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What is Gained by Having Magnet Accreditation?

To answer this question, Kammie Monarch, director of the accreditation and Magnet recognition program for the ANCC, said nurses are staying an average of almost nine years at magnet facilities, whereas nurses in non-magnet environments generally stay an average length of three and one-half to four years.

"[Magnet] facilities are able to keep nurses for a much longer period of time, and so continuity of care is much better and patient care is obviously improved," she said.

From the perspective of the health care facilities, they are not only retaining nurses and providing better care to their patients but they are also benefiting from having a team environment.

Catherine Broom, ARNP, clinical specialist and magnet project coordinator at the University of Washington Medical Center, said the University of Washington Medical Center’s Magnet status encourages nurses to participate and take part in the decision-making process, which also motivates nurses in their day-to-day tasks. Though Broom did not have specific numbers, she said the facility has also had a higher percentage of nurses who have stayed on. She named herself a "case in point," having been with the facility for 17 years.

At Avera McKennan, Darcy Sherman-Justice, RN, MS, who helped work on the Magnet application, said, "The journey to Magnet in itself was an exciting experience…we have seen a lot of nursing pride."

Borchardt added, "We haven’t necessarily changed much of our culture once we went through the Magnet process. I think we have always had this culture of excellence. The Magnet designation is just a formal recognition that we do really good things here and so it has increased our nurses’ pride that they have been recognized at a national level for things they have been doing all along."

By Kristin Rothwell, NurseZone feature writer

"There are only [42] magnet hospitals," said Mary E. Foley, RN, MS, president of the American Nurses Association, which supports the American Nurses Credentialing Center Magnet program, while speaking to members of the Florida Nursing Association District 5 in October. "We [ANA] think there are about 5,000 hospitals in the country. So what about the rest of them?"

As nursing shortages, mandatory overtime and burnout among nurses continue to worsen, several health care organizations across the United States are stepping up to the challenge to support, maintain and encourage nurse-friendly, patient-friendly environments by applying for and receiving Magnet award status through the American Nurses Association (ANA) American Nurses Credentialing Center (ANCC).

"What we’ve seen is that patient satisfaction at Magnet facilities is much higher, as well as nurse satisfaction," said Kammie Monarch, director of the accreditation and magnet recognition program for the American Nurses Credentialing Center .

Established in 1994, the Magnet Hospital Recognition Program, which has since been renamed the Magnet Nursing Services Recognition Program for Excellence in Nursing Services, was created following a study of 41 hospitals by the American Academy of Nursing (AAN) in 1982. Results from the study identified characteristics of health care environments that attracted and retained well-qualified nurses, as well as provided quality patient care with first-rate nursing services.

By 1990, the ANA approved a Magnet program and in 1993, once the infrastructure was in place, the ANCC invited several hospitals to apply. The first and only health care facility to receive Magnet designation in the program’s first year was given to the University of Washington Medical Center in 1994.

"We are in a unique position because we had been identified and recognized for what we were," said Catherine Broom, ARNP, clinical specialist and Magnet project coordinator at the University of Washington Medical Center. "However, we cannot rest on our laurels. We need to focus on how to sustain our Magnet environment. That means looking for ways to continue to support and promote high quality nursing practice and patient care in the context of cutbacks in reimbursement, changes in organizational structure and leadership, and changes in regulations that affect healthcare. We strive for an environment where nurses feel supported and are proud of the patient care they provide."

The University of Washington Medical Center was re-designated Magnet status in 1998. Broom, with the assistance of a steering committee, is currently completing the facility’s third application for Magnet re-designation, due at the end of this month.

The Process

Health care facilities interested in applying for ANCC Magnet status can expect a lengthy process. To help facilities discern whether they have the qualities necessary for magnet accreditation, the ANCC provides them with a short questionnaire, which asks various questions about the facility.

"If the facility answers ‘yes’, then maybe the facility is ready to apply for Magnet status," Monarch said. "If ‘no’, then maybe there’s some room for work prior to applying."

