A National Comparison of Nursing-Sensitive Patient Safety Indicators in Magnet and Non-Magnet Hospitals

Tuesday, 13 July 2010

Joy B. Solomita, PhD, RN, MSN, MPH, NEA-BC
Administration, Dr. P. Phillips Hospital, Orland, FL

Learning Objective 1: The learner will see what effect Magnet designation had on five combined Patient Safety Indicators from the Agency for Healthcare Research and Quality.

Learning Objective 2: The learner will see what effect Magnet designation had on five individual Patient Safety Indicators.

The purpose of this study was to determine if there was a difference in risk-adjusted rates for five of AHRQ’s Patient Safety Indicators (PSIs) in relation to ANCC’s Magnet® designation, including decubitus ulcer, death among surgical inpatients, postoperative respiratory failure, postoperative deep vein thrombosis (DVT)/pulmonary embolus (PE), and postoperative sepsis.
This exploratory, cross-sectional study used data from AHRQ’s Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS, 2006), American Hospital Association data (AHA, 2006), and ANCC Magnet® designation (2006). MANCOVA was used to determine if there was a relationship between the combined PSIs and magnet status, while controlling for RN staffing and operated beds.
MANCOVA analysis indicated that hospital groups did not differ on the combined variable created from the five PSIs (p = .383), while controlling for RN staffing and number of operated beds. In further analyses, RN hours per adjusted patient day were significantly higher in magnet hospitals (t = 4.132, df  = 1001, p < .000). Magnet hospitals had a significantly higher rate of postoperative DVT/PE, (t = 2.44, df = 914, p = .015) and a significantly lower rate of death among surgical inpatients (t = -2.05, df = 64.15, p = .044).
Multivariate analysis results did not support that Magnet hospitals differed from non-Magnet hospitals on the combined PSIs, while controlling for nurse staffing and number of beds. Magnet hospitals had higher postoperative DVT/PEs and lower surgical mortality rates. Findings showed that Magnet hospitals provided higher RN staffing.
This study adds further information on nurse-sensitive outcomes in Magnet designated hospitals and is aligned with ANCC’s new five step model focusing on empirical evidence (ANCC, 2008) and quality outcomes.
American Nurses Credentialing Center. (2008). Application manual. Magnet recognition program (2008 ed.). Silver Spring, MD: American Nurses Credentialing Center.