Nurses That Stay.

The 2024 NSI National Health Care Retention & RN Staffing Report published by NSI Nursing Solutions, Inc, was released early this year and indicated hospitals' average turnover and vacancy rates for RNs nearly returned to their 2019 levels in 2023 after peaking in the middle of that timeframe. Simultaneously, healthcare organizations continue to struggle with nurse retention. As nurses begin to return or enter the nursing profession, the time is here to ask why nurses are leaving your organization. In 1983, the original study, "Magnet Hospitals: Attraction and Retention of Professional Nurses," identified hospital characteristics that were able to "attract and retain a staff of well-qualified nurses and are therefore consistently able to provide quality care."

Growing the Next Generation of Nurses and Nurse Leaders.

It is imperative to support the next generation of nurses and nurse leaders facing the challenges of our complex health systems. A formal mentoring program provides a structure that allows nurses to have a relationship that promotes ongoing counsel, career development, and a myriad of other benefits with another nurse or other healthcare professionals. The 2023 Magnet® Application Manual requires organizations to implement and use mentoring and succession planning programs under the transformational leadership standard. Adopting and sustaining effective and meaningful mentoring and succession planning activities and programs promote an environment of inclusion and professional development. In addition to formal mentoring programs, the importance of informal mentoring relationships can have a lasting impact on nurses along their nursing journey.

Magnet Recognition® and Pathway to Excellence®, Complementary Programs.

The American Nurses Credentialing Center® (ANCC) provides healthcare organizations with 2 complementary programs: Magnet Recognition Program® and Pathway to Excellence®. Both programs support nurses in providing the best care. Understanding each program's framework and focus allows organizations to choose which program is the best fit. Nursing is searching for solutions, the ANCC's Magnet Recognition®, and the Pathway to Excellence® programs offer evidence-based frameworks to support professional nursing practice. The frameworks result in improved nurse engagement, retention, interprofessional collaboration, nurse and patient safety, and patient outcomes.

Eco-safe composite edible coating of hydrocolloids with papaya leaf extract improves postharvest quality and shelf life of papaya fruit under ambient storage.

Papaya postharvest management using low-temperature storage is discouraged as it is a tropical fruit. Extensive research is going on to preserve papaya quality at ambient storage using edible coatings and its composites. The present investigation examined the effects of an eco-safe composite edible coating consisting of hydrocolloid carboxymethyl cellulose (CMC) (1%), guar gum (1.5%), xanthan gum (0.3%), and Gum Arabic (10%) combined with papaya leaf extract (PLE) (1:1 ratio by volume) applied as dip treatment on "Red Lady" papaya fruit at ambient storage condition. Among all the attempted treatments, "PLE incorporated with CMC (1%)" was found to be the best, as the treated fruit exhibited the highest levels of biochemicals, whereas the lowest levels of physiological and enzymatic activity, which positively affected the shelf life. The "CMC + PLE" treatment enhanced the fruit gloss score by 70.1%, phenolics by 6.1%, ascorbic acid by 22.3%, total carotenoid content by 7.4%, and fruit predilection score by 22.0% over the control fruit. However, it lowered (controlling) the physiological loss in weight by 51.0%, decay incidence by 66.6%, and polygalacturonase and pectin methylesterase activity by 24.92% and 35.29%, respectively, over control. Moreover, this treatment exhibited the highest fruit purchase predilection score and prolonged the storage life for >3 days on the physiological loss standard basis (≤10%). This study indicates that "CMC (1%) with PLE (1:1)" composite coating application on papaya under ambient conditions might be an effective, environmentally friendly, and health-friendly way to retain the quality and extend the storage life.

Updated Magnet® Certification Requirements.

In 1983, the original study "Magnet Hospitals: Attraction and Retention of Professional Nurses" identified professional development, continuing education, formal education, and career development as critical success factors in creating an environment that fosters nurse engagement. In alignment with the findings, the Magnet Recognition Program® requires organizations to have structures and processes to support nurse certification. In June of 2021, the Magnet Recognition Program announced only nursing and healthcare-related professional board certifications would be accepted as of January 1, 2024. The 2.5-year timeline allowed organizations the opportunity to prepare for the change.

Learning From Our Global Community of Nurses.

Nursing is a global profession, with nearly 27 million nurses working around the world. This month's Magnet Perspectives examines the mutual benefit of this diverse and growing global community, puts the spotlight on some of the innovative initiatives taking place overseas, and considers how we can learn from each other to achieve our ultimate goals of an engaged nursing workforce, evidence-based patient care, and superior outcomes.

The Future of Magnet®.