Avera McKennan Hospital and University Health Center in Sioux Falls, South Dakota, answered ‘yes.’ Soon after several nursing leaders at Avera McKennan attended a Magnet conference in Atlanta, Georgia, Carla Borchardt, RNC, Magnet project director and director of professional practice at Avera McKennan explained that a core group, composed of staff in different leadership levels throughout the organization, was developed to identify what components needed to be included in the Magnet application.

The core members submitted a report, proving that Avera McKennan could meet ANCC’s 14 standards. They highlighted nursing philosophy and structure, expertise and role of nursing administration, use of the nursing practice, and use of nursing research and recognition of a diverse client population.

A review follows the application submission.

"There's a site visit by ANCC representatives to verify that what has been written matches what is actually occurring at the facility," Broom said. "ANCC appraisers will meet with representatives from leadership, other disciplines, and nurses at all levels of the organization."

Monarch further explained that, "Oftentimes there are gaps or particular pieces of information that needs to be gathered on-site that wasn’t available in the written documentation. The appraisers look for those things and try to ensure that the actual environment, the day-in and day-out practice at the environment, is consistent with the evidence that was submitted in writing."

She added, "It’s a way to verify that an organization is doing what it is they say they do."

The process to receive magnet accreditation not only requires time but also financing and support from hospital administrators and nursing leaders.

"What might hold hospitals back [from earning Magnet status] might be the cost because it certainly is not inexpensive between the fees to apply and the financial and human resources, such as time, that it takes to pull everything together for the application," said Darcy Sherman-Justice, RN, MS, who helped work on the magnet application at Avera McKennen.

"I think there are a certain number of organizations that don’t have the organizational culture that supports the principals of what a Magnet facility is," said Sherman-Justice. "It’s very important to have the support of your CEO and whoever your chief nurse leader is and the belief that nursing is a very important, integral part of what your organization does."

Avera McKennan earned magnet status for the first time in June 2001.

The Future of the ANCC Magnet Program

Currently 19 states have at least one Magnet facility, which have been labeled by the ANCC as "magnet states."

"We haven’t tapped into all of the states in the United States yet, but we are working on that," said Monarch.

So far New Jersey is in the lead with nine Magnet facilities. Wisconsin and Florida are a close second, each have five Magnet facilities.

While the ANCC has tried to keep the cost of the program reasonable so that more organizations can apply, Monarch said the government affairs department of the ANA has been working with Congress to pass a bill that would make it an incentive for hospitals to attain Magnet status. Democratic Sen. Hillary Rodham-Clinton of New York, one of the co-sponsors of the bill, introduced the Nurse Retention and Quality Care Act of 2001, which would provide grants to hospitals to improve nurse retention and implement successful nursing care models.

The ANCC’s Magnet program has also received international attention among nurses and nursing organizations from around the world who have heard and seen how the magnet program has made a difference for nurses and patients in the United States.

Significant interest in the magnet program has been shown in places such as Australia, Canada, Korea, Hong Kong, Central and South America and Central and Eastern Europe.

"We’re finding that there is a high-degree of transferability between the programs as it’s implemented in the United States and as it will be implemented internationally," said Monarch.

Already, the ANCC has established a pilot project in the United Kingdom at the Rochdale National Health Trust. Next month, ANCC appraisers will make a site visit to the facility. If it passes all of the requirements for ANCC accreditation, it will be the first international organization to receive Magnet status.

"That will be exciting," said Monarch. "It’s a really nice position for us to be in."

She added, "We believe these [Magnet organizations] are ones that really use excellence as their benchmark for a day-in and day-out basis rather than the status quo or rather than what would be normal or predictable. They really look at how and what would be the excellent way to approach a situation or an excellent way to provide patient care services."

For more information about the ANCC magnet accreditation program, visit http://nursingworld.org/ancc/magnet/magnet.htm.

Jan. 11, 2002. © 2002. NurseZone.com. All Rights Reserved.