Global use of the Practice Environment Scale of the Nursing Work Index.
BACKGROUND
Although the Practice Environment Scale of the Nursing Work Index has been endorsed as a gauge of the quality of the nursing practice environment by several organizations in the United States promoting healthcare quality, there is no literature describing its use in different practice settings and countries.


OBJECTIVE
The purpose of this study was to inform research by describing the modifications and use of the scale in a variety of practice settings and countries.


METHODS
The Cumulative Index to Nursing and Allied Health Literature and the PubMed databases were searched for the years 2002-2010 to identify 37 research reports published since 2002 describing use, modification, and scoring variations in different practice settings and countries.


RESULTS
The scale was modified for 10 practice settings in five countries and translated into three languages. Composite scores ranged from 2.48 to 3.17 (on a 1-4 scale). The Staffing and Resource Adequacy subscale most often scored lowest. A new Nursing Information Technology subscale has been developed. New scoring methods to identify the favorability of practice environments are described. Over time, the nature of the research conducted using the measure has changed. Overall, most publications report significant associations between scale scores and multiple nurse, patient, and organizational outcomes.


CONCLUSIONS
Scale use is growing across different clinical settings and countries. Recommendations for future research use include reducing scale length, using consistent scoring methods, considering the impact of various modifications on the basis of cultural and clinical setting nuances, and using the measure in longitudinal and intervention research designs.
School of Nursing, University of North Carolina at Chapel Hill, NC 27599-7460, USA.
Nora E
NE
Warshawsky
Donna Sullivan
DS
Havens
D001291:Attitude of Health Personnel; D003625:Data Collection / Q000379:methods / Q000706:statistics & numerical data; D003627:Data Interpretation, Statistical; D004059:Diffusion of Innovation; D005163:Factor Analysis, Statistical; D006272:Health Facility Environment / Q000458:organization & administration; D006801:Humans; D007588:Job Satisfaction; D019303:Multilingualism; D015399:Nursing Research / Q000379:methods* / Q000706:statistics & numerical data; D009740:Nursing Staff / Q000458:organization & administration / Q000523:psychology; D017063:Outcome Assessment, Health Care; D011787:Quality of Health Care; D012107:Research Design; D011795:Surveys and Questionnaires / Q000706:statistics & numerical data*; D014175:Translating; D017132:Workplace / Q000458:organization & administration / Q000523:psychology