Hospital Magnet® Designation and Missed Nursing Care in Neonatal Intensive Care Units

J Pediatr Nurs. 2017 May-Jun:34:5-9. doi: 10.1016/j.pedn.2016.12.004. Epub 2016 Dec 9.

Abstract

Missed nursing care is an emerging measure of front-line nursing care effectiveness in neonatal intensive care units (NICUs). Given Magnet® hospitals' reputations for nursing care quality, missed care comparisons with non-Magnet® hospitals may yield insights about how Magnet® designation influences patient outcomes. The purpose of this secondary analysis was to evaluate the relationship between hospital Magnet® designation and 1) the occurrence of nurse-reported missed care and 2) reasons for missed nursing care between NICU nurses employed in Magnet® and non-Magnet® hospitals. A random sample of certified neonatal intensive care unit nurses was invited to participate in a cross-sectional survey in 2012; data were analyzed from nurses who provided direct patient care (n=230). Logistic regression was used to model relationships between Magnet® designation and reports of the occurrence of and reasons for missed care while controlling for nurse and shift characteristics. There was no relationship between Magnet® designation and missed care occurrence for 34 of 35 types of care. Nurses in Magnet® hospitals were significantly less likely to report tensions and communication breakdowns with other staff, lack of familiarity with policies/procedures, and lack of back-up support from team members as reasons for missed care. Missed nursing care in NICUs occurs regardless of hospital Magnet® recognition. However, nurses' reasons for missed care systematically differ in Magnet® and non-Magnet® hospitals and these differences merit further exploration.

Keywords: Magnet® hospital; Missed care; NICU; Nursing; Quality.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Female
  • Hospitals, Pediatric / standards
  • Hospitals, Pediatric / trends
  • Hospitals, Special*
  • Humans
  • Intensive Care Units, Neonatal / standards*
  • Intensive Care Units, Neonatal / trends
  • Intensive Care, Neonatal / standards
  • Intensive Care, Neonatal / trends
  • Logistic Models
  • Male
  • Medical Errors / statistics & numerical data*
  • Middle Aged
  • Neonatal Nursing / standards*
  • Neonatal Nursing / trends
  • Patient Safety / statistics & numerical data
  • Quality of Health Care*
  • Risk Assessment
  • United States