Nursing Center - Journal Article

The Magnet Recognition Program Application Manual's1 Guidelines for Written Documentation describes the written documentation submission process and identifies the source-of-evidence (SOE) narratives as a critical component of the appraisal process. Organizations applying for Magnet status will write narrative statements and provide written examples for each SOE to illustrate how each SOE is enculturated in the organization.

The work of evidence development is a comprehensive task for any organization. Central to one's success is the ability to organize the writing process to produce a final product that reflects the presence of nursing excellence in the organization and meets or exceeds the SOE requirements.

Evidence Development

West Virginia University Hospitals (WVUH), Morgantown, received initial designation as a Magnet facility in 2005. Through the efforts of the WVUH Magnet program director, Magnet Steering Committee, and use of an internal core writer (nurse), the organization successfully completed initial designation, 4 subsequent interim reports, and 1 redesignation evidence submissions without request for additional evidence. At WVUH, the use of an internal core writer, while involving as many individuals as possible in the storytelling process, brought ownership to the final product and promoted a flow of evidence that was reader-friendly and met the Magnet Recognition Program requirements. Figure 1 shows recommended steps to facilitate the process of evidence development, and Figure 2 shows steps to facilitate the evidence-writing phase of evidence development.

Figure 1 - Click to enlarge in new window

Figure 1. Steps to facilitate the process of evidence development.

Figure 2 - Click to enlarge in new window

Figure 2. Steps to facilitate the evidence-writing phase of evidence development.

Role of the Core Evidence Writer

Compiling evidence into a comprehensive document requires writing and editing skills. Storytellers vary in their writing skill level and the use of language; therefore, the use of a core evidence writer, who can revise and edit submitted stories, can support evidence flow and format consistency. At WVUH, the core evidence writer, a nurse with proven professional writing and publication skills, performed the following functions:

* Organized each model component (transformational leadership, structural empowerment, exemplary professional practice, new knowledge, innovations and outcomes, and empirical outcomes) into an individual chapter

* Wrote an opening narrative and conclusion for each chapter and SOE

* Matched each submitted story to an appropriate chapter and SOE, using each story only once

* Developed a glossary of terms concurrently throughout the writing process

* Archived and labeled attachments by relevant SOE concurrently, as submitted

* Highlighted all levels of nursing staff in all departments in which nursing is practiced

* Ensured that the evidence maintained a broad-brush perspective of the nursing organization, reflected enculturation of the Forces of Magnetism, and reflected required empirical outcomes

Role of the Magnet Program Director

Separate from writing narratives and stories, data compilation and reporting through the National Database of Nursing Quality Indicators, the compilation of additional organizational data points required for evidence submission at WVUH was facilitated by the Magnet program director. Through the use of a centralized database, data points (Figure 3) were tracked for the demographic information form.

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Figure 3. Data points tracked for the demographic information form.

Final Edits and Compilation of Evidence

The stories are written, the attachments compiled, and the data displayed. The following tips will facilitate the editing process and the production of the required copies of final evidence.

1. Through a combination of steering committee meetings and off-site retreats, read each chapter of evidence, word by word, and revise concurrently via the use of a laptop.

2. Consider the use of marketing and communication staff to review evidence content grammatically.

3. Number the tables and figures consecutively and create the table of contents per chapter after all edits are completed.

4. Consider the use of an external consultant to review the final draft for content, flow, and internal consistency in use of titles, degrees, and terminology (add 2 months to the completion timeline to allow for this review).

5. Organize the final evidence into 4 books. Book 1: Our History/Organizational Overview Documents; Book 2: Transformational Leadership and Structural Empowerment; Book 3: Exemplary Professional Practice; and Book 4: New Knowledge, Innovations, and Outcomes, and Empirical Outcomes and a separate book of Appendixes for those documents that may be referred to more than once (ie, organizational charts, nursing strategic plan).

Conclusion

It is through the evidence identification process that an organization will embark on a journey of self-reflection and, at times, self-discovery. As the Magnet Recognition Program standards have evolved to an outcomes focus, an organization must also evolve. It is through this journey that an organization will present the many contributions of the nursing staff and the healthcare team as a whole. The journey allows for reflection on outcomes and accomplishments, evaluation of the work that is performed and the manner in which it is done, and assessment of the environment that serves as the arena for the services provided.

Reference

1. American Nurses Credentialing Center (ANCC). Recognizing Nursing Excellence: Magnet Recognition Program(R) Application Manual. Silver Spring, MD: American Nurses Credentialing Center; 2008. [Context Link]