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

• Published in: Journal of pediatric nursing 2017-05, Vol.34, p.5-9
• Main Authors: Tubbs-Cooley, Heather L., Pickler, Rita H., Mara, Constance A., Othman, Mohammad, Kovacs, Allison, Mark, Barbara A.
• Format: Article
• Language: English
• Subjects: 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; Magnet® hospital; Male; Medical Errors - statistics & numerical data; Middle Aged; Missed care; Neonatal Nursing - standards; Neonatal Nursing - trends; NICU; Nursing; Patient Safety - statistics & numerical data; Quality; Quality of Health Care; Risk Assessment; United States
• ISSN: 0882-5963; 1532-8449
• DOI: 10.1016/j.pedn.2016.12.004

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. •Magnet® designation reflects a hospital’s investment in high nursing care quality.•Missed nursing care is an emerging measure of nursing quality. We expected that NICU nurses in Magnet® hospitals would report less missed care.•Missed nursing care in NICUs occurs regardless of hospital Magnet® designation.•Nurses’ reasons for missed care differ in Magnet® and non-Magnet® NICUs possibly due to practice environment differences.