Magnet Status: Implications for Quality of Patient Care

Abstract

Research has shown that hospital structure, e.g. nursing characteristics, affects patient outcomes. Nursing characteristics have been shown to be better in Magnet® hospitals. Previous studies have found that nursing workforce characteristics such as nurse‐to‐patient ratio, job satisfaction, and skill mix correlate with lower incidence of nosocomial infection and higher nurse‐reported and patient‐reported quality of care. Little research has been done, however, on the correlation between Magnet status and patient outcomes. The purpose of this study was to determine if patients have fewer nosocomial infections in Magnet hospitals than non‐Magnet hospitals. The Donabedian structure‐processes‐outcomes model for assessing quality of health care was the underlying conceptual framework for the study. The study design employed a descriptive correlational design. Over 500 critical care units from hospitals participating in the National Database of Nursing Quality Indicators® contributed data for the analysis. T‐tests indicated that there was a higher number of total nursing hours per patient day (TNHPPD), percentage of RNs with a bachelor’s degree, and higher job satisfaction scores, on critical care units in Magnet accredited facilities than those without Magnet status (p < 0.001). The mean rates of three types of nosocomial infections were similar for Magnet and non‐Magnet hospitals, and no significant correlations were found between these workforce characteristics and patient outcomes. The analysis conducted for this study did not support the hypothesis that Magnet hospitals would have lower nosocomial infection rates because they have superior nursing workforce attributes. Further research is indicated to determine why the workforce characteristics that contribute to Magnet accreditation do not lead to a higher quality of care, and to find what factors do determine higher quality of patient care.