During the 1980s, there was a significant nursing shortage and high turnover at hospitals. Nurse leaders observed that some hospitals were better able to retain nurses and fill vacancies compared with similar hospitals in the same labor markets. A study by the American Academy of Nursing (AAN) identified 41 hospitals that acted as “magnets” for nurses because of their more supportive work environments. 5
Research by Kramer and Hafner6
confirmed that AAN Magnet hospitals had common organizational features not found in other hospitals that were associated with higher nurse satisfaction and retention. Aiken and colleagues7
followed with a study showing that the AAN-identified hospitals also had better patient outcomes, namely lower hospital mortality, than matched hospitals.
In 1990, the ANCC, an organizational component of the American Nurses Association, developed a voluntary recognition program for formally credentialing Magnet organizations, and the first Magnet hospital was credentialed8
in 1994. Aiken and associates 3
compared the first 7 ANCC Magnet®
-recognized facilities with the original AAN reputational Magnet hospitals, finding the ANCC hospitals to have better nurse work environments and nurse outcomes, such as higher job satisfaction, lower burnout rates, and lower intent to leave, than the original AAN hospitals.
The ANCC Magnet Recognition Program®
has grown exponentially in recent years. To date, approximately 7% of US hospitals, close to 400, have achieved Magnet Recognition.9,10
Magnet hospitals have been recognized thus far in 5 countries besides the United States (England, Australia, New Zealand, Singapore, and Lebanon). Magnet-credentialed hospitals have consistently been shown to have better nurse work environments and better nurse and patient outcomes.1,11–14
In addition, Magnet-recognized hospitals have demonstrated higher nurse-physician collaboration and safer work environments.15,16
Recent research has focused on the work environment of nurses as a potential contributor to nurse outcomes.4,17,18
Many hospitals use the process of Magnet credentialing as a road map for improving the quality of care and the work environment of their hospital.19
In a case study of the first hospital outside the United States to become Magnet recognized, a hospital in England was shown to significantly improve its work environment after Magnet Recognition as compared with that before preparing for Magnet credentialing.20
Ulrich et al21
examined the practice environments of Magnet hospitals, finding that the improved environment in Magnet-credentialed hospitals is demonstrated through significantly higher emphasis on patient care, more opportunities for advancement, and a greater ability to influence decisions. In addition, Lake and Friese4
confirmed that Magnet-credentialed hospitals documented better practice environments than other hospitals in a single-state sample of Pennsylvania.
This study was conducted to use a unique recent database derived from a survey of hospital nurses in 4 states to determine whether organizational nursing characteristics and nurse job-related outcomes differ in Magnet compared with non-Magnet hospitals. We compare differences in nurses’ work environment and nurses’ educational qualifications in Magnet hospitals compared with nurses in non-Magnet hospitals. We also evaluated nurses’ satisfaction, burnout, and intention to leave their position in Magnet and non-Magnet hospitals, controlling for individual nurse, hospital, and hospital-level nursing characteristics.