Background Information

The facility at which I practice has been awarded Magnet status: 

Name of facility: (optional)

Location: (optional)  (City)  (State)

I have worked on my present unit at this facility:  

Within My Organization

1. Nursing enjoys strong and effective representation on planning and policy-making bodies within the organization.

 Strongly Disagree  Disagree  Undecided  Agree  Strongly Agree

2. The organizational structure is collaborative.

 Strongly Disagree  Disagree  Undecided  Agree  Strongly Agree

3. The organizational structure cultivates a positive relationship between clinical and administrative staff.

 Strongly Disagree  Disagree  Undecided  Agree  Strongly Agree

4. Nurses serving in leadership positions are accessible and visible.

 Strongly Disagree  Disagree  Undecided  Agree  Strongly Agree

5. Nurses serving in leadership positions have a participative style and value open communication.

 Strongly Disagree  Disagree  Undecided  Agree  Strongly Agree

6. Personnel policies and programs are indicative of the employer's concern about employees.

 Strongly Disagree  Disagree  Undecided  Agree  Strongly Agree

7. Personnel policies and programs are created with employee involvement.

 Strongly Disagree  Disagree  Undecided  Agree  Strongly Agree

8. Professional models of care are used in the delivery of patient care services.

 Strongly Disagree  Disagree  Undecided  Agree  Strongly Agree

9. Staff nurses provide the level and intensity of care consistent with the needs of the patient.

 Strongly Disagree  Disagree  Undecided  Agree  Strongly Agree

10. Quality assurance/improvement activities are implemented with staff nurse involvement.

 Strongly Disagree  Disagree  Undecided  Agree  Strongly Agree

11. Quality assurance/improvement activities are viewed as a mechanism to improve the quality of care.

 Strongly Disagree  Disagree  Undecided  Agree  Strongly Agree

12. Staff nurses have access to clinical experts including, but not limited to, advanced practice nurses.

 Strongly Disagree  Disagree  Undecided  Agree  Strongly Agree

13. A practice environment exists that encourages and expects staff nurses to exercise independent judgment consistent with their scope of practice.

 Strongly Disagree  Disagree  Undecided  Agree  Strongly Agree

14. A practice environment exists that encourages and expects nurses to serve as teachers.

 Strongly Disagree  Disagree  Undecided  Agree  Strongly Agree

15. Nurses are seen as essential providers of core health care organization services.

 Strongly Disagree  Disagree  Undecided  Agree  Strongly Agree

16. Professional development (orientation, in-service, continuing education, formal education, and career development) is highly valued.

 Strongly Disagree  Disagree  Undecided  Agree  Strongly Agree

17. Ongoing opportunities are provided to meet the learning needs of the nursing staff.

 Strongly Disagree  Disagree  Undecided  Agree  Strongly Agree

18. I have the opportunity to work with other nurses who are clinically competent.

 Strongly Disagree  Disagree  Undecided  Agree  Strongly Agree

19. Nurse-physician relationships are collegial.

 Strongly Disagree  Disagree  Undecided  Agree  Strongly Agree

20. My practice environment permits me to be autonomous and accountable.

 Strongly Disagree  Disagree  Undecided  Agree  Strongly Agree

21. My nurse manager is supportive of my professional goals.

 Strongly Disagree  Disagree  Undecided  Agree  Strongly Agree

22. I am empowered to manage my nursing practice.

 Strongly Disagree  Disagree  Undecided  Agree  Strongly Agree

23. Nurses on my unit are empowered to manage their practice environment.

 Strongly Disagree  Disagree  Undecided  Agree  Strongly Agree

24. There is support for education and other professional development activities.

 Strongly Disagree  Disagree  Undecided  Agree  Strongly Agree

25. There is adequate nurse staffing.

 Strongly Disagree  Disagree  Undecided  Agree  Strongly Agree

26. Concern for the patient is paramount.

 Strongly Disagree  Disagree  Undecided  Agree  Strongly Agree

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