Magnet hospitals, a concept developed in the U.S., have been associated with improved nurse recruitment and retention, and better patient outcomes. Magnet principles may be useful to address workforce challenges in European hospitals, but they have not been implemented or evaluated on a large scale in the European hospital context. This study aims to explore the initial phase of implementing Magnet principles in 11 acute care hospitals in six European countries. The specific objectives of the study were to investigate the type of work that characterises the early phase of implementation and how implementation leaders engage with their context. A multinational qualitative study was conducted, with data from 23 semi-structured, one-to-one interviews with implementation leaders in 11 acute care hospitals in six European countries. Thematic analyses guided the analysis of data. Three themes of core work processes during the early phase of implementing Magnet principles in European hospitals were identified. The first theme, ‘Creating space for Magnet’, describes how work was directed towards creating both political and organisational space for the project. The second theme, ‘Framing to fit: understanding and interpreting Magnet principles’, describes the translational work to understand what the Magnet model entails and how it relates to the local hospital context. Finally, the third theme, ‘Calibrating speed and dose’, describes the strategic work of considering internal and external factors to adjust the process of implementation. The first phase of implementation was characterised by conceptual and relational work; translating the Magnet concepts, considering the fit into existing structures and practices and making space for Magnet in the local context. Understanding the local context played an important role in shaping and guiding the navigation of professional and organisational tensions. Hospitals employed diverse strategies to either emphasise or downplay the role of nurses and nursing to facilitate progress in the implementation.

中文翻译：

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为欧洲医院实施 Magnet 原则奠定基础：定性分析

磁力医院是美国提出的一个概念，它与改善护士招募和保留以及改善患者治疗效果有关。磁铁原则可能有助于解决欧洲医院的劳动力挑战，但尚未在欧洲医院环境中大规模实施或评估。本研究旨在探索在 6 个欧洲国家的 11 家急症护理医院实施 Magnet 原则的初始阶段。该研究的具体目标是调查实施早期阶段的工作类型以及实施领导者如何融入其环境。我们进行了一项跨国定性研究，数据来自对 6 个欧洲国家 11 家急症护理医院的实施负责人进行的 23 次半结构化、一对一访谈。主题分析指导数据分析。确定了欧洲医院实施 Magnet 原则早期阶段核心工作流程的三个主题。第一个主题“为磁铁创造空间”描述了如何为该项目创造政治和组织空间。第二个主题是“框架适应：理解和解释 Magnet 原则”，描述了为理解 Magnet 模型的含义及其与当地医院环境的关系而进行的转化工作。最后，第三个主题“校准速度和剂量”，描述了考虑内部和外部因素来调整实施过程的战略工作。第一阶段实施的特点是概念性和相关性工作；翻译 Magnet 概念，考虑与现有结构和实践的契合度，并在当地环境中为 Magnet 腾出空间。了解当地环境在塑造和指导专业和组织紧张局势的应对方面发挥了重要作用。医院采用不同的策略来强调或淡化护士和护理人员的作用，以促进实施的进展。