Paper: Does the Magnet Hospital Concept Transfer to European Hospitals: A Multi-Level Approach (20th International Nursing Research Congress Focusing on Evidence-Based Practice)

Friday, 17 July 2009: 8:50 AM

Yao-Mei Chen, PhD, RN
Department of Nursing/ College of Nursing, Kaohsiung Medical University Hospital/ Kaohsiung Medical University, Kaohsiung, Taiwan
Meg Johantgen, PhD, RN
School of Nursing, University of Maryland Baltimore, Baltimore, MD

Learning Objective 1: understand the intercultural applicability of Magnet-Hospital attributes.

Learning Objective 2: describe the relevance of multi-level modeling to both quantify and account for the nested nature of nursing practice within organizations.

Purpose: The purpose of this study was to explore the applicability of Magnet Hospital concepts to nurses working in hospitals in 2 Eurpoean countries. The relationship between organizational attributes and job satisfaction was examined at both the individual level and the organizational level.

Methods: A secondary data analysis was conducted using the baseline data of the European Nurses′ Early Exit (NEXT) Study. This cross-sectional study was designed and analyzed using a multilevel approach with latent constructs. The sample population included 3182 registered nurses who had worked in the ICUs, hospital wards and psychiatric units of 31 hospitals in Belgium and Germany. Mplus 4.21 and SPSS 12.0 were used for analysis. Two-level confirmative factor analyses and structural regression models were used to estimate parameters.

Results: The measurement models fitted well to the data (CFI>0.90, RMSEA<0.08, SRMR<0.10). All six Magnet Hospital attributes (autonomy, interdiscipinary relations, professional development, personnel policies, management style, and quality of leadership) were significant predictors of job satisfaction (Beta= 0.35-0.96, R²=12.5%-92.6%) at the individual level. At the organizational level, only four attributes were significant predictors (Beta=0.26-0.68, R²=7.2%-71.2%). The variance of job satisfaction at the individual level was explained mostly by personnel policies (as represented by salary and organizational support); the variance of job satisfaction at the organizational level was explained mostly by management style (as represented by supervisor support and communication).

Conclusion: The latent Magnet Hospital factors indeed predicted job satisfaction in the two-level modeling approach. Though most Magnet Hospital attributes were applicable to the two European countries, further research is imperative to explore the universality of the concepts at the organizational level and at the unit level. While the nursing work environment has received increasing emphasis in nursing research, a more complete conceptulization is needed.

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