title: Hospital Magnet® Designation and Missed Nursing Care in Neonatal Intensive Care Units.
abstract: 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.
authors.affiliation: Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave. MLC 11016, Cincinnati, OH 45229, USA. Electronic address: Heather.tubbs_cooley@cchmc.org.
authors.forename: Heather L
authors.initials: HL
authors.lastname: Tubbs-Cooley
authors.affiliation: The Ohio State University College of Nursing, Cincinnati Children's Hospital Medical Center, 324 Newton Hall, 1585 Neil Ave, Columbus, OH 43210, USA. Electronic address: Pickler.1@osu.edu.
authors.forename: Rita H
authors.initials: RH
authors.lastname: Pickler
authors.affiliation: Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave. MLC 7014, Cincinnati, OH 45229, USA. Electronic address: Constance.mara@cchmc.org.
authors.forename: Constance A
authors.initials: CA
authors.lastname: Mara
authors.affiliation: University of Cincinnati College of Nursing, 3110 Vine St., 310 A, Cincinnati, OH 45221, USA. Electronic address: othmanms@mail.uc.edu.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Othman
authors.affiliation: Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave. MLC 11016, Cincinnati, OH 45229, USA. Electronic address: kovacsa@purdue.edu.
authors.forename: Allison
authors.initials: A
authors.lastname: Kovacs
authors.affiliation: The University of North Carolina at Chapel Hill School of Nursing, 1301 Carrington Hall, CB# 7460, Chapel Hill, NC 27599, USA. Electronic address: bmark@email.unc.edu.
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Mark
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006776:Hospitals, Pediatric / Q000592:standards / Q000639:trends; D006782:Hospitals, Special; D006801:Humans; D007363:Intensive Care Units, Neonatal / Q000592:standards* / Q000639:trends; D015931:Intensive Care, Neonatal / Q000592:standards / Q000639:trends; D016015:Logistic Models; D008297:Male; D019300:Medical Errors / Q000706:statistics & numerical data*; D008875:Middle Aged; D017283:Neonatal Nursing / Q000592:standards* / Q000639:trends; D061214:Patient Safety / Q000706:statistics & numerical data; D011787:Quality of Health Care; D018570:Risk Assessment; D014481:United States
keywords: Magnet® hospital; Missed care; NICU; Nursing; Quality