Magnet Status in Nurse Practitioners’ Care Assessments and Hospital Recommendations

Background: Nurse practitioners (NPs) are a growing segment of the acute care hospital workforce, yet little is known about how organizational factors, such as Magnet designation, influence their workplace experiences. Objectives: We examined whether employment in a Magnet hospital was associated with NPs’ strong recommendation of their hospital and whether this relationship was explained by NPs’ assessments of care quality, patient safety, and care transitions. Methods: In this cross-sectional study we analyzed data from 774 NPs across 425 U.S. hospitals using the 2024 Nurses4All Survey and the American Hospital Association Annual Survey. The independent variable was employment in a Magnet hospital versus a non-Magnet hospital. The dependent variable was NPs’ strong recommendation of their hospital to family and friends. Mediating variables included NPs’ assessments of nursing care quality, patient safety, and confidence in patient care transitions. Mediation analysis using weighting estimators was conducted to adjust for confounding variables and to evaluate the extent to which the hypothesized mediators explained the relationship between Magnet status and hospital recommendation. Results: NPs employed in Magnet hospitals were 15% more likely to strongly recommend their hospital compared to those in non-Magnet hospitals. The natural indirect associations through stronger quality of nursing care, patient safety grade, and confidence in care transitions accounted for approximately 13.3%, 26.6%, and 40% of the total association, respectively. The natural direct association remained positive and significant, suggesting that Magnet employment is associated with hospital recommendation among NPs independently of quality and safety assessments. Discussion: NPs in Magnet hospitals are more likely to endorse their hospital, partially due to more favorable assessments of care quality and safety. This supports Magnet’s aim to attract and retain registered nurses and suggests the benefit extends to NPs. Healthcare leaders should apply Magnet principles to strengthen NP engagement, development, and retention.