Describing the Essentials of Magnetism and Quality in Home Health

The purpose of this descriptive study was to determine what Home Health nurses perceived to be the Essentials of Magnetism (EOM), the degree to which the EOM exists within each Home Health agency (HHA), and whether there was a relationship between quality HHAs and their scores on the EOM. HHAs were determined to be high or low quality agencies based on their published Home Health Compare results as obtained on the Medicare.gov website. The system research organizing model (SROM) was used as an organizing framework for this study.Research in this study was conducted with two different sets of RNs in two different phases. The first phase of RNs (N = 106) determined what Home Health nurses perceived to be the EOM from the 37-item Dimensions of Magnetism (DOM) instrument. The results showed that 7 of the top 8 EOM items chosen by the Home Health nurses were the same EOM items chosen by acute care nurses in previous studies. A test retest of the top 10 items revealed a high level of reliability (Spearman-Brown correlation of .77).Phase Two RNs (N = 125) determined the degree to which the EOM existed in each HHA and whether there was a significant difference between high and low quality agencies. RNs were given the new 10-item EOM instrument and were asked to rank each of the items based on the degree of its presence in their current work environment. The results showed that low quality agencies had a lower and better mean score (M = 1.40, SD = .34) than did higher quality agencies (M = 1.67, SD = .48). An independent sample t-test was significant t (110.91) = -3.63, p = .00, which is counter to the literature.While the results were not as expected, the high reliability of the instrument suggests that it is a reliable measure of attributes perceived by RNs that allow them to provide quality patient care. Several issues identified with the outcome variables such as time sensitivity and validity may provide some explanation of the results.