title: Transformative impact of Magnet designation: England case study.
abstract: OBJECTIVE
  To test the impact of the implementation of Magnet principles of improving nurses' work environments.
  
  
  BACKGROUND
  Magnet hospital designation developed in the USA in the 1980s to recognise hospitals that had created excellent patient care environments and supported the professional practice of nursing. A pilot initiative in England was the first test of the applicability of Magnet standards outside the USA.
  
  
  METHODS
  Research methods included surveys of nurses in the demonstration hospital in a predesign and postdesign and comparisons to survey results of nurses practicing in a national sample of 30 National Health Service Trusts.
  
  
  RESULTS
  Prior to beginning the Magnet journey, the demonstration hospital had a nurse work environment that was somewhat less positive than the national sample NHS hospitals. Nurses practicing in the demonstration hospital were somewhat less satisfied with their jobs than nurses in other NHS hospitals. Following a two-year period during which the evidence-based Magnet standards were implemented and Magnet Designation was awarded, the quality of the nurse practice environment had improved significantly, as had job satisfaction of nurses and their appraisals of the quality of patient care. The quality of the nurse practice environment after Magnet designation was better than that of a national sample of NHS trusts. Improved nurse outcomes were because of the improved practice environment rather than staffing enhancements.
  
  
  CONCLUSIONS
  Implementation of the Magnet hospital intervention was associated with a significantly improved nursing work environment as well as improved job-related outcomes for nurses and markers for quality of patient care.
  
  
  CONCLUSIONS
  Nurses can use Magnet principles to improve the quality of their work environments.
authors.affiliation: Center for Health Outcomes and Policy Research, University of Pennsylvania, Philadelphia, PA 19104-6096, USA. laiken@nursing.upenn.edu
authors.forename: Linda H
authors.initials: LH
authors.lastname: Aiken
authors.forename: James
authors.initials: J
authors.lastname: Buchan
authors.forename: Jane
authors.initials: J
authors.lastname: Ball
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Rafferty
mesh_terms: D000328:Adult; D004739:England; D005260:Female; D006782:Hospitals, Special; D006801:Humans; D008297:Male; D009741:Nursing Staff, Hospital; D013222:State Medicine; D016526:Workload