Nurses’ Perceptions of the Practice Environment in the Two Groups of Hospitals
Original magnet hospitals
ANCC magnet hospitals
Percentage agreeing that the characteristic is present
Chi-square values (with one degree of freedom) associated with the tests of independence of the seven variables across the two hospital settings are 84.4, 117.4, 49.3, 41.7, 28.0, 28.3, and 45.6 for the variables as listed above (from top to bottom), respectively. All have p values of less than 0.001. Standard errors associated with the percentages shown are between 1% and 2%.
Nurse Burnout in the Two Groups of Hospitals
ANCC Magnet Hospitals
Original Magnet Hospitals
Nurses who reported frequently feeling
burned out from their work
emotionally drained from their work
frustrated by their job
Chi-square values (with one degree of freedom) associated with the tests of independence of the three variables across the two types of hospitals are 14.6, 13.3, and 23.1 for burnout, emotional exhaustion, and frustration, respectively. All have p values of less than 0.001. Standard errors associated with the per- centages shown in the table are between 1% and 2%.
mented an association between attributes of the clini- cal practice environment and patient outcomes. For example, the greater control nurses reported having in t h e p r a c t i c e s e t t i n g , t h e h i g h e r p a t i e n t s r a t e d s a t i s f a c - In this study, we did not interview tion with care.9, 13
patients, but we used nurses to judge the quality of care in their hospitals; 43% of those in ANCC mag- net hospitals, versus only 21% of nurses in the origi- nal magnet hospitals, indicated that the quality of care delivered to their patients was excellent (see Nurses’ Assessments of the Quality of Care in the Two Groups of Hospitals, page 32). Only one in 10 nurses in ANCC hospitals described the quality of care deliv- ered to patients as either adequate or poor, whereas almost 25% of the nurses in the original magnet hospitals did so. However, nurses in both groups ranked care in their hospitals substantially higher than did a national convenience sample of nurses polled in a recent AJN study, in which only 10% of nurses rated care in their hospitals as excellent.23
DISCUSSION The purpose of this study was to investigate whether the ANCC’s application-based process for designat- ing magnet hospitals identifies institutions that nurses evaluate as favorably as the hospitals origi- nally selected by the AAN for magnet designation (based on their reputations as good places to practice professional nursing). The original magnet hospitals have been shown to have substantially improved patient outcomes and greater respect for nurses than for those in nonmagnet hospitals. A finding that the ANCC magnet hospital designation identified hospi- tals with nurse practice environments that are com- parable to those of the original magnet hospitals would provide strong evidence for consumers and nurses of the usefulness of ANCC recognition in identifying hospitals with good nursing care.
Our findings provide this evidence. The ANCC’s magnet hospital designation process successfully identified hospitals that provided practice environ-
JONA • Vol. 39, No. 7/8 • July/August Supplement 2009
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