The magnet designation process: a qualitative approach using Donabedian's conceptual framework.

Twelve nurse leaders and 12 registered nurses from 2 hospitals were interviewed to gain an understanding on the process for preparing for magnet designation. These leaders and nurses provided insight into whether a cultural shift within the organization was occurring while striving for magnet designation and the level of staff nurses' engagement during the process. Donabedian's framework provided the conceptual context for this study. According to Donabedian, stable organizational structures will influence professional nursing processes and result in better outcomes as measured by magnet status. The authors discuss how a magnet culture is achieved when structural factors such as adequate staffing and pay are present before building the processes, as well as the ways certain ingredients such as professional governance councils need to be primed to achieve the desired magnet outcome. However, transforming the culture into a "valued-practice" magnet organization entails a paradigm shift marked by the willingness to share information and the depth and breadth of commitment toward staff engagement in fulfilling the mission of a culture that truly values nursing expertise.