Abstract
Magnet hospitals share nurse work environment characteristics associated with superior patient, nurse and financial outcomes. In Switzerland, however, it is uncertain how nurses appraise their work environments. To describe the quality of the nurse work environment in 35 Swiss acute care hospitals and to benchmark findings based on international Magnet hospital research. This study used two data sources: (1) the Swiss arm of the RN4CAST study; and (2) a structured literature review. Hospitals were categorised based on Magnet and non-Magnet data. Our outcome variable of interest was the quality of nurse work environment measured with the Practice Environment Scale of the Nurse Work Index (PES-NWI). We reviewed 13 American, Canadian, and Australian studies of acute-care hospitals. Three provided Magnet hospitals' nurse work environment data, and all included non-Magnet hospitals' data. Swiss hospitals' evaluations on nurse work environment quality varied widely, but 25% achieved scores indicating "Magnet nurse work environments". Swiss hospitals' average "Nursing manager ability" subscale scores fulfilled Magnet hospital criteria, although "Nurse participation in hospital affairs" and "Nursing staffing and resource adequacy" scores neared non-Magnet levels. On average, our results indicated high quality nurse work environments in Swiss hospitals. Implementing Magnet model organisational principles might be a valuable approach for Swiss acute-care hospitals to both improve mixed and unfavourable nurse work environments and to improve nurse and patient outcomes. National benchmarking of nurse work environments and other nurse-sensitive indicators may facilitate evaluating the impact of current developments in Swiss healthcare.
Highlights
The Magnet hospital concept Excellence in nursing practice is recognised as a quintessential feature of high performing healthcare systems [1]
Authors (MD, DA) decided to exclude one study reporting on the nurse work environment of a hospital in the Magnet recognition process, based on our definition of Magnet-hospitals and Non-Magnet hospitals, since this data could not be clearly assigned to one of the two groups without the risk of bias
Our literature research revealed frequent use (n = 33) of measures other than the PES-Nursing Work Index (NWI) to gauge the quality of the nurse work environment, including the revised version of the Nurse Work Index, the Collaborative Practice Scale, the Conditions of Work Effectiveness Questionnaire II and the Perceived Nurse Work Environment Instrument
Summary
The Magnet hospital concept Excellence in nursing practice is recognised as a quintessential feature of high performing healthcare systems [1]. In 1990, the AAN board of directors approved the “Magnet recognition program for excellence in nursing services®” Since its inception, this accreditation programme has evolved, expanded to different types of care facilities, changed its name into the “ANCC Magnet Recognition Program®” and become a standard for excellence in nursing care and the nurse work environment. In 2007, the original 14 forces of Magnetism were refined into five Magnet Model Components: (1.) Transformational leadership, (2.) Structural empowerment, (3.) Exemplary professional practice, (4.) New knowledge, innovations and improvements, and (5.) Empirical quality outcomes. As a whole, these components cover structure, Swiss Medical Weekly · PDF of the online version · www.smw.ch
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