Evaluation of "Magnet Journey to Nursing Excellence Program" in Russia and Armenia

Objective: To provide an outcomes-evaluation of an intervention to strengthen professional nursing practice in Russian and Armenian hospitals. Design: The Nursing Quality Improvement Initiative using the ANCC Forces of Magnetism to develop professional nurse practice was implemented in four hospitals in Russia and Armenia. Cross-sectional survey data were collected at two time points from 840 nurses in Wave 1 and 859 nurses in Wave 2. Comparisons were undertaken between targeted units in each hospital compared to nontargeted units, and each hospital served as its own control in surveys that took place in years 1 and 3 of the demonstration. Methods: Descriptive information on nurse samples was derived from survey items. Changes in characteristics of nurse practice environments, nurse-reported patient care quality, and nurse burnout in Russia and Armenia, overall and separately for targeted and nontargeted units, were tested using chi-square statistics and difference of means tests. Findings: Practice environment features such as nurses' involvement in hospital affairs, better collegial relationships with physicians, more support for nursing care from administrators, and continuity of nursing care improved after the intervention. Resource adequacy indicators did not change over the demonstration period. Changes in indicators of patient care quality were favorable, though differences in changes in targeted and nontargeted units were equivocal. Conclusions: Changes consistent with evolving professional nursing practice were associated with program implementation. Forces of magnetism appear to have the same potential for transforming nursing practice in countries with fewer resources as in wealthier Western countries. Clinical Relevance: Magnet Recognition, an evidence-based best practice for improving the nursing-care environment developed in Western countries, was feasible to implement in countries with transitioning economies, limited resources, and truncated professional nursing education.