New Manual for Magnet Application Process Centers on 14 Forces of Magnetism

from Caring For Our Future, Fall 2004

By Ann Froese-Fretz, MS, RN, CPNP, Magnet Program Coordinator

Right in the middle of the documentation collection process for Magnet Status, the American Nurses Credentialing Center has changed the manual.

This new manual will be implemented Jan. 1, 2005. Since we will not be submitting our documentation until March 2005, we must use the new manual for collecting and organizing our documentation. I received the new manual only two days ago, so as I write this column I am thinking about the reading I should be doing right now to determine what we need to do next. We should be able to use most, if not all, of the documentation many of you have written or collected for this process.

The new manual is organized around the Fourteen Forces of Magnetism. I hope by now all of you have heard these words and have some understanding about what I am writing! The “Forces” are really characteristics that can be found in a Magnet institution.

1. “Quality of nursing leadership” examines whether an organization has knowledgeable, strong nurse leaders who are willing to take risks and advocate for staff. Nurse leaders at every level follow an articulated philosophy in the day-to-day operations of nursing services. The results of quality leadership should be evident in bedside nursing care.
2. “Organizational structure” is about decentralized nursing departments with unit-based decision-making. The organizational structure is flat rather than tall. Nurses are well represented in committees throughout the organization. The Chief Nursing Officer (CNO) is an influential member of the Board of Directors. The organizational structure can respond to changes in the health-care environment.
3. “Management style” describes administrators (both organizational and nursing) as using participative management and incorporating feedback from staff at all levels of the organization. Feedback is encouraged and valued. Nursing leaders are visible, accessible and committed to communicating effectively with staff.
4. “Personnel policies and programs” include competitive salaries and benefits. Rotating shifts are minimized; creative and flexible staffing models that support a safe and healthy work environment are used. The performance appraisal process is goal-oriented and is linked to professional standards of practice and career development. Strategic nursing recruitment and retention programs involve direct-care nurses.
5. “Professional models of care” give nurses the responsibility and authority for the provision of direct patient care. Nurses are accountable for their own practice and are the coordinators of care. The models of care used by the organization provide for continuity of care and take into consideration the unique needs of the patient and family.
6. “Quality of care” is an organizational priority, and nurses in the organization feel they are providing high-quality care to their patients. Nursing leaders are responsible for providing an environment that positively influences patient outcomes. This force includes issues around patient safety, ethical practice and research and evidence-based practice.
7. “Quality improvement” states that the organization has structures and processes for the measurement of quality and programs for improving the quality of care and services within the organization. Nurses are involved at all levels in quality improvement planning and improvement processes.
8. “Consultation and resources” refers to the idea of having knowledgeable experts, particularly advanced practice nurses, available for consultation. In addition, the organization promotes involvement of nurses in professional organizations and among peers in the community.
9. “Autonomy” describes an organization in which nurses are permitted and expected to practice autonomously, consistent with professional standards. Nurses have the ability to assess and provide nursing actions as appropriate for patient care based on competence, professional expertise and knowledge. Independent judgment is exercised within the context of interdisciplinary and multidisciplinary approaches to patient care.
10. “Community and the health-care organization” looks at the presence of the organization in the community. The organization has ongoing, long-term outreach programs that result in the perception of it as a strong, positive and productive corporate citizen. There are strong partnerships between the health-care organization and the community that result in improved patient outcomes and improved health of the community.
11. “Nurses as teachers” states that nurses are permitted and expected to incorporate teaching in all aspects of their practice. Professional nurses are involved in educational activities within the organization and community. Staff in all positions serve as faculty and preceptors for a variety of students, and patient education programs meet the diverse needs of all patients.
12. “Image of nursing” is viewed as integral to the organization’s ability to provide patient care services. Other members of the health-care team characterize nursing services as essential. Nurses effectively influence system-wide processes.
13. “Interdisciplinary relationships” are characterized as positive, and there is a sense of mutual respect among all disciplines. Collaborative working relationships within and among the disciplines are valued.
14. “Professional development” looks at the emphasis placed on orientation, in-service education, continuing education, formal education and career development. Personal and professional growth and development are valued, and opportunities for competency-based clinical advancement exist along with the resources to maintain competency.

If you have had a chance to look at any of the posters the Magnet Steering Committee has produced about these forces, you will know that we have many examples to provide for each force. The hard part of the documentation collection process will be deciding what NOT to include. Children’s already has all the Magnet “characteristics;” now we just have to show the world!

Reference

Magnet Recognition Program Application Manual (2004). American Nurses Credentialing Center: Silver Spring, Md.