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J Nurs Manag. 2011 Mar;19(2):277-86. doi: 10.1111/j.1365-2834.2011.01224.x. Epub 2011 Feb 14.

Sustaining the pivotal organizational outcome: magnet recognition.

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  • 1Graduate Administration Program, University of Texas Health Science Center, School of Nursing, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900,USA.



To identify the facilitators and barriers for health-care organizations to sustain Magnet Recognition, the exemplar of a professional practice environment and quality care.


Recognition as a Magnet Hospital is the gold standard for acknowledging excellence in nursing. However, limited evidence exists to inform nursing management practices for sustainability.


This qualitative study was conducted using a national convenience sample of 15 Chief Nursing Officers of Magnet Recognized hospitals in the USA.


Key macrosystem facilitators included executive management and leadership themes about quality, people, education, and the nurse executive's commitment and intent. Barriers were executive management turnover and financial challenges. Infrastructure supports and resources for empowerment and quality and unit leadership practices were found to be essential for quality outcomes. The key theme at the microsystem level was moving nursing practice to managing outcomes from tasks; barriers were challenges with unit management turnover and development.


Multiple factors at system levels were found to contribute to sustainability. Further research is needed on the concept of sustainability.


The findings contribute to executives' armamentarium to inform management practice for the design of evidenced based organizational systems and programs for nursing excellence.

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