The Henderson Repository is a free resource of the HonorSociety of Nursing, Sigma Theta Tau International. It isdedicated to the dissemination of nursing research, research-related, and evidence-based nursing materials. Take credit for allyour work, not just books and journal articles. To learn more,visit www.nursingrepository.org
Item type Presentation
Format Text-based Document
Title The Practice Environment Scale of the Nurse Work Index:Translating Scores for Practice
Authors Warshawsky, Nora E.
Downloaded 29-May-2018 09:46:42
Link to item http://hdl.handle.net/10755/291010
The Practice Environment Scale of the Nurse Work Index: Translating Scores for Practice
Nora Warshawsky, PhD, RN [email protected] University of Kentucky April 13, 2013
Creating Healthy Work Environments Conference Sigma Theta Tau International Indianapolis, IN
Practice Environment Scale of the Nurse Work Index
• Nurse Participation in Hospital Affairs
• Nursing Foundations for Quality Care
• Nurse Manager Leadership, Ability, & Support
• Adequate Staffing & Resources
• Collegial Nurse-Physician Relationships
Lake, E. T. (2002). Development of the Practice Environment Scale of the Nursing Work Index. Research in Nursing & Health, 25(3), 176-188.
Nurse Participation in Hospital Affairs
Subthemes Items
CNO and Administration A chief nursing officer who is highly visible and accessible to
staff.
A chief nursing officer equal in power and authority to
other top-level hospital executives.
Administration that listens and responds to employee
concerns.
Nursing administrators consult with staff on daily problems
and procedures.
Staff Nurses Involved in
Governance
Staff nurses are involved in the internal governance of the
hospital (i.e. practice and policy committees).
Opportunity for staff nurses to participate in policy
decisions.
Staff nurses have the opportunity to serve on hospital and
nursing committees.
Career Development Opportunities for advancement.
Career development/ clinical ladder opportunity.
Nursing Foundations for Quality Care
Subthemes Items
Competent Nurses Working with nurses who are clinically competent.
A preceptor program for newly hired nurses.
Active staff development or continuing education
programs for nurses.
Quality Culture A clear philosophy of nursing that pervades the patient
care environment.
High standards of nursing care are expected by the
administration.
An active quality assurance program.
Nursing care is based on a nursing, rather than medical
model.
Patient Care Management Use of nursing diagnosis.
Patient care assignments that foster continuity of care, i.e.,
the same nurse cares for the patient from one day to the
next.
Written up-to-date care plans for all patients.
Nurse Manager Leadership, Ability & Support
Subthemes Items
Nurse Manager A nurse manager who is a good manager and leader.
A nurse manager who backs up the nursing staff in
decision making, even if the conflict is with a physician.
Praise and recognition for a job well done.
Supervisor?? Supervisors use mistakes as learning opportunities, not
criticism.
A supervisory staff that is supportive of nurses.
Adequate Staffing & Resources
• Enough staff to get the work done.
• Enough registered nurses to provide quality patient care.
• Enough time and opportunity to discuss patient care problems with other nurses.
• Adequate support services allow me to spend time with my patients.
Collegial Nurse-Physician Relationships
• A lot of teamwork between nurses and physicians.
• Physicians and nurses have good working relationships.
• Collaboration (joint practice) between nurses and physicians.
