Objective: Magnet hospitals exhibit higher patient satisfaction than non-Magnet hospitals, yet the underlying mechanisms driving these differences remain underexplored. This study examined the associations between Magnet status, hospitals' inclusion efforts for diverse populations, and patient satisfaction, and whether inclusion efforts explain Magnet hospitals' higher satisfaction.
Methods: This cross-sectional study analyzed 2023 secondary data from 4 sources: the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), the Healthcare Equality Index (HEI), the American Hospital Association Annual Survey, and the list of Magnet-recognized organizations.
Background: Nurse retention and wellbeing have reached alarmingly low levels in recent years and health systems globally are searching for large-scale systemic solutions to reduce nurse burnout, improve wellbeing, and increase job satisfaction and retention while simultaneously enhancing patient care quality and safety.
Objective: To evaluate whether a minimum nurse staffing policy intervention in Queensland Australia improved nurse wellbeing, intentions to leave employment, and patient safety.
Methods: This is a quasi-experimental intervention study in which we compared nurse outcomes, patient safety measures, quality of care indicators, and operational failures among 27 hospitals subject to a minimum nurse staffing policy (i.
J Nurs Adm
September 2025
Objective: This study investigated the association of Pathway to Excellence® (Pathway) status with patient satisfaction.
Background: The Pathway program recognizes hospitals committed to fostering optimal practice environments, yet research on its impact on patient satisfaction is limited.
Methods: This cross-sectional study linked 3 datasets: the Hospital Consumer Assessment of Healthcare Providers and Systems, the American Nurses Credentialing Center® Pathway and Magnet® organizations, and the American Hospital Association Annual Survey.
Objective: To evaluate staffing conditions, patient outcomes, quality of care, patient safety and nurse job outcomes in British Columbia (BC), Canada hospitals.
Design: Cross-sectional study of 58 hospitals in BC with surveys of nurses and independent measures of patient outcomes.
Setting: 58 hospitals in BC.
Background: Emergency medicine is a highly interdisciplinary field, and emergency nurses and physicians have high rates of burnout compared to other specialties. National and international agencies prioritize investments in systems-based solutions to improve clinicians' work environments. The objective of this study was to determine whether emergency department (ED) clinicians agree on the quality of work environments, and whether their agreement is associated with job outcomes, patient safety, and quality of care.
View Article and Find Full Text PDFAim: Evaluate the relationship between hospital nursing resources and outcomes among patients with chronic wounds.
Design: Cross-sectional observational.
Methods: Hospital-level predictors included the nurse work environment, proportion of Bachelor of Science (BSN)-prepared nurses, and skill mix (i.
Objective: To determine modifiable organizational factors associated with advanced practice RN (APRN) burnout in Magnet ® -designated hospitals to guide organizational interventions to improve APRN well-being and retention.
Methods: Cross-sectional study of work environments of 50 US Magnet hospitals and the associated well-being of 21 855 of their clinicians (APRNs, physician assistants, physicians [MDs], RNs).
Results: Overall, 37% of APRNs experienced high burnout compared with 34% of MDs ( P < 0.
Background: Sepsis is a common cause of hospitalization among Medicare beneficiaries, often leading to prolonged hospital stays and high costs.
Purpose: To estimate the impact of registered nurse (RN) staffing and skill mix on hospital lengths of stay and associated costs for Medicare beneficiaries with sepsis.
Methods: A retrospective, cross-sectional analysis was conducted using 2018 data from 2,107 acute care hospitals, including 653,496 patients with sepsis.
Int J Nurs Stud
October 2024
Background: During the Covid-19 pandemic, Covid-19 mortality varied depending on the hospital where patients were admitted, but it is unknown what aspects of hospitals were important for mitigating preventable deaths.
Objective: To determine whether hospital differences in pre-pandemic and during pandemic nursing resources-average patient-to-registered nurse (RN) staffing ratios, proportion of bachelor-qualified RNs, nurse work environments, Magnet recognition-explain differences in risk-adjusted Covid-19 mortality; and to estimate how many deaths may have been prevented if nurses were better resourced prior to and during the pandemic.
Methods: This is a cross-sectional study of 87,936 Medicare beneficiaries (65-99 years old) hospitalized with Covid-19 and discharged (or died) between April 1 and December 31, 2020, in 237 general acute care hospitals in New York and Illinois.
Background: Hospitals are resurrecting the outdated "team nursing" model of staffing that substitutes lower-wage staff for registered nurses (RNs).
Objectives: To evaluate whether reducing the proportion of RNs to total nursing staff in hospitals is in the best interest of patients, hospitals, and payers.
Research Design: Cross-sectional, retrospective.
Aim: To examine if and how selected German hospitals use nurse-sensitive clinical indicators and perspectives on national/international benchmarking.
Design: Qualitative study.
Methods: In 2020, 18 expert interviews were conducted with key informants from five purposively selected hospitals, being the first in Germany implementing Magnet® or Pathway®.
