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Organization Eligibility Requirements

Entity

The applicant organization must exist within a healthcare organization.

Nursing Leadership

The applicant organization must include one or more nursing settings with a single governing authority and one individual serving as the Chief Nursing Officer (CNO). The CNO is ultimately responsible for sustaining the standards of nursing practice in all areas in which nurses practice.

All entities (hospitals, long term care, rehab center, hospice, surgicenters, ambulatory clinics, etc.) and all settings (MedSurg, OB, NICO, ICU, CCU, Step-Down, Rehab, Pediatrics, Psych, ER, Dialysis, Home Care, Long Term Care, etc.) where the CNO is ultimately responsible for sustaining the standards of nursing practice in the environment in which nurses practice must be included. See the Magnet® Application Manual, Eligibility Criteria, page 8.

The CNO must participate on the applicant organization's highest governing decision-making and strategic planning body.

Educational Eligibility Criteria (at the time of Application

Chief Nursing Officer
Effective 2003, the CNO must hold at a minimum, a master's degree at the time of application. If the master's degree is not in nursing then either a baccalaureate degree or doctoral degree must be in nursing. The requirement must be maintained throughout the application phase, review phase, and designation as a Magnet organization. Appointees as interim CNOs must also comply with this requirement.

Nurse Managers
A Registered Nurse with 24/7 accountability for the overall supervision of all Registered Nurses and other healthcare providers in an inpatient or outpatient area. The Nurse Manager is typically responsible for recruitment and retention, performance review, and professional development; involved in the budget formulation and quality outcomes; and helps to plan for, organize and lead the delivery of nursing care for a designated patient care area.

  • Effective 1/1/2013 (at time of application) – 100% Nurse Managers must have a degree in nursing (baccalaureate or graduate degree)

Nurse Leaders (06/2015)

  • Effective 1/1/2013 (at time of application) – 100% of nurse leaders must have a degree in nursing (baccalaureate or graduate degree)
  • Nurse leaders must have a degree in nursing (bachelor's or higher).
  • Nurse leader is not a title and should not be interpreted as such for the purpose of the written documentation.
  • The definition of nurse leader is exclusive of the chief nursing officer (CNO).
  • Nurse educators who serve in the top educator role and are responsible for other nurse educators are considered nurse leaders.
  • Nurse leaders may have clinical oversight and responsibility for nurse managers or for other nurses who influence clinical care.
  • Nurses may be represented on only one eligibility table—either the Nurse Manager or Nurse Leader Eligibility Table.
    • Only nurse leaders annotated on the Nurse Leader Eligibility Table may be selected when a nurse leader example is required by the SOE.
    • Note: For applicants with flat organizational structures without nurse managers, the nurse leader may be substituted for nurse manager SOE examples.
  • Nurse leaders may report directly or indirectly to the CNO.
  • Nurse leaders practice (clinical and nonclinical) in a variety of settings (inpatient, ambulatory, or other environments) throughout the organization.
  • Other registered nurses who may broadly influence or impact the clinical practice of nurses in the organization may be considered a nurse leader. If these nurses are referenced as nurse leaders in the organization's Magnet® application, they must meet the educational criteria (bachelor's in nursing or higher) and report directly or indirectly to the CNO. Examples may include, but are not limited to, RN director of risk management or quality, RN director of nursing informatics, infection preventionists, and wound ostomy nurses.

Validation

  • CNO will attest to this eligibility requirement on application.
  • When written documentation is submitted the organization will include a table that identifies each nurse manager and nurse leader and their highest nursing degree. Download the template titled 2019 Nurse Leader AVP Education Table. Use this tool to document the highest nursing education, baccalaureate or graduate degree, of nurse managers and leaders, to demonstrate compliance with eligibility criteria. Provided at time of written documentation submission.

Standards for Nurse Administrators

Applicant organizations must have the Nursing Administration: Scope and Standards of Practice (2010) currently implemented throughout nursing.

Protected Feedback Procedures

Applicant organizations must have policies and procedures that permit and encourage nurses to confidentially express their concerns about their professional practice environment without retribution. Policies and procedures that discourage nurses to express their concerns about their professional practice environment are prohibited.

Regulatory Compliance

Organizations must comply with all federal laws and regulations administered by the Occupational Safety and Health Review Commission (OSHRC, the Equal Employment Opportunity Commission (EEOC), the U.S. Department of Health and Human Services (HHS) or other federal agencies that administer healthcare programs, the U.S. Department of Labor (DOL), and the National Labor Relations Board (NLRB) as they relate to registered nurses in the workplace. Institutions that have their Magnet designation revoked, or are prevented from continuing the application process due to an adverse decision, are prohibited from reapplying for Magnet designation for a period of 1 year.

