Aiken Linda H, Buchan James, Ball Jane, Rafferty Anne Marie
Center for Health Outcomes and Policy Research, University of Pennsylvania, Philadelphia, PA 19104-6096, USA.
J Clin Nurs. 2008 Dec;17(24):3330-7. doi: 10.1111/j.1365-2702.2008.02640.x.
To test the impact of the implementation of Magnet principles of improving nurses' work environments.
Magnet hospital designation developed in the USA in the 1980s to recognise hospitals that had created excellent patient care environments and supported the professional practice of nursing. A pilot initiative in England was the first test of the applicability of Magnet standards outside the USA.
Research methods included surveys of nurses in the demonstration hospital in a predesign and postdesign and comparisons to survey results of nurses practicing in a national sample of 30 National Health Service Trusts.
Prior to beginning the Magnet journey, the demonstration hospital had a nurse work environment that was somewhat less positive than the national sample NHS hospitals. Nurses practicing in the demonstration hospital were somewhat less satisfied with their jobs than nurses in other NHS hospitals. Following a two-year period during which the evidence-based Magnet standards were implemented and Magnet Designation was awarded, the quality of the nurse practice environment had improved significantly, as had job satisfaction of nurses and their appraisals of the quality of patient care. The quality of the nurse practice environment after Magnet designation was better than that of a national sample of NHS trusts. Improved nurse outcomes were because of the improved practice environment rather than staffing enhancements.
Implementation of the Magnet hospital intervention was associated with a significantly improved nursing work environment as well as improved job-related outcomes for nurses and markers for quality of patient care.
Nurses can use Magnet principles to improve the quality of their work environments.
测试实施“磁性医院”原则对改善护士工作环境的影响。
“磁性医院”称号于20世纪80年代在美国设立,旨在表彰那些营造了优质患者护理环境并支持护理专业实践的医院。英国的一项试点举措是首次在美国以外地区测试“磁性医院”标准的适用性。
研究方法包括在示范医院对护士进行预设计和后设计调查,并与在30家国民健康服务信托机构的全国样本中执业的护士的调查结果进行比较。
在开始“磁性医院”之旅之前,示范医院的护士工作环境比国民健康服务体系样本医院稍差。在示范医院执业的护士对工作的满意度略低于其他国民健康服务体系医院的护士。在实施基于证据的“磁性医院”标准并授予“磁性医院”称号的两年期间,护士执业环境质量显著改善,护士的工作满意度以及他们对患者护理质量的评价也有所提高。获得“磁性医院”称号后的护士执业环境质量优于国民健康服务信托机构的全国样本。护士工作成果的改善是由于执业环境的改善,而非人员配备的增加。
实施“磁性医院”干预措施与显著改善护理工作环境以及护士的工作相关成果和患者护理质量指标相关。
护士可运用“磁性医院”原则来改善其工作环境质量。