Journal of Nursing Administration:
Departments: Letter to the Editor
Chair, Commission on Magnet Recognition
Director, Magnet Recognition Program
The authors declare no conflict of interest.
The article “Comparison of Patient Outcomes in Magnet® and Non-Magnet Hospitals” in the December 2011 issue of Journal of Nursing Administration (available at http://journals.lww.com/jonajournal/Fulltext/2011/12000/Comparison_of_Patient_Outcomes_in_Magnet__and.7.aspx) has multiple limitations that complicate interpretation of the results. Although we agree with the authors that the Magnet Recognition Program® is worthy of research to understand how outcomes are improved, the study used data from 2005. This is problematic, as the requirements for Magnet at that time were significantly different than they are today. After a major transformation in 2008 focusing on outcomes, Magnet organizations now have requirements for nurse, workforce, patient, and clinical outcomes not required in 2005. The standards require outcomes above the 51st percentile of the benchmarking database for 2 consecutive years. Over the past 6 years, a growing body of research demonstrates that Magnet characteristics do impact patient outcomes (http://www.nursecredentialing.org/MagnetReferences.aspx).
In addition, the sample size was only 19 Magnet hospitals when there are 391 Magnet organizations today. This time lag, the small sample size, and the change in the Magnet requirements call into question the relevance of the study. Although the study shows statistically significant differences (P < .05), the clinical significance is limited.
As a voluntary credential, many excellent facilities may not seek Magnet designation. This study does not account for non-Magnet hospitals that may be Magnet-like. University HealthSystem Consortium (UHC) hospitals are likely to have implemented evidence-based practices, hallmarks of Magnet, and many were on the journey to Magnet excellence. Evidence of the UHC excellence is that 13 UHC academic medical centers were designated Magnet in 2006-2007, the 2 years following the year in which the study data were sampled.
The Commission on Magnet encourages researchers to strengthen their methods, data selection and analysis, and sample size and identify key variables that may better explain findings. Current and rigorous studies are needed to improve our ability to provide positive practice environments that impact excellence in patient care.
Patricia Reid Ponte, DNSc, RN, FAAN
Chair, Commission on Magnet
Craig Luzinski, MSN, RN, NEA-BC, FACHE
Director, Magnet Recognition
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