Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
School of Health Sciences, University of Southampton, Southampton, Hampshire, United Kingdom.
Int J Nurs Stud. 2024 Jun;154:104754. doi: 10.1016/j.ijnurstu.2024.104754. Epub 2024 Mar 14.
Magnet hospitals, a concept developed in the U.S., have been associated with improved nurse recruitment and retention, and better patient outcomes. Magnet principles may be useful to address workforce challenges in European hospitals, but they have not been implemented or evaluated on a large scale in the European hospital context.
This study aims to explore the initial phase of implementing Magnet principles in 11 acute care hospitals in six European countries. The specific objectives of the study were to investigate the type of work that characterises the early phase of implementation and how implementation leaders engage with their context.
A multinational qualitative study was conducted, with data from 23 semi-structured, one-to-one interviews with implementation leaders in 11 acute care hospitals in six European countries. Thematic analyses guided the analysis of data.
Three themes of core work processes during the early phase of implementing Magnet principles in European hospitals were identified. The first theme, 'Creating space for Magnet', describes how work was directed towards creating both political and organisational space for the project. The second theme, 'Framing to fit: understanding and interpreting Magnet principles', describes the translational work to understand what the Magnet model entails and how it relates to the local hospital context. Finally, the third theme, 'Calibrating speed and dose', describes the strategic work of considering internal and external factors to adjust the process of implementation.
The first phase of implementation was characterised by conceptual and relational work; translating the Magnet concepts, considering the fit into existing structures and practices and making space for Magnet in the local context. Understanding the local context played an important role in shaping and guiding the navigation of professional and organisational tensions. Hospitals employed diverse strategies to either emphasise or downplay the role of nurses and nursing to facilitate progress in the implementation.
磁石医院是美国首创的概念，与改善护士招聘和留用以及更好的患者结局有关。磁石原则可能有助于解决欧洲医院的劳动力挑战，但在欧洲医院环境中尚未大规模实施或评估。
本研究旨在探索在欧洲六个国家的 11 家急症护理医院实施磁石原则的初始阶段。该研究的具体目标是研究构成实施早期阶段的工作类型，以及实施领导者如何与他们的背景相联系。
进行了一项多国家定性研究，数据来自于欧洲六个国家的 11 家急症护理医院的 23 名实施领导者的 23 次半结构式一对一访谈。主题分析指导了数据分析。
确定了在欧洲医院实施磁石原则的早期阶段的三个核心工作流程主题。第一个主题是“为磁石创造空间”，描述了如何致力于为项目创造政治和组织空间。第二个主题是“框架适配：理解和解释磁石原则”，描述了理解磁石模型的含义以及它与当地医院背景的关系的翻译工作。最后，第三个主题是“校准速度和剂量”，描述了考虑内部和外部因素以调整实施过程的战略工作。
实施的第一阶段的特点是概念性和关系性工作；翻译磁石概念，考虑与现有结构和实践的适配，并在当地背景下为磁石创造空间。了解当地背景在塑造和指导对专业和组织紧张关系的处理方面发挥了重要作用。医院采用了不同的策略来强调或淡化护士和护理的作用，以促进实施的进展。
