LIFTING OFF WITH MAGNETISM: TRANSFORMING AIR FORCE NURSING PRACTICE
The aims of this evidence based project were to transform a global organization’s practice culture and advance nursing excellence by infusing Magnet® characteristics into healthcare settings. The project satisfied academic requirements for an accredited Doctor of Nursing Practice program.
Rationale/Background
A call to action by the organization’s senior nursing officer signaled a new strategic focus and triggered a review of evidence specific to magnet culture, nursing excellence, and patient outcomes. A gap analysis revealed three transformational opportunities: 1) lack of a defined model for professional practice; 2) a compliance-based organizational culture; and 3) limited understanding of performance-based outcome measures. The American Nurses Credentialing Center (ANCC) Magnet credential is synonymous with nursing excellence and quality patient care. Magnet®-designated facilities embody a culture that supports nurses. A robust body of literature links magnet hospitals to increased patient and staff satisfaction, positive clinical outcomes for patients, and higher ratings on nurse-sensitive indicators than non-magnet hospitals. A well-constructed practice model is a crucial structural element of magnet culture.
Overview of approach, methods, or process
Change fusion fueled the appreciative inquiry (AI)-infused contemporary change theory developed for this project. At the heart of transformational change is an individual’s reaction to change; thus, stakeholder engagement and consensus building factored into the selection of interventions. The merits of magnetism and a practice model prototype were presented to stakeholder focus groups during hour-long sessions. Targeted stakeholder groups were defined as direct care nurses (n=11), service line consultants (n=5), and senior nurse executives (n=21). Data were collected using a scholar-developed questionnaire that included scaled response and free-text fields. Plan-do-study-act cycles clarified project aims and signaled additional opportunities for advancing nursing excellence. This project was deemed research-exempt by an academic IRB.
Outcomes achieved/documented
The intervention strategy was designed to elicit consensus for change rather than to perform statistical analysis. Direct care and service line consultant stakeholders were united in their approval to use magnetism as the desired paradigm for nursing excellence. However, the practice model prototype did not garner united support. The consultant group rejected the model prototype, but endorsed the project for executive level consideration and continued study.
Conclusions
Consistent with elements of magnetism, a collaborative effort involving nurses at all levels of the organization produced benchmarks for transformation. Most significant was the insertion of this project’s aims into the organizational strategic plan. Curriculum revisions are also underway to integrate the magnet model and measures of nursing excellence into more than ten formal nursing courses. Early feedback from revised course evaluations indicate nurse participants support renewed focus on nursing practice and want to see leading practices incorporated into organizational policies. Finally, a research proposal is being prepared for IRB consideration to leverage momentum in cultural transformation generated by this EBP project.