title: Comparison of nurse practice environments in Denmark and the USA.
abstract: OBJECTIVE
  The aims were to translate, validate and test the reliability of the Practice Environment Scale of the Nursing Work Index in a Danish context; and to compare Danish nurses' ratings of their nurse work environments with the highest rated work environments, USA magnet hospitals.
  
  
  BACKGROUND
  Patient quality and safety are priorities for managers, administrators and policy makers worldwide. A supportive work environment is an important factor to improve quality and safety. The most used scale to measure the nurse work environment is Practice Environment Scale of the Nursing Work Index. There is no Danish translation of the scale or a comparison of nurse work environment between Denmark and other countries.
  
  
  METHODS
  The translation and cultural adaption followed the steps recommended by the World Health Organization. Content validity was evaluated using cognitive interviewing in-person and through surveys. The reliability was tested using Cronbach's alpha. Finally, Practice Environment Scale of the Nursing Work Index ratings from 127 nurses were compared with results from Magnet and non-Magnet hospitals using t-tests.
  
  
  RESULTS
  The Danish translation of Practice Environment Scale of the Nursing Work Index had a high validity and reliability. Danish nurses rated their nurse work environment more favourable than nurses in non-Magnet hospitals and at the same level as Magnet hospitals. Lowest Danish scores were found in the two hospital-level subscales in items related to staff nurses' involvement in discussions on daily problems, the visibility of the chief nursing officer and importance of up-to-date nursing documentation.
  
  
  CONCLUSIONS
  Danish nurses report a supportive nurse work environment with overall scores at the same level as Magnet hospitals. Opportunities for improvement were identified in the subscales.
  
  
  CONCLUSIONS
  A first step to improve patient quality and safety is addressing factors that influence quality and safety. Using the Danish Practice Environment Scale of the Nursing Work Index, interventions to improve specific areas can be planned, implemented and evaluated. Further, Practice Environment Scale of the Nursing Work Index is a nursing quality indicator that can be included in quality databases in Denmark.
authors.affiliation: Department of Orthopaedic, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: H
authors.initials: H
authors.lastname: Mainz
authors.affiliation: School of Nursing, Virginia Commonwealth University, Richmond, VA, USA.
authors.forename: M
authors.initials: M
authors.lastname: Baernholdt
authors.affiliation: Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark.
authors.forename: C H
authors.initials: CH
authors.lastname: Ramlau-Hansen
authors.affiliation: Department of Orthopaedic, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: O
authors.initials: O
authors.lastname: Brink
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003718:Denmark; D005260:Female; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D009740:Nursing Staff; D015279:Organizational Culture; D010559:Personnel Management; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D014177:Translations; D014481:United States; D017132:Workplace
keywords: Denmark; Health Nursing; Magnet Hospitals; Nursing; Translation; USA; Validation Studies; Work Environment