Study finds no significant disparities in nursing practice environment, patient safety culture

Since 1994, hospitals achieving Magnet status by the American Nurses Credentialing Center have boasted of nursing excellence, quality care, and innovations in nursing practice above that provided by hospitals not attaining the recognition.

Professor Alison M. Trinkoff, ScD, RN, FAAN explains that advances in nursing practice and leadership capabilities at Magnet-designated hospitals make those institutions attractive to nurses and patients alike. But along with her colleagues, she contemplated whether working conditions for nurses differ between the settings, noting the high nurse turnover and low retention rates at issue in United States hospitals.

After evaluating working conditions at 171 Magnet and non-Magnet designated hospitals through responses from 837 nurses, Trinkoff and her colleagues concluded that Magnet hospitals do not provide superior working conditions for nurses over non-Magnet designated hospitals.

The study, funded by the National Council of State Boards of Nursing and published in the July/August 2010 issue of the Journal of Nursing Administration, concluded that although nurses working in Magnet hospitals reported less mandatory overtime and on-call, their hours worked each day and each week were similar. In addition, there were no differences in psychological demands reported by the nurses, although nurses in Magnet-recognized hospitals reported fewer physical demands. On all other measures of working conditions, including nursing practice environment, patient safety culture, and overall job satisfaction, there were no significant disparities.

With regard to long work hours and tough working conditions at both Magnet and non-Magnet hospitals, Trinkoff maintains that work schedules, including a prevalence of 12-hour and longer nursing shifts and overtime requirements at most hospitals, affect the
overall health of nurses and impact the care that patients receive.

"A great many nurses find the 12-hour shift wearing them down, draining and incompatible with other aspects of their lives," says Trinkoff, the study's lead investigator." Nurses do not sleep well, rest well, recuperate well from injury, or practice well when they work 12 hours."

In general, Magnet and non-Magnet hospitals require the same long shifts, and nurses often cannot take their meal breaks and other needed respites.

"I certainly thought there would be more differences than there were," says Trinkoff. "The fact that we don't see a difference suggests it's something all hospitals could pay attention to."

Source: Journal of Nursing Administration