A road map for creating a Magnet work environment.

OBJECTIVE: The authors examine the relationship between working environment and the developmental level of the workforce, against the backdrop of the American Nurses Credentialing Center Magnet Recognition Program, to provide a road map for creating a positive work environment. BACKGROUND: With the daily demands on nurse managers, there is a need to identify focused strategies to achieve a Magnetized, high-performing work environment. METHODS: The American Nursing Association Magnet survey was administered to nurses at a large healthcare system. Patient units at each hospital were categorized as reactive, responsive, proactive, or high performing. Similar categories of units across all 6 hospitals were analyzed. Analysis of variance was performed on each Force of Magnetism by developmental level. RESULTS: Mean scores measuring the Forces of Magnetism were statistically significant between reactive and responsive units. Likewise, mean scores between responsive and proactive units were also statistically significant. Between reactive and responsive units, there were 3 statistically significant forces of Magnetism: organizational structure, management style, and interdisciplinary relations. These are labeled primary priority forces. Between responsive and proactive units, there were 6 statistically significant forces of Magnetism labeled secondary priority forces: policies and programs; professional models of care; quality of care; consultation and resources; autonomy; and interdisciplinary relations. CONCLUSIONS: Nursing staff perceive the "Magnetism" of the work environment differently, depending on the developmental level of the unit. Nurse managers with reactive units should focus on the 3 Forces of Magnetism identified as the primary priority forces, in order to help develop their unit to the next level of responsive. Once a responsive level has been achieved, the next 6 forces should be addressed.

Nursing work environment and quality of care: differences between units at the same hospital.

The literature suggests that improvements in nurses' work environments may improve the quality of patient care. Furthermore, monitoring the work environment through staff surveys may be a feasible method of identifying opportunities for quality improvement. This study aimed to confirm five proposed sub-scales from the Nursing Work Index - Revised (NWI-R) to assess the nursing work environment and the performance of these sub-scales across different units in a hospital. Data were derived from a cross-sectional survey of 243 nurses from 13 units of a 300-bed university-affiliated hospital in Quebec, Canada, during 2001. Using confirmatory factor analysis, the five subscales were confirmed; three of the sub-scales had greater ability to discriminate between units. Using hierarchical regression models, "resource adequacy" was the sub-scale most strongly associated with the perceived quality of care at the last shift. The NWI-R sub-scales are potentially useful for comparison of work environments of different nursing units at the same hospital.

Noise level measurements in four Phoenix emergency departments.

OBJECTIVE: Our objective was to compare the noise levels in 4 Phoenix-area emergency departments with published safety and comfort standards for noise levels. METHODS: A device used to record sound levels was placed in the nurses' station of 4 Phoenix-area emergency departments for brief periods. Readings were compared with published safety and comfort standards. RESULTS: Noise levels measured in the 4 emergency departments were higher than levels at which one can work comfortably. All the noise levels measured approached or exceeded levels that can cause feelings of annoyance ad other negative effects in individuals. DISCUSSION: A comparison of actual noise levels in 4 local emergency departments with published safety and comfort standards found that 100% of the tested departments were too noisy. Anyone who spends any time exposed to this level of noise is subject to deleterious physical and psychological effects.