Engaged nurses who feel like they work in an organization that values their efforts and opinions have an incredibly positive effect on the quality of care patients receive. Studies have shown that organizational support for nursing leads to better quality of care, which can reduce mortality rates and improve rates for nursing-sensitive indicators, such as patient falls, pressure ulcers, and central line infections.
For the past 17 years, the American Nurses Credentialing Center's (ANCC) Magnet Recognition Program® (MRP) has given healthcare facilities a framework around which to structure their nursing programs to achieve quality patient outcomes. Those facilities that have been designated as MRP organizations say that their hospitals have been able to take improvement in quality and patient safety to new levels. Even those facilities that have not yet been recognized but are in the application process for becoming an MRP hospital say the exercise has been a positive one.
How can one program help elevate the standard of nursing care and, thereby, patient safety nationwide?
"[The MRP program] encourages us by way of their standards—they almost mandate it—to make sure we are on our journey towards quality and that we do embark on safety, and that we not just meet the standard, that we take it to higher levels," says Denise Occhiuzzo, MS, RNC, BC, administrative director of clinical education and nursing practice, and MRP program director in the Department of Patient Care at Hackensack (NJ) University Medical Center (HUMC). HUMC was the second facility to ever be MRP-designated and has been redesignated four times since 1995, most recently in 2008.
At its core, the MRP program requires hospitals to consider five model components: structural empowerment; exemplary professional practice; new knowledge, innovation, and improvements; transformational leadership; and empirical outcomes, the last of which really overlaps all of the other domains. These areas guide the development of many initiatives at MRP facilities. There are currently 371 MRP-designated facilities, and many more are in the process of becoming one.
No small undertaking
Becoming an MRP hospital requires years of preparation and data collection, as well as a binder of materials that can be hundreds to thousands of pages long. Additionally, the cost of being designated can be substantial, depending on the size of the organization. The cost of an appraisal by the ANCC ranges from around $14,000 for hospitals with fewer than 100 beds to nearly $58,000 for hospitals with 950 beds.
However, the investment, time, and resources required are generally found to be worthwhile by organizations that go through the process.
The road to empowerment
Because shared governance is one of the major components of designated organizations, nurses are more than simply encouraged to take part in hospital initiatives. MRP facilities give their nurses the tools and resources they need to create and lead new programs. That empowerment leads to better outcomes for patients and more satisfied staff members.
"[MRP] requires that we have a quality council and that it is staff led," says Theresa Colarusso, RN, BSN, MPA, administrative director for performance improvement and regulatory compliance in the Department of Patient Care at HUMC. "It's wonderful to see how bright, educated, and engaged they are. They really take this to heart, and it's good discussion at the table."
HUMC had success with a patient falls prevention initiative, which is led by a staff nurse. The nurse was part of a larger "champion" group, and through it found her passion for reducing falls, says Claudia Douglas, RN, MA, CNN, APN.C, supervisor of clinical practice affairs and MRP coordinator in the Department of Patient Care at HUMC. The nurse's program has been in place for the past four years, and many efforts around the organization can be attributed to her ability to identify a need and take hold of the resources available.
"Our organization's philosophy from the nursing department of patient care services is to encourage nurses to be leaders, because we're all leaders at the bedside," says Douglas. "Staff nurses in particular are encouraged to be leaders, and the support, resources, education, and time are provided, and the nurse was able to take this to a great level."
Heather Comak is a Managing Editor at HCPro, Inc., where she is the editor of the monthly publication Briefings on Patient Safety, as well as patient safety-related books and audio conferences. She is also is the Assistant Director of the Association for Healthcare Accreditation Professionals. Contact Heather by e-mailing hcomak@hcpro.com.