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APHA Scientific Session and Event Listing

Teresa Tai, PhD, Health Management, Quinnipiac University, 275 Mount Carmel Avenue, Hamden, CT 06518, 2035828279, teresa.tai@quinnipiac.edu

American Nursing Credentialing Center (ANCC) established a formal program “Magnet Nursing Services Recognition Program” to acknowledge excellence in nursing services. Magnet hospital as an “employer of choice model” was long known to be a long term solution to the recruitment and retention of high qualified nurses. Considerable research has examined the benefits of magnet program such as impact of “magnet hospital” on nurse's perception of quality of care, burnout, and job satisfaction. Yet no research has examined the variations of quality performance by magnet designation or not. The purpose of this study was to examine whether “magnet hospitals” known to be good places to practice nursing continue to provide better quality care to patients with heart attack, heart failure, and pneumonia than non-magnet hospitals. This study presents a unique opportunity to investigate the effects of excellence nursing services on quality of care in a large case-control analysis. To compare the quality of care provided to patients with heart attack, heart failure, and pneumonia by magnet status, a case-control study was conducted in the fall of 2005. Magnet hospitals were identified from the ANCC web site. All U.S. hospitals that received magnet designation as of September 8, 2005 were eligible for inclusion in this study (n=154). The final study group consisted of 133 magnet hospitals across the country. The control group was matched by the nearest driving distance from each magnet hospital. Matching magnet hospitals with non-magnet hospitals with comparable geographic, economic and demographics characteristics helps control confounding bias in case-control study. The control group consists of 266 general medical and surgical hospitals that did not received magnet designation as of September 8, 2005. Heart disease and pneumonia are the leading causes of death in U.S. They are also leading causes of hospital admissions, disease and economic burden, and premature deaths in American adults. Research to date on determination of hospital quality performance has not focused on the organization of nursing. This case-control study use data obtained from the Center for Medicare and Medicaid Services' Health Compare Website to examine if differences exist in hospital performance by magnet designation on three disease conditions for which patients are commonly hospitalized: heart attack, heart failure, and pneumonia. Substantial scientific findings indicate that there are well established evidence-based best practices for treating the above conditions. Consistent with prior research, magnet hospitals continue to provide better care to patients when compared with non-magnet hospitals. Magnet hospitals were significantly more likely to give heart attack patients aspirin at arrival, aspirin at discharge, Beta Blocker at arrival, Beta Blocker at discharge, and adult smoking cessation advice/counseling than non-magnet hospitals. Magnet hospitals were significantly more likely to give heart failure patients assessment of left ventricular function and adult smoking cessation/counseling than non-magnet hospitals. Magnet hospitals were significantly more likely to give pneumonia patients oxygenation assessment than non-magnet hospitals. Magnet program is still attractive after all these years because it uses team- and culture-building, nurse autonomy, participative management, strong nursing leadership and board commitment for measurably improved patient care.

Learning Objectives:

• Examine whether “magnet hospitals” known to be good places to practice nursing continue to provide better quality care to patients with heart attack, heart failure, and pneumonia than non-magnet hospitals. This study presents a unique opportunity to investigate the effects of excellence nursing services on quality of care in a large case-control analysis.

Keywords: Quality, Hospitals

Presenting author's disclosure statement:

Any relevant financial relationships? No