Development of a reliable and valid organization-specific professional practice assessment tool

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Purpose: This article describes a study to devise an organization-specific professional practice model (PPM) assessment that reflects actual unit involvement. A secondary study goal is the development of a unit-based index that can be used to conduct comparative analyses in an efficient way. Design: Each of the 5 elements of the organization's PPM was represented by 1 or more items on an author-developed instrument. The tool was structured so that item scores could be summed to achieve a single subscale for each PPM element and further aggregated into a total score. Methods: The instrument was administered to a 40% random sample of all regularly scheduled, full- and part-time registered nurses in an academic, community Magnet hospital in 2003 and 2005. Descriptive statistics were calculated for items, subscales, and summary scores for each patient care unit and overall. A weighted, unit-based index was developed to reflect each unit's score on a scale of 100. Findings: The 2003 assessment response rate was 51% (n = 200); the 2005 response rate was 48% (n = 193). Subscale scores and a total PPM score were calculated by summing the values of each individual item. Submissions enabled calculations of total scores by unit, mean scores by item, and the development of a unit-specific PPM index of performance. Conclusions: Beyond shared principles of empowerment, the specifics of each organization's PPM may differ in those key components of care delivery nurses are empowered to effect. Thus, fidelity to the organization-specific PPM is not well tested with generic decisional-involvement instruments. An organization-specific assessment such as this one can provide evidence of not only organizational PPM fidelity but a quantitative method to ensure that staff nurse decisional involvement is continuously evolving to an ever higher state. Copyright © 2010 Wolters Kluwer Health, Lippincott Williams & Wilkins.

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