Practice Environment Scale Data
2.44
2.62
2.80
2.81
2.91
2.72
1 2 3 4
Adequate Resources
Nurse Participation
Nurse Manager
Foundations for Quality
RN - MD Relationships
Composite
1. Create excel file displaying data and benchmarks.
HO
SPIT
AL
Med
ical
ICU
Surg
ical
ICU
Med
-Sur
g 1
Med
-Sur
g 2
Med
-Sur
g 3
Peri
-op
1
Peri
-op
2
Mean PES Score
2011 Benchmark 2.93 2.89 2.90 2.90 2.91 2.88 2.90 2.90
2011 2.72 2.95 2.85 2.63 3.05 2.87 2.46 2.42
Nursing Participation in Hospital Affairs
2011 Benchmark 2.84 2.77 2.86 2.86 2.90 2.85 2.79 2.79
2011 2.62 2.76 2.72 2.50 3.11 2.81 2.54 2.49
Nursing Foundations for Quality Care
2011 Benchmark 3.08 3.05 3.10 3.10 3.11 3.09 3.02 3.02
2011 2.81 2.98 2.92 2.81 3.17 2.98 2.68 2.69
Nurse Manager Ability, Leadership and Support of Nurses
2011 Benchmark 2.95 3.27 2.95 2.95 2.98 2.96 2.87 2.87
2011 2.80 3.27 3.21 3.00 3.22 3.26 2.17 2.35
Staffing and Resource Adequacy 2.70
2011 Benchmark 2.75 2.71 2.60 2.60 2.59 2.54 2.73 2.73
2011 2.44 2.70 2.33 2.24 2.51 2.48 2.04 2.08
Collegial Nurse Physician Relations
2011 Benchmark 3.05 3.03 2.97 2.97 2.97 2.95 3.07 3.07
2011 2.91 3.04 3.06 2.60 3.23 2.81 2.86 2.50
ADULT CRITICAL
CAREADULT Med/Surg
Peri-Operative
2. Apply stop light color coding.
> 5% Below Benchmark
Within 5% of Benchmark
Meet or Exceed Benchmark
HO
SPIT
AL
Me
dic
al IC
U
Surg
ical
ICU
Me
d-S
urg
1
Me
d-S
urg
2
Me
d-S
urg
3
Pe
ri-o
p 1
Pe
ri-o
p 2
Mean PES Score
2011 Benchmark 2.93 2.89 2.90 2.90 2.91 2.88 2.90 2.90
2011 2.72 2.95 2.85 2.63 3.05 2.87 2.46 2.42
Nursing Participation in Hospital Affairs
2011 Benchmark 2.84 2.77 2.86 2.86 2.90 2.85 2.79 2.79
2011 2.62 2.76 2.72 2.50 3.11 2.81 2.54 2.49
Nursing Foundations for Quality Care
2011 Benchmark 3.08 3.05 3.10 3.10 3.11 3.09 3.02 3.02
2011 2.81 2.98 2.92 2.81 3.17 2.98 2.68 2.69
Nurse Manager Ability, Leadership and Support of Nurses
2011 Benchmark 2.95 3.27 2.95 2.95 2.98 2.96 2.87 2.87
2011 2.80 3.27 3.21 3.00 3.22 3.26 2.17 2.35
Staffing and Resource Adequacy 2.70
2011 Benchmark 2.75 2.71 2.60 2.60 2.59 2.54 2.73 2.73
2011 2.44 2.70 2.33 2.24 2.51 2.48 2.04 2.08
Collegial Nurse Physician Relations
2011 Benchmark 3.05 3.03 2.97 2.97 2.97 2.95 3.07 3.07
2011 2.91 3.04 3.06 2.60 3.23 2.81 2.86 2.50
ADULT CRITICAL CARE ADULT Med/Surg Peri-Operative
3. Count the number of subscales by benchmark status to create summary report.
Subscale
Met or
Exceeded
Benchmark
Within 5% of
Benchmark
> 5% below
Benchmark
Nurse Manager Ability, Leadership, and Support
5 0 2
Collegial Nurse-Physician Relationships
3 1 3
Nursing Participation in Hospital Affairs
2 2 3
Nursing Foundations for the Quality Care
1 2 4
Staffing and Resource Adequacy 0 2 5
3. Draw conclusions
• Med-Surg 2
• Nurse Manager Leadership
• Peri-operative Services
• Staffing & Resources
Strengths Opportunities
Favorability Classification
Subscale scores >2.5
• Favorable if 4-5 subscales >2.5
• Mixed if 2 -3 subscales >2.5
• Poor if ≤ 1 subscales >2.5
Lake, E. T., & Friese, C. R. (2006). Variations in nursing practice environments: Relation to staffing and hospital characteristics. Nursing Research, 55(1), 1-9.