Investment in Nursing Helps Achieve Lower Mortality

A new study claims that lower mortality and other improved patient outcomes at designated "Magnet hospitals" are explained partly by better nurse staffing, education, and work environment.

Researchers at the University of Pennsylvania (Philadelphia, USA) compared patient outcomes at Magnet hospitals versus non-Magnet hospitals in the US states of California, Florida, Pennsylvania, and New Jersey in 2006-07. The researchers linked patient, nurse, and hospital data on 56 Magnet hospitals and 508 non-Magnet hospitals. The main outcomes were to ascertain whether Magnet hospitals achieved better patient outcomes, and to identify characteristics of Magnet hospitals that led to improved outcomes.

The results showed that Magnet hospitals had significantly better work environments, a higher proportions of nurses with bachelor's degrees and specialty certification, and higher nurse-to-patient staffing ratios. Key patient outcomes were also better at Magnet hospitals, with mortality rates 20% lower, after accounting for clinical factors. Nurse staffing, education, and work environment explained much of the superior patient outcomes at Magnet hospitals. In addition, there was a residual mortality advantage attributable to the ongoing process of maintaining Magnet recognition status. The study was published in the May 2013 issue of Medical Care.

“Magnet hospitals have lower mortality because of investments in nursing; magnet recognition likely stimulates positive organizational behavior that improves patient outcomes,” said lead author Matthew McHugh, PhD, JD, MPH, RN, of the school of nursing. “Even controlling for differences in nursing, hospital, and patient characteristics, surgical patients in Magnet hospitals had 14% lower odds of inpatient death within 30 days and 12% lower odds of failure-to-rescue, compared to patients cared for in non-Magnet hospitals.”

“This large study makes an important contribution to an emerging literature attempting to understand what makes some hospitals superior in terms of patient outcomes they obtain, how to best manage hospitals, and whether or not the Magnet designation process as it now exists truly designates institutions where patients fare better,” commented Jeroan Allison, MD, editor-in-chief of Medical Care.

The Magnet Program is a voluntary recognition and certification program administered by the American Nurses Credentialing Center (ANCC), an arm of the American Nurses Association (Silver Spring, MD, USA). Magnet hospitals are recognized for quality patient care, nursing excellence, and innovations in professional nursing practice.

Related Links:
University of Pennsylvania
American Nurses Association