The Magnet Recognition Program® is built on the results of a study. Magnet® has continued to be evidence-based and forward reaching with each new manual requirement. The foundation of the Forces of Magnetism combined with current future-facing evidence continues to promote a culture of excellence. While it is nursing recognition, Magnet is an organizational credential from which an entire organization benefits.

The Enduring Power of Magnet®.

More than 3 decades have passed since an enterprising team of nurse researchers unearthed groundbreaking findings that led to the creation of the American Nurses Credentialing Center's Magnet Recognition Program®. Over time, the program has grown bigger and broader than anyone could predict, making a significant impact on nurses, the nursing profession, and healthcare delivery around the world. After the recent upheavals caused by the COVID-19 pandemic, is Magnet® still relevant today? This month's Magnet Perspectives column examines the program's enduring significance and proven value in supporting nurses and helping healthcare organizations navigate the financial, labor, and regulatory challenges of the post-COVID era.

Influence of silylated nano cellulose reinforcement on the mechanical, water resistance, thermal, morphological and antibacterial properties of soy protein isolate (SPI)-based composite films.

The aim of this research work is to improve the mechanical and water-resistance properties of soy protein isolate (SPI) biofilm. In this work, 3-aminopropyltriethoxysilane (APTES) coupling-agent modified nanocellulose was introduced into the SPI matrix in the presence of citric acid cross-linker. The presence of amino groups in APTES facilitated the formation of - cross-linked structures with soy protein. The incorporation of a citric acid cross-linker made the cross-linking process more productive, and the surface smoothness of the film was confirmed by a Scanning Electron Microscope (FE-SEM). From the study of the mechanical and thermal properties and water resistance of the film, it was confirmed that the results were highly satisfactory for the modified nanocellulose-incorporated film compared to the non-modified one. Additionally, coating of citral essential oil onto SPI nanocomposite film displayed antimicrobial properties due to the presence of various phenolic groups in the citral oil. The Tensile Strength and Young's Modulus of silane-modified nanocellulose containing film were enhanced by ∼119 % and âˆ¼ 112 %, respectively on incorporation of 1 % APTES-modified nanocellulose. Consequently, this work is expected to offer an effective way for silylated nano-cellulose reinforcing soy protein isolate (SPI)-based bio nanocomposite films for packaging applications. As an example, we have demonstrated one of the applications as wrapping films for packing black grapes.

Why Shared Decision Making Matters.

Shared decision making is a hallmark of Magnet® organizations. Although the terminology can vary, the essence is the same: nurses at all levels, and in all settings, need to be a part of the decision making structure and process. Their voices, along with those of their interprofessional colleagues, ensure a culture of accountability. During times of financial challenges, trimming shared decision making councils may seem an easy place to save money. However, eliminating the councils may lead to increased unintentional costs. This month's Magnet Perspectives takes a closer look at the benefits of shared decision making and its enduring value.

An Interview With Jeanette Ives Erickson, DNP, RN, NEA-BC, FAAN.

At the end of 2022, American Nurses Credentialing Center Magnet Recognition Program® bid farewell to Jeanette Ives Erickson, DNP, RN, NEA-BC, FAAN, as she stepped down as Chair of the Commission on Magnet® (COM). Dr Ives Erickson, the Chief Nurse Emerita and the Distinguished Paul M. Erickson Chair in Nursing at Massachusetts General Hospital (MGH), joined the COM in 2015 as the chief nurse representative. She served a 2nd term as the American Academy of Nursing representative and Commission Chair. As her tenure closed, Dr Ives Erickson shared her thoughts on the nursing profession, changes and challenges in the healthcare environment, and the enduring value of American Nurses Credentialing Center Magnet Recognition Program.

Introducing Magnet® With Distinction.

At the 2022 National Magnet Conference®, leaders of the American Nurses Credentialing Center's Magnet Recognition Program® introduced Magnet Recognition with Distinction (Magnet With Distinction), a new designation recognizing the highest performing Magnet® organizations around the world. Magnet With Distinction is based on validated empirical data, and only a select few hospitals will achieve this elite level of performance. They will serve as exemplary role models for nursing excellence and for creating an environment of care that improves patient outcomes. This month's Magnet Perspectives explores Magnet With Distinction, why it was created, how organizations can achieve it, and who is eligible. The column also discusses the value of implementing a tiered approach to the Magnet program.

Rekindling a Passion for Nursing.

Daily, I see another story about a nurse who has decided to leave the profession. The constant stress of caring for desperately ill COVID-19 patients, staffing issues, and other challenges have combined to push nurses out of our profession at an alarming rate. What we don't hear about are stories of nurses who leave the profession temporarily and then opt to return. I recently read an editorial written by a nurse who resigned at the height of the COVID pandemic. After a year off, she realized how much being a nurse was a part of her identity and she returned to bedside care. Her story is my story, too. Reading it inspired me to depart from the usual format of the Magnet® Perspectives column to share my nursing story in hopes it will inspire others.

