title: Using the Nursing Culture Assessment Tool (NCAT) in Long-Term Care: An Update on Psychometrics and Scoring Standardization.
abstract: An effective workforce performing within the context of a positive cultural environment is central to a healthcare organization's ability to achieve quality outcomes. The Nursing Culture Assessment Tool (NCAT) provides nurses with a valid and reliable tool that captures the general aspects of nursing culture. This study extends earlier work confirming the tool's construct validity and dimensionality by standardizing the scoring approach and establishing norm-referenced scoring. Scoring standardization provides a reliable point of comparison for NCAT users. NCAT assessments support nursing's ability to evaluate nursing culture, use results to shape the culture into one that supports change, and advance nursing's best practices and care outcomes. Registered nurses, licensed practical nurses, and certified nursing assistants from 54 long-term care facilities in Kentucky, Nevada, North Carolina, and Oregon were surveyed. Confirmatory factor analysis yielded six first order factors forming the NCAT's subscales (Expectations, Behaviors, Teamwork, Communication, Satisfaction, Commitment) (Comparative Fit Index 0.93) and a second order factor-The Total Culture Score. Aggregated facility level comparisons of observed group variance with expected random variance using rwg(J) statistics is presented. Normative scores and cumulative rank percentages and how the NCAT can be used in implementing planned change are provided.
authors.affiliation: School of Nursing, University of North Carolina at Charlotte, Charlotte, NC 28223, USA. skenner2@uncc.edu.
authors.forename: Susan
authors.initials: S
authors.lastname: Kennerly
authors.affiliation: Department of Psychology and Organizational Science, University of North Carolina at Charlotte, Charlotte, NC 28223, USA. edhegges@uncc.edu.
authors.forename: Eric D
authors.initials: ED
authors.lastname: Heggestad
authors.affiliation: Department of Organizational Science, University of North Carolina at Charlotte, Charlotte, NC 28223, USA. hmyers11@uncc.edu.
authors.forename: Haley
authors.initials: H
authors.lastname: Myers
authors.affiliation: School of Nursing, Duke University, Durham, NC 27710, USA. tracey.yap@duke.edu.|Center for the Study of Aging and Human Development, Duke University, Durham, NC 27710, USA. tracey.yap@duke.edu.
authors.forename: Tracey L
authors.initials: TL
authors.lastname: Yap
keywords: assessment; long-term care; nursing culture; occupational subculture