participate in all levels of hospital policy decisions about professional practice and patient care (Kramer and Schmalenberg, 2002; Scott et al., 1999). Magnet hospitals score higher on greater autonomy for nurses to act and greater nurse control over resources for patient care (Aiken et al., 1997).

A series of studies comparing the hospitals identified as having magnet characteristics in 1983 (the original magnet hospitals) with hospitals that subsequently received that designation from the ANCC found that the latter hospitals had significantly higher levels of nurse autonomy and control over practice. Staff nurses perceived the ANCC magnet hospitals as having greater resources available for patient care; increased time to discuss patient problems with other colleagues; greater involvement in decision making; and strong, visionary CNEs. Stronger magnet characteristics were also evident in the ANCC magnet hospitals when CNEs were interviewed. CNEs in ANCC magnet hospitals (n = 24) viewed autonomy and control over nursing practice as stronger than did CNEs in the original magnet hospitals (n = 24). Three differences among the hospitals were identified as explaining the higher rating of the ANCC hospitals: the latter hospitals had a department of nursing to which nurses were responsible; they were more apt to have a nurse-researcher providing data for decision making; and they regarded nursing as a distinct profession, making a highly valued contribution (Havens, 2001).

Knowledge Management

Professional development, including teaching students, is consistently cited as an important magnet characteristic in terms of continued learning and career development through formal and informal methods. In the original magnet hospital study (McClure et al., 1983), an essential characteristic identified was professional development, including continuing educational opportunities and support for career development through formal education. A high proportion (92.7 percent) of the directors of nursing held masters or doctoral degrees. In Kramer and Schmalenberg’s 1986 study of a subset of the magnet hospitals, a median of 51 percent of the staff nurses had a BSN or had matriculated in BSN study, compared with a national average of 33–34 percent (Kramer and Schmalenberg, 1988a,b).

This magnet characteristic was identified more recently by Kramer and Schmalenberg as one of the most essential features of magnetism cited by staff nurses. Magnet hospitals use a number of strategies to provide support for education and continuing career development for staff nurses, such as tuition for degree programs, in-service programs, short-term courses, externships for student nurses, and internships for new graduates (Kramer and Schmalenberg, 2002).



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