Magnet Accredited Hospitals and Patient Outcomes

1. Magnet Accredited Hospitals and Patient Outcomes Jennifer Delasko RN, BSN Juline Lloyd RN, BSN NURS 531 Spring 2016 Ferris State University

2. Objective • Hospitals are under pressure to improve patient outcomes and patient satisfaction. Magnet accreditation has become the gold standard. • Is this the best option? • What does evidence say?

3. Introduction • “Benefits of Magnet Designation • Attract and retain top talent • Improve patient care, safety and satisfaction • Foster a collaborative culture • Advance nursing standards and practice • Grow your business and financial success” (American Nurse Credentialing Center, 2016)

4. Introduction • Cost • Total average cost reported • Time – 4.25 years • Money- $2,125,000 (American Nurse Credentialing Center, 2016)

5. PICO Question In regards to hospitalized patients dose the implementation of Magnet status in hospitals, compared to non-magnet hospitals, show improved patient outcomes?

6. Evidence-Based Practice • Empowering Nurses With Evidence-Based Practice Environments • Presented in Worldviews on Evidence-Based Nursing • Magnet Recognition and advancing nursing knowledge= • Fewer EBP barriers • Higher EBP desire and ability • Increased EBP frequency • (Wilson et al., 2015)

7. Central Line-Associated Bloodstream Infection (CLABI) Rates Magnet Hospital Recognition Linked to Lower CLABI Rates Presented in Research in Nursing & Health Magnet recognized hospitals compared to similar = non-magnet hospitals 54% higher odds of better CLABSI rates (Barnes, Rearden, & McHugh, 2016)

8. Mortality Rates • Magnet Hospitals are a Magnet for Higher Survival Rates at Adult Trauma Centers • Presented in the Journal of Trauma and Acute Care Surgery • 10 Magnet and 17 non-Magnet trauma center similarities: • Level of designation • Medical school association • Surgical residency programs • In-house surgeon • Urban location • Magnet hospitals were associated with a 20% reduction in mortality rates • (Evans et al.,2014)

9. Suggested Practice Change • Initiating Magnet recognition: • Improvement EBP • Reduction in CLABSI • Decrease in mortality rates

10. Patient Outcomes Comparison of Patient Outcomes in Magnet and Non-Magnet Hospitals Presented in The Journal of Nursing Administration (Goode, Blegen, Park, Vaughn & Spetz, 2011)

11. Working Conditions A Comparison of Working Conditions Among Nurses in Magnet and Non-Magnet Hospitals Presented in The Journal of Nursing Administration (Trinkoff et al., 2010)

12. Patient Outcomes – FallsDeterminants of hospital fall rate trajectory groups: A longitudinal assessment of nurse staffing and organizational characteristicsPresented in Health Care Management (Everhart et al., 2014)

13. Suggested Practice Change • Increased nursing staff • Improve fall rate • Improve nurse related patient outcomes • Improved working conditions. Patient Outcomes

14. Critique of Evidence • One article: LOE IV • Five articles: LOE V • Evidence not strong to conclude Magnet status significance to patient outcomes

15. Recommendation -Weighing the evidence Mortality rate – Magnet status reduced rate by 20% Non-magnet hospitals in this study had no statistical differences in mortality rate. Infection rate – Magnet designated hospitals had 54% better odds of reduced CLABI Non-magnet hospitals had lower rates of post-operative sepsis and HAI Fall rate trajectory – Magnet designated hospitals and hospitals with increased patient care hours increased their chances of being in the consistently low fall category. EBP – Magnet hospitals encourage EBP which in turn has shown to improve outcomes The articles supporting magnet status are using more current data.

16. References • American Nurses Credentialing Center. (2016). Magnet recognition program • overview. Retrieved from http://www.nursecredentialing.org/Magnet/ProgramOverview • Barnes, H., Rearden, J., & McHugh, M. D. (2016). Magnet hospital recognition linked to lower central line-associated bloodstream infection rates. Research in Nursing & Health, 39, 96-104. Retrieved from http://0-onlinelibrary.wiley.com.libcat.ferris.edu/doi/10.1002/nur.21709/epdf • Elsevier. (2014). Is magnet status worth the cost? Retrieved from http://confidenceconnected.com/blog/2014/10/30/is-magnet-status-worth-the-cost/ • Evans, T., Rittenhouse, K., Horst, M., Osler, T., Rogers, A., Miller, J. A., ... Rogers, F. B. • (2014). Magnet hospitals are a magnet for higher survival rates at adult trauma centers. • Journal of Trauma and Acute Care Surgery , 77, 88-94. • http://dx.doi.org/10.1097/TA.0000000000000262 • Everhart, D., Schumacher, J., Duncan, R. P., Hall, A.. G., Neff, D. F., & Shorr, R., I. (2014). • Determinants of hospital fall rate trajectory groups: A longitudinal assessment of nurse • staffing and organizational characteristics. Health Care Management, 39, 352-360. • doi: 10.1097/HMR.0000000000000013

17. References Cont. • Goode, C. J., Blegen, M. A., Park, S. H., Vaughn, T., & Spetz, J. (2011). Comparison of patient outcomes in magnet and non-magnet hospitals. The Journal of Nursing Adminstration, 41, 517-523. doi: 10.1097/NNA.0b013e3182378b7c • Ponte, P. R., & Luzinski, C. (2012). Comparison of patient outcomes in magnet and non-magnet hospitals. Journal of Nursing Administration, 42, 65-66. doi:10.1097/NNA.0b013e318244bdc0 • Trinkoff, A. M., Johantgen, M., Storr, C. L., Han, K., Liang, Y., Gurses, A. P., & Hopkinson, S. (2010). A comparison of working conditions among nurses in magnet and non-magnet hospitals. The Journal of Nursing Administration, 40, 309-315. doi: 10.1097NNA.0b013e3181e93719 • Wilson, M., Sleutel, M., Newcomb, P., Behan, D., Walsh, J., Wells, J., & Baldwin, K. M. (2015). Empowering nurses with evidence-based practice environments: Surveying Magnet, Pathway to Excellence, and non-Magnet facilities in one healthcare system. Worldviews on Evidence-Based Nursing, 12, 12-21. Retrieved from https://fsulearn.ferris.edu/courses/1/10720.201601/groups/_32356_1//_1735949_1/Wilson_et_al-2015-Worldviews_on_Evidence-Based_Nursing.pdf