DiversityNursing Blog

Source: Nurse.com

A professional practice environment that is supportive of nursing helps explain why Magnet hospitals have better nurse-reported quality of care than non-Magnet hospitals, according to a study.

As published earlier this year in the Journal of Nursing Administration, researchers with the New York University College of Nursing and University of Pennsylvania School of Nursing explored links between recognized nursing excellence and quality patient outcomes.

Only 9% of American hospitals have Magnet recognition, according to an NYU news release, and Magnet hospitals have higher job satisfaction and lower odds of patient mortality than non-Magnet hospitals. Research into the causes of the differences could create an infrastructure for positive change in nurse and patient outcomes.

“Many of the recent efforts to improve quality and enhance transparency in healthcare have been dominated by physician services and medical outcomes,” Amy Witkoski Stimpfel, RN, PhD, assistant professor at NYUCN, said in the news release. “Our study shows that the overall quality of patient care can be optimized when nurses work in a positive environment, with adequate resources and support at the organizational level.”

The study, “Understanding the Role of the Professional Practice Environment on Quality of Care in Magnet and Non-Magnet Hospitals,” focused on cross-sectional data, including the American Hospital Association’s annual survey, and an analysis of 56 Magnet and 495 non-Magnet hospitals.

Witkoski Stimpfel’s team found a clear correlation between positive work environments for nurses and nurse-reported quality of care. Even after taking into consideration hospital characteristic differences between Magnet and non-Magnet hospitals, Magnet hospitals still were positively correlated with higher reports of excellent quality of care.

“Having visible and accessible chief nurses, encouraging and including nurses in decision-making in their unit and throughout the organization, supporting nursing practice and engaging in interdisciplinary patient care are but a few examples of readily modifiable features of a hospital,” Witkoski Stimpfel said.

“Because all organizations, Magnet and otherwise, have the potential to enrich their practice environment, every organization stands to benefit from improving the organization of nursing care.

“Our findings suggest that Magnet hospitals produce better quality of care through their superior practice environments. Hospitals that invest in improving the nursing work environment have the potential to benefit from increased quality of care for their patients and families.”

Witkoski Stimpfel is continuing to research the outcomes associated with Magnet hospitals. Her current project is an assessment of the relationship between Magnet recognition and patient satisfaction in a national sample of hospitals.

Study abstract: http://bit.ly/1hxEUhy

By Nurse.com News

A qualitative study on assaults on emergency nurses, sponsored by the Emergency Nurses Association, found a need to change the culture of acceptance that is prevalent among hospital administrators and law enforcement.

Better training to help nurses recognize signs of potential trouble also is key, according to researchers, whose study was published Jan. 17 on the website of the Journal of Emergency Nursing.

“Assaults on emergency nurses have lasting impacts on the nurses and the ability of emergency care facilities to provide quality care,” 2014 ENA President Deena Brecher, RN, MSN, APN, ACNS-BC, CEN, CPEN, said in a news release. 

“More than 70% of emergency nurses reported physical or verbal assaults by patients or visitors while they were providing care. As a result, we lose experienced and dedicated nurses to physical or psychological trauma for days or sometimes permanently. Healthcare organizations have a responsibility to nurses and the public to provide a safe and secure environment.”

According to Bureau of Labor statistics, an assault on a healthcare worker is the most common source of nonfatal injury or illness requiring days off from work in the healthcare and social assistance industry. 

Despite that statistic, the qualitative research study discovered a culture of acceptance among hospital administrators, prosecutors and judges. One emergency nurse assault victim told the researchers the “administration will only take action when some lethal event happens.”

Perhaps in correlation with the culture of acceptance, the study also concluded that emergency nurses and hospital personnel in general are not trained to recognize cues for violent behavior. 

“It is imperative that hospitals and emergency care workers address the issue preemptively through adoption of violence prevention education, zero-tolerance policies, safety measures and procedures for reporting and responding to incidents of workplace violence when they do occur,” the researchers noted. “Such actions are necessary to help nurses recognize incipient violence.”

The ENA long has taken the position that healthcare organizations must take preventive measures to circumvent workplace violence and ensure the safety of all healthcare workers, their patients and visitors.

“There will always be the potential for violence against emergency nurses,” Brecher said. “But we must not accept it as the price of helping the sick and injured. With training and a change of culture, we can significantly decrease the occurrence of assaults against emergency nurses.”

The study was conducted using a qualitative descriptive exploratory design. In the fall of 2012, a sample of ED nurses was recruited by email from the roster of ENA nurses and through an announcement on the ENA website. Eight men, 37 women and one person of unknown gender responded to the question, “Tell me about your experience of violence in the emergency setting.” Answers were emailed to and analyzed by the Institute for Emergency Nursing Research. 

Only one other previous qualitative study is known to have been conducted to address workplace violence against emergency nurses in the United States since at least 2004, according to the news release.

Study abstract: http://bit.ly/1iwMuM8 

Source: Nurse.com