Abstract
Purpose: The purpose of this study was to investigate the relationship between nursing care and the HCAHPS patient satisfaction scores of Magnet hospitals located in California. Nursing care was defined as direct and indirect patient care activities performed by nursing and hospital staff. Theoretical Framework: The theoretical framework for this study was transformational leadership. One of the criteria that Magnet hospitals are expected to produce is evidence of an established transformational leadership environment in the hospital before Magnet certification is granted. Methodology: This was a mixed method cross sectional study. Qualitative data was obtained through telephone interviews with eight chief nursing officers (CNOs) who worked at Magnet hospitals. The interviews were guided by a CNO interview instrument developed by the researcher that included seven open-ended questions related to nursing care activities performed by nursing staff. The interview was semi-structured, allowing the participants to elaborate in their responses. The secondary data was obtained from the Centers for Medicare and Medicaid Services hospital compare website, which publishes HCAHPS patient satisfaction scores from all participating hospitals. Findings: The results of the study showed that the relationship between nursing care, which was defined in this study as direct and indirect patient care activities, and the HCAHPS patient satisfaction survey scores is based on the individual HCAHPS domain that is addressed. Conclusions and Recommendations: Each HCAHPS domain requires a combination of direct and indirect patient care activities to help reach top box scores. Hospitals will need to assess which combination works best for them to meet their patient satisfaction goals. Recommendations for future research: include non-Magnet hospitals in future data collection research endeavors, include hospitals outside of California, and recruit nurse managers and clinical nurse specialists as participants in the data collection process.