Influences of context, process and individual differences on nurses' readiness for change to Magnet status

J Adv Nurs. 2009 Jul;65(7):1412-22. doi: 10.1111/j.1365-2648.2009.05012.x. Epub 2009 Apr 30.


Aim: The aim of this study was to test hypotheses associated with a model which explains individuals' readiness in early stages of a change.

Background: In an effort to improve the quality of nursing care, hospitals in the United States of America seek to obtain Magnet recognition. While it is commonly known that Magnet hospitals provide higher quality patient care, little is known about the variability in nurses' attitudes and behaviour within Magnet hospitals.

Method: We collected data in 2006 from 310 Registered Nurses to investigate the factors that influence their willingness to embrace the changes necessary for the high levels of excellence accompanying Magnet status. Hierarchical linear modelling was used because the data were multi-level.

Results: Both change-specific context, such as a culture of research exhibited by the manager, and formal education of the nurse moderated the positive influences of the organization's procedural justice actions. Specifically, procedural justice was stronger when the nurse manager demonstrated a culture of research, and negative effects of low justice were mitigated when nurses had a higher level of formal education.

Conclusion: Preparing managers beforehand to appreciate and adopt new behaviours associated with a forthcoming organizational change should enhance the success of change practices as new changes are initiated. Moreover, education that exposes employees to the pending realities of their industry, such as nursing research, can play an important role in the development of positive beliefs about changes facing their organizations.

MeSH terms

  • Accreditation*
  • Adult
  • Aged
  • Attitude of Health Personnel*
  • Delivery of Health Care / standards*
  • Delivery of Health Care / statistics & numerical data
  • Female
  • Humans
  • Linear Models
  • Male
  • Middle Aged
  • Nursing Staff, Hospital / organization & administration
  • Nursing Staff, Hospital / psychology*
  • Organizational Innovation*
  • Quality of Health Care / standards*
  • Quality of Health Care / statistics & numerical data
  • United States
  • Young Adult