Healthcare Systems
Arielle Greenlee
University of Detroit Mercy
Healthcare Systems Project Proposal
The American Nurses Credentialing Center (ANCC) developed the Magnet Recognition Program, originally designed to recognize healthcare organizations (HCOs) that demonstrate nursing excellence (Urden, Ecoff, Baclig, & Gerber, 2013). The intent of Magnet recognition was primarily for the recruitment and retention of nurses and dates back to the 1980s. There are over 300 Magnet hospitals worldwide, but less than 7% of hospitals in the United States are Magnet designated (Urden, Ecoff, Baclig, & Gerber, 2013). Magnet designation opens staff nurses to teach, lead, as well as role model in all practice settings (McHugh et al., 2013).
The ANCC (2013) states the top three goals of the Magnet Recognition Program within HCOs. These three goals are:
1. Promote quality in a setting that supports professional practice.
2. Identify excellence in the delivery of nursing services to patients and residents.
3. Disseminate best practices in nursing services.
ANCC is the world’s largest and most prestigious nurse credentialing organization, and a subsidiary of the American Nurses Association (ANA). The ANCC further exemplifies the benefits of Magnet designation to include: recruitment and retention, improvement of patient care and satisfaction, collaboration, higher nursing standards for practice, and continuing education (McHugh et al., 2013).
In one particular study by Urden et al. (2013), nine particular themes were identified in Magnet recognized healthcare organizations. These themes were: relationships with leaders, Magnet continuum, professional relationships, professional development, staff voice, resources and support, professional accountability, Magnet slippage, and recommendations from nurses (Urden, Ecoff, Baclig, & Gerber, 2013). From the article, these themes were illustrated by including personal quotes from the staff nurses. “Our nurse leader made an effort to meet with all the nurses on our unit….” (Urden, Ecoff, Baclig, & Gerber, 2013). “It’s the RN’s that get it (Magnet designation) from the hospital…”(Urden, Ecoff, Baclig, & Gerber, 2013). Further quotes embodied the overall good communication, opportunities for higher education, empowerment, staff involvement, positive remarks on the orientation process, and was overall recommended by the nurses (Urden, Ecoff, Baclig, & Gerber, 2013).
Michele Seator MSN, RN, Magnet Program Manager at Harper University Hospital DMC, explains the ‘Pathway to Excellence’ as a journey, where nuts and bolts, structures and processes, get put together for ultimate nursing satisfaction. “….to create an environment where nurses can succeed and develop professionally” (personal communication, September 12, 2014). To epitomize Magnet recognition, a professional practice model was developed by designated “Magnet champions” of specified nursing units. These champions work as primary motivators to the staff. The model was developed based on Swanson’s theory of caring and has changed from the previous practice professional model by embracing Harper-Hutzel Hospitals mission statement, as well as core values, respect, quality, commitment, and safety.
Staff nurses on acute care units 4, 5, & 10 Webber south and 6 Brush at Harper Hospital were each supplied with a self assessment questionnaire to develop a needs assessment on individual knowledge on the Harper-Hutzel professional practice model, including its origin, concepts, and integration. Important to note, it was a challenge for the nurses to find time to complete the questionnaire, which should be considered when assessing reliability. From the completed questionnaires, it was evident that there was a lack of familiarity with the professional practice model. Most nurses were unable to identify the model by sight, while others had difficulty simply relating their practice to the professional practice model.
The needs assessment revealed the necessity to educate staff nurses on the professional practice model to increase awareness and to subsequently implement to personal practice, to generally improve patient care and staff satisfaction congruent with Magnet standards. It is paramount that the nurses understand their impact on patient satisfaction and outcomes through multiple spheres of influence. With a review of deficiencies and areas of improvement, including patient falls and device related pressure ulcers, as well as the feedback received from the needs assessment it has been determined that the CNS student will educate staff nurses, during designated in-service times, on the new professional practice model by developing a poster board presentation.
System barriers, including the education of the staff nurses on the new professional practice model will include the monetary cost of the printed assessment tools and other teaching tools that will be needed for implementation. Getting enough staff to cover patient assignments during in-service times may serve as a barrier. Achieving a thorough understanding with the ability to apply the knowledge to the practice setting is a higher level of learning and will be difficult to obtain.
The facilitators of this project include my preceptor, Michele Seator. Furthermore, the managers on each of the proposed units have agreed to assist during the education phase. Each unit also has a dedicated Magnet champion, which will serve as motivators for the staff and will also help solidify the education materials and assist with those unable to attend the in-service dates and times.
Variables, or outcome data, based on the intervention may include confusion about the two different professional practice models and the application to personal practice as it relates to patient outcomes and personal satisfaction. The compliance of staff may vary, while some might be motivated to learn and apply their knowledge to the practice setting and personal practice, others might feel the intervention is irrelevant or too time consuming.
Tuesday, November 09, 2010, Harper and Hutzel Women’s DMC Hospitals were the first in Michigan to announce their designation as a Pathway to Excellence® facility (News Archive, 2010). Both hospitals are committed to promoting a safe, positive work environment that is committed to nurses and high quality patient care. Thomas Malone, M.D. (2010) president of Harper and Hutzel hospitals expresses that achieving such a status reflects the teamwork of patient care staff. The professional practice model is the gateway to Magnet status and serves as a guideline to practice. Excelling in these areas not only supports nurses, which results in better retention and higher job satisfaction, but also influences important patient outcomes (Witkoski-Stimpfel, Rosen, & McHugh, 2014). The CNS student plays an important role in the educational project as coordinator to collaborate among nursing and managerial staff within the organization and consultation as well as researching staff compliance, patient outcome data, and patient and nurse satisfaction.
References
Magnet Recognition Program Model. (2014, January 1). Retrieved September 18, 2014 from
http://www.nursecredentialing.org/
McHugh et al. (2013) Lower mortality in magnet hospitals. Med Care . 2013 May ; 51(5): 382–
388. doi:10.1097/MLR.0b013e3182726cc5.
(M. Seator, personal communication, September 12, 2014)
News Archive: Two DMC Hospitals are first in Michigan to achieve top nursing accreditation.
(2010, Nov 9). Retrieved from http://www.harperhutzel.org/news/?sid=1&nid=16
Urden, L.D., Ecoff, L.K., Baclig, J., & Gerber, C.S. Staff nurse percetions of the Magnet jouney.
The Journal of Nursing Administration, Vol. 43, No. 7/8, pp. 403–408.
Witkoski-Stimpfel, A., Rosen, J.E., & McHugh, M.D. (2014) Understanding the role of the
professional practice environment on quality of care in Magnet and non-Magnet hospitals. J Nurs Adm. 2014 January ; 44(1): 10–16. doi:10.1097/NNA.0000000000000015.
