Assessing the practice environment for nurses: The Practice Enivronment Scale of the Nursing Work Index

In 2006, the Nursing Division of Arnot Ogden Medical Center conducted a survey of nursing personnel for the purpose of understanding the association between practice environment and patient outcomes and assessing the readiness for Magnet status. Arnot Ogden Medical Center is an independent, not-for-profit, 256-bed tertiary medical facility providing services to the Southern Tier of New York State and the Northern Tier of Pennsylvania. The Practice Environment Scale of the Nursing Work Index (PES-NWI) was selected based on its ability to capture attributes that characterize professional practice environments. The National Quality Forum (NQF) endorses a set of 15 voluntary consensus standards for nursing-sensitive care including the PES-NWI. These nationally recognized standards assess the unique contribution of nursing in acute care hospitals with regards to health care quality, patient safety, and a professional and safe work environment. Thus, the PES-NWI is a measure of considerable importance in promoting excellence in nursing care and achieving superior patient outcomes.

The PES-NWI consists of 31 questions. In addition to an overall Work Index, the instrument yields five sub-scales: Nurse Participation in Hospital Affairs; Nursing Foundations for Quality; Nurse Manager Ability, Leadership, and Support of Nurses; Staffing and Resource Adequacy; and Collegial Nurse-Physician Relations.

The sample for this study consisted of 243 nursing personnel. Initial analyses included group comparisons of the overall Work Index and the related sub-scales by RN status (Staff RN, CNI, CNII, ACN, Case Manager, and Other), basic nursing preparation (BS, AD, and Diploma), and highest degree obtained (MS Nursing, MS Other, BS Nursing, and BS Other). The development of PES-NWI, data collection procedures, and results of the analyses will be discussed in the presentation. Comparisons of the results of the Arnot Ogden nursing personnel with the overall other Magnet and Non-Magnet hospitals will be included.