by Lindy Keane Carter
The MUSC Medical Center has achieved the ultimate credential for high-quality nursing care. In September, the hospital received Magnet Recognition® from the American Nurses Credentialing Center (ANCC), a status held by only 7% of all U.S. hospitals.
“From the very beginning of our Magnet journey, there has been full support from the Board of Trustees, administration, and the entire medical team,” states Patrick J. Cawley, M.D., MHM, FACHE, Chief Executive Officer, MUSC Health and Vice President for Health Affairs, MUSC. “What this designation means for our patients is that they will be cared for in an environment that attracts top-rate providers and promotes the most advanced nursing standards.”
Schaffner got the ANCC’s phone call on September 14. She was surrounded by almost 100 people, many of whom were the nurses who had been preparing for the Magnet® review for more than ten years. Within seconds, the room erupted in celebration. Eventually, Schaffner was able to hear the highlights being shared by the Chair of ANCC’s commission on Magnet® recognition. “She said the reviewers were most impressed by our professional practice model—that is, the core values defined within it—the autonomy of our nurses to participate in decisions about care, and our interprofessional collaboration, among other things,” says Schaffner.
While Schaffner and Coyle mapped out their plan for this complicated journey, they knew one thing had to be heard loud and clear every step of the way: the voice of the bedside nurse. Thus, in 2014 when the committee to redesign nursing’s governance structure was being formed, 21 nurses from all levels (direct care and administration) were invited to contribute; 60% of them were bedside nurses. Their committee created a new structure that as of January 2016 gives every one of MUSC Health’s 2,700 nurses a voice in how they deliver care to their patients in their units. The new MUSC Health Nursing Shared Governance promotes a culture that supports evidence-based systems and empowers all registered nurses to take ownership of nursing practice, processes, and outcomes.
Christopher Hairfield, BSN, RN, CMSRN, a nurse in the Medical/Surgical ICU who chaired the Nurse Alliance (the previous governance council) and co-chaired the Shared Governance Design Committee, says this push to review what has been published and then apply it has changed his practice. “Talk about culture change,” he says. “Once, I heard two providers disagree on the best approach for a patient and then heard the nurse say ‘What does the literature say?’ That’s a powerful phrase to hear from nurses.” Nurse-led research is supported by the medical center’s Center for Evidence-Based Practice and Values Institute, which helps clinicians develop evidence-based guidelines and order sets and analyze best practice evidence for use in decision-making processes, such as time restriction of laboratory orders and integration of IV infusion pumps.
Nursing leadership is now working toward the next Magnet® milestone: redesignation in four years. The ANCC’s standards won’t change dramatically, explains Coyle. “But what they expect to see when you go for redesignation is more robust outcomes.” Magnet® hospitals must outperform national benchmarks on nurse-sensitive indicators, such as patient falls, incorrect use of restraints, health care–acquired pressure ulcers, central line–associated blood stream infections, and ventilator-acquired pneumonia.