The Practice Environment Scale of the Nursing Work Index (PES-NWI) has been utilized for two decades globally to measure nurse work environments. Its 31 items in five domains present a substantial respondent burden, threatening survey response rates. The purpose of this study was to derive and validate a short form: the PES-5.
View Article and Find Full Text PDFHigher nurse-to-patient ratios are associated with poor patient care and adverse nurse outcomes, including emotional exhaustion and intention to leave. We examined the effect of nurses' intention to leave and nurse-patient workload on in-hospital patient mortality in Italy. A multicentered descriptive and regression study using clinical data of patients aged 50 years or older with a hospital stay of at least two days admitted to surgical wards linked with nurse variables including workload and education levels, work environment, job satisfaction, intention to leave, nurses' perception of quality and safety of care, and emotional exhaustion.
View Article and Find Full Text PDFObjectives: To determine the well-being of physicians and nurses in hospital practice in Europe, and to identify interventions that hold promise for reducing adverse clinician outcomes and improving patient safety.
Design: Baseline cross-sectional survey of 2187 physicians and 6643 nurses practicing in 64 hospitals in six European countries participating in the EU-funded Magnet4Europe intervention to improve clinicians' well-being.
Setting: Acute general hospitals with 150 or more beds in six European countries: Belgium, England, Germany, Ireland, Sweden and Norway.
J Am Coll Emerg Physicians Open
October 2023
Objective: To determine the association between emergency nurses' work environments and patient care quality and safety, and nurse burnout, intent to leave, and job dissatisfaction.
Methods: Cross-sectional study of 221 hospitals in New York and Illinois informed by surveys from 746 emergency nurses and 6932 inpatient nurses with linked data on hospital characteristics from American Hospital Association Annual Hospital Survey. The RN4CAST-NY/IL study surveyed all registered nurses in New York and Illinois between April and June 2021 about patient safety, care quality, burnout, intent to leave, and job dissatisfaction and aggregated their responses to specific hospitals where they practiced.
Introduction: Many countries in Europe are facing a shortage of nurses and seek effective recruitment and retention strategies. The nursing workforce is increasingly diverse in its educational background, ranging from 3-year vocational training (diploma) to bachelor and master educated nurses. This study analyses recruitment and retention strategies for academically educated nurses (minimum bachelor), including intention to leave, job satisfaction and work engagement compared with diploma nurses in innovative German hospitals; it explores recruitment and retention challenges and opportunities, and identifies lessons on recruitment and retention taking an international perspective.
View Article and Find Full Text PDFIntroduction: This study aimed to determine the well-being outcomes and quality of work environment among emergency nurses compared with inpatient nurses working in Magnet hospitals and identify recommendations in emergency department work environments that hold promise for enhancing emergency nurses' well-being.
Methods: This is a cross-sectional analysis of multicenter survey data collected in 2021 from 11,743 nurses practicing in 60 United States Magnet hospitals. Nurses report on burnout, job dissatisfaction, intent to leave, work environment, and recommendations to improve well-being.
Importance: Disruptions in the hospital clinical workforce threaten quality and safety of care and retention of health professionals. It is important to understand which interventions would be well received by clinicians to address the factors associated with turnover.
Objectives: To determine well-being and turnover rates of physicians and nurses in hospital practice, and to identify actionable factors associated with adverse clinician outcomes, patient safety, and clinicians' preferences for interventions.
Objectives: Evaluate whether hospital factors, including nurse resources, explain racial differences in Medicare black and white patient surgical outcomes and whether disparities changed over time.
Design: Retrospective tapered-match.
Setting: 571 hospitals at two time points (Early Era 2003-2005; Recent Era 2013-2015).
Background: Clostridioides difficile is the leading cause of hospital-onset diarrhea and is associated with increased lengths of stay and mortality. While some hospitals have successfully reduced the burden of C. difficile infection (CDI), many still struggle to reduce hospital-onset CDI.
View Article and Find Full Text PDFIntroduction: International evidence shows that nurses' work environments affect patient outcomes, including their care experiences. In Chile, several factors negatively affect the work environment, but they have not been addressed in prior research. The aim of this study was to measure the quality of the nurse work environment in Chilean hospitals and its association with patient experience.
View Article and Find Full Text PDFBackground: The shortage of nursing care in US hospitals has become a national concern.
Purpose: The purpose of this manuscript was to determine whether hospital nursing care shortages are primarily due to the pandemic and thus likely to subside or due to hospital nurse understaffing and poor working conditions that predated it.
Methods: This study used a repeated cross-sectional design before and during the pandemic of 151,335 registered nurses in New York and Illinois, and a subset of 40,674 staff nurses employed in 357 hospitals.
Unlabelled: To determine whether better nursing resources (ie, nurse education, staffing, work environment) are each associated with improved postsurgical outcomes for patients with opioid use disorder (OUD).
Background: Hospitalized patients with OUD are at increased risk of adverse outcomes. Evidence suggests that adverse postsurgical outcomes may be mitigated in hospitals with better nursing resources, but this has not been evaluated among surgical patients with OUD.