with 13 original magnet hospitals (see More on Methods and Statistics, page 33). We do not contend that the two groups are matched groups of hospitals (as in our previous studies); they are simply two groups of magnet hospitals selected through different processes a decade apart. In fact, there are several differences between the two groups of hospitals. The ANCC magnet hospitals are larger, with an average of 457 beds, compared with 398 beds in the original magnet hospitals. Also, ANCC magnet hospitals are more likely to be teach- ing institutions; 71% of ANCC magnet hospitals are members of the Council of Teaching Hospitals, compared with 31% of the original hospitals.

Nurses on medical-surgical units at all institutions were invited to complete a 15-page self-administered survey that took approximately 30 minutes to com- plete. It included the following sections:

  • job characteristics, including hours worked, work- load, supervisory responsibilities, non-nursing duties

  • job outlook, including job satisfaction, intent to leave, and perceptions of job security and job market

  • organizational attributes of the work setting as measured by the revised Nursing Work Index (NWI-R)18

  • job-related feelings as measured by the Maslach Burnout Inventory19

JONA • Vol. 39, No. 7/8 • July/August Supplement 2009

Copyright @ 2009 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.


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