Data Collection

Applicants for Magnet designation must collect nurse-sensitive quality indicators at the unit level and benchmark that data against a database at the highest/broadest level possible (i.e., national, state, specialty organization, regional, or system) to support research and quality improvement initiatives. The intent is to collect data that is applicable and value-added for the particular unit and organization. Organizations must contribute their own data (patient and nurse satisfaction, clinical nurse sensitive indicators) to a national database that compares the organization's data against cohort groups at the national level.

System Eligibility Requirements

Applicants applying as a system must meet each of the following requirements in addition to the requirements for individual organizations.

System Applications: For those organizations submitting as a system a separate demographic report submitted via the Demographic Data Collection Tool, Research Table, and Nurse Manager Education Eligibility Table must be completed for each component organization of the system and submitted electronically via email to the Magnet Program Office at time of documentation submission.

System Written Documentation - In addition to the above-required documents, the data for 0012 and EP3EO (Nurse Satisfaction), 0023 andEP32EO (Nurse Sensitive Clinical Indicators), and 0026 and EP35EO (Patient Satisfaction) must be presented separately for each organization submitted in the system application. Separate tables and graphs must be presented for each organization. For NK4EO one completed research study must be presented for each organization or there must be clear representation by each organization if a combined study is presented. The outcome data must show an impact for each organization.

Transformational Leadership

  • There must be one organizational mission, vision, and set of values for the entire system.
  • There must be one chief executive officer for the entire system.
  • There must be one governing board for the entire system.
  • The same shared leadership/participative decision-making mechanism must be operationalized throughout the entire system.
  • There must be one chief nursing officer (CNO) for the entire system. The CNO must have at a minimum, a master's degree at the time of application. If the master's degree is not in nursing then either the baccalaureate degree or doctoral degree must be in nursing. The requirement must be maintained throughout the application phase, review phase and designation as a Magnet organization. Appointees as interim CNOs must also comply with this requirement.
  • Each component entity shall have a designated RN executive leader who:
    • Is prominently responsible for nursing service at that entity;
    • Has detailed knowledge and control over the day-to-day operations of the clinical practice of nursing within that entity; and
    • Meets the CNO educational requirements.

Organizational Structure

  • There must be an established nursing council/committee in which representatives from all component entities participate in shared decision-making and developing strategy for system-wide nursing initiatives.
  • The component entities must demonstrate how nurses participate in shared decision-making.

Structural Empowerment

  • The same educational opportunities, to include orientation, certification, clinical ladders, and financial support in budget, must exist across the entire system.
  • There must be an integrated nursing education department serving the entire system.
  • There must be an established system-wide patient and family education committee.
  • The same support for nursing research, to include personnel and finance, must exist throughout the entire system.
  • There must be system-wide nursing participation in a community advisory committee.
  • There must be system-wide nursing participation in community-sponsored events.
  • There must be system-wide marketing and integration of publications that are promoted to the community and nursing staff.

Exemplary Professional Practice

  • The same mission, vision, and values must be used throughout the system.
  • The same performance appraisals must be used throughout the system.
  • The same pay practices must be used throughout the system.
  • The same policies and procedures must be used throughout the system.
  • The same policies supporting career development and advancement must be used throughout the system.
  • The same credentialing and privileging process for advanced-practice nurses must exist throughout the entire system.
  • The same clinical documentation system(s) must be used throughout the system to support integration of evidence-based practice into clinical and operational processes.
  • The same policies and procedures governing interdisciplinary relationships must be applied across the entire system.
  • The same performance improvement methodology/structure must exist throughout the entire system.

Knowledge Improvement

The same clinical documentation system(s) must be used throughout the system to support integration of research into clinical and operational processes.

Application

A single application will be submitted for the system.

Written Documentation

Each component entity, a stand-alone group that is part of a multi-hospital or diversified single hospital system, must submit written documentation addressing each required source of evidence with examples occurring within that entity. For the purposes of the Magnet Recognition Program, the number of component entities within a system is equal to the number of designated RN executive leaders who are responsible for separate stand-alone groups within that system.

This evidence must independently demonstrate the full implementation of the Nursing Administration: Scope and Standards of Practice (2009) and the existence of a Magnet environment for nurses in the workplace. The documents and exhibits compiled to demonstrate compliance with the system eligibility requirements must be included in the written documentation submitted by each component entity. A separate demographic report submitted via the Demographic Data Collection Tool must be completed for each component entity.

Site Visit

Each component entity whose written documentation is scored within the range of excellence will receive a site visit by the team of appraisers who reviewed those written documents. The Magnet requirements must be fully evident across each component entity and at every level of each component entity.

System Recognition

If a healthcare organization with multiple entities opts to apply for Magnet recognition as a system and if any component entity fails to meet Magnet requirements, the system will not be designated as Magnet.

Biennial Monitoring

Each component entity must complete interim monitoring requirements with evidence specific to that entity. If during the period of recognition any component entity ceases to meet Magnet requirements as determined as a result of an investigation by the Commission on Magnet Recognition (COM), the system loses Magnet recognition.

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