Magnet-recognized hospitals may have better outcomes for low birth rate babies
A recently released interdisciplinary study revealed that very low birth weight infants fare better in hospitals that have earned Recognition for Nursing Excellence (RNE) and are designated Magnet Hospitals by the American Nurses Credentialing Center (ANCC).
The study, published in the current issue of the Journal of the American Medical Association and funded by the Robert Wood Johnson Foundation Interdisciplinary Nursing Quality Research Initiative and the National Institute of Nursing Research, suggests that the focus on nursing excellence in Magnet Hospitals improves the care very low birth weight infants receive and their outcomes.
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Babies born weighing less than 1,500 grams (just under three pounds, five ounces) are among the highest risk pediatric patients in hospitals. They account for only 1.5 percent of births but over half of infant deaths. One in four dies in the first year of life and 87 percent of those deaths occur within the first month. While they are in the hospital, very low birth weight infants require an intense level of nursing care and nurses caring for these babies must make complex assessments, implement highly intensive therapies and make adjustments in care based on the patient’s response.
According to Eileen Lake, associate director of the Center for Health Outcomes and Policy Research at the School of Nursing at the University of Pennsylvania, ANCC’s Magnet Recognition Program, which has been in existence for around 20 years, recognizes healthcare organizations for quality patient care, nursing excellence and innovations in professional nursing practice. Lake and Jeannette Rogowski, university professor in health economics in the School of Public Health at the University of Medicine and Dentistry of New Jersey, led the research team that conducted the recent study.
For Magnet recognition, organizations are evaluated for evidence that they have achieved five key elements: transformational leadership; structural empowerment; exemplary professional practice; new knowledge, innovations and improvements; and empirical outcomes. It generally takes two years for a healthcare organization to achieve Magnet status and hospitals must undergo a redesignation process every four years and provide interim reports. Only 7 percent of U.S. hospitals are Magnet hospitals, Lake said.
The team studied the outcomes of 72,235 very low birth weight infants born in hospitals and placed in neonatal intensive care units (NICUs) between Jan. 1, 2007 and Dec. 31, 2008. They measured the infants’ rates for seven-day, 28-day and hospital-stay mortality; severe intraventricular hemorrhage; and nonsocomial (blood or cerebrospinal fluid) infection.
Nurses working with these high-risk babies, usually in the NICU, must constantly be on their toes to monitor their patients for subtle changes or signs of distress that could signal cardiac, respiratory or neurologic problems, said Lake. They also have to maintain a scrupulously hygienic environment, especially where catheters are concerned. Hospitals that receive RNE designation are evaluated for many of the attributes associated with nursing excellence, including exemplary professional practice, and implementing new knowledge, innovations and improvements.
Despite having more risk factors than very low birth rate infants in the non-RNE hospitals, babies in the RNE hospitals had lower rates of death, hemorrhage and infection.