The Enduring Relevance of Magnet®.

As nurse leaders across the country contend with critical challenges, including the ongoing impact of COVID-19, tightening budgets, staff resignations, nurse burnout, and declining nurse engagement, some wonder whether the Magnet® framework is still relevant today. It has been nearly 40 years since the original Magnet research was published. How does it stand up in the wake of modern-day realities? Do the findings continue to hold true? This Magnet Perspectives column takes a closer look at the research that led to the program's creation, development of the Magnet Model, and the program's relevance in meeting the challenges of today's demanding healthcare environment. In addition, this month's JONA includes "The Business Case for Magnet® Designation: Using Data to Support Strategy" demonstrating the framework Magnet continues to provide cost savings and cost avoidance.

Correlation of Serum Nt-Pro Bnp Levels and Myocardial Performance Index in Asymptomatic Type 2 Diabetics for Assessment of Myocardial Ischaemia.

Diabetes mellitus is a global health problem. Cardiovascular events accounts for approximately 50 percent of mortality amongst the diabetics. Diabetics often present with silent myocardial ischaemia, since myocardial ischaemia is a strong trigger of N-terminal pro-B-type natriuretic peptide (NT-proBNP) release, we hypothesized that NT-proBNP might be useful in the early diagnosis. This study also evaluates whether any correlation exits between NT-proBNP levels and myocardial performance index (MPI). MATERIAL: This case control study was done on 30 patients with type 2 diabetes and similar matched group of 30 controls. Investigations like fasting and postprandial sugar level, kidney function test, HBA1c, lipid profile and NT-ProBNP levels were done. TMT was done to diagnose silent MI. Echocardiography was performed to assess MPI. The outcome measures were cut off levels of NT-ProBNP for predicting silent myocardial ischaemia based on TMT. P<0.05 was considered as significant. OBSERVATION: NT-proBNP (pg/mL) was significantly increased in Diabetics in comparison to controls (595.33±464.48 vs 110.97 ± 34.81, p <.0001). MPI was significantly higher in diabetics (0.54±0.08 vs 0.33±0.02, p<.0001), and NT-proBNP showed significant positive correlation myocardial performance index (r= 0.726, p<0.0001). Silent MI was seen in 18(60%) patients which was based on TMT testing. Compared to those without silent MI, patients with silent MI had higher NTproBNP levels (795.5 vs 106, p value=0.0001) and higher MPI (0.59 ± 0.06 vs 0.46 ± 0.05, p value<.0001). A cut off of NT-pro BNP(pg/ mL) of >152 predicted silent MI in 93.33% cases with 100% sensitivity, 83.33% specificity, 90% PPV and 100% NPV. CONCLUSION: NT-proBNP is a novel marker with positive correlation with MPI. It may be used as an independent predictor for silent MI in diabetics, thereby helping in reduction and treatment of CVD among them. Thus, it is suggested to screen all asymptomatic diabetics for underlying myocardial ischaemia by MPI, preferably, or by NTproBNP levels.

Dispelling Magnet® Myths.

ABSTRACT: Organizations on the journey to Magnet® excellence have questions. In many cases, those questions are based on myth, not fact. In this month's Magnet Perspectives, we break down the most commonly asked questions, dispel the myths, and explore the resources available to help organizations get the answers they need to achieve Magnet® recognition.

The Professional Nurse: Four Decades of Immense Change.

As one of the world's oldest occupations, nursing has seen, inspired, and innovated a host of changes. The evolution has been especially evident for the last 39 years. Since the 1980s, a growing focus on autonomy, research, and evidence-based practice has transformed nursing from a job to a profession. Concepts such as shared governance, interprofessional collaboration, and frontline engagement have transformed nurses from doctors' assistants to empowered and independent clinicians directly impacting patient outcomes and the healthcare environment. As the 30th anniversary of the American Nurses Credentialing Center comes to an end and the original Magnet® research celebrates a 39th birthday, we take a closer look at how the Magnet framework reflects these changes and how Magnet-designated organizations continue to advance nursing practice with innovation, knowledge, and leadership.

Introducing the 2023 Magnet Application Manual®.

In November, the American Nurses Credentialing Center (ANCC) released its revised 2023 Magnet Application Manual®, the 13th manual in the program's 31-year history. This month's "Magnet Perspectives" takes a deep dive into the new edition of the manual, examining the rigorous, multistep review process, the modernized standards, and the coalition of experts that contributed insights to inform the latest edition. Each edition raises the bar to promote the highest levels of nursing excellence, and the 2023 manual is no exception. Learn how this forward-looking edition addresses emerging challenges and changes to reflect what is happening in healthcare today.