Lake Eileen T
University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Med Care Res Rev. 2007 Apr;64(2 Suppl):104S-22S. doi: 10.1177/1077558707299253.
Improvements in nurses' practice environments are essential to retain nurses and keep patients safe. The pace of improvements can accelerate if evidence is translated clearly for researchers, managers, and policymakers. This article evaluates the utility of published multidimensional instruments to measure the nursing practice environment. The assessment criteria are theoretical relevance, ease of use, and dissemination. This article also synthesizes the research that has used these instruments. Seven instruments and 54 studies are evaluated. The Practice Environment Scale of the Nursing Work Index (PES-NWI) is proposed as the most useful instrument. Its content, length, and dissemination best satisfy the set of criteria. Researchers should use the PES-NWI to generate consistent and comparable evidence; expand the content to reflect all conceptual domains; develop a short form; test the instrument in different care settings; expand the evidence of the practice environment's influence on patient outcomes; and test interventions for practice environment improvements.
改善护士的执业环境对于留住护士和保障患者安全至关重要。如果能将证据清晰地传达给研究人员、管理人员和政策制定者,改善的步伐就能加快。本文评估已发表的多维工具在衡量护理执业环境方面的效用。评估标准包括理论相关性、易用性和传播情况。本文还综合了使用这些工具的研究。共评估了七种工具和54项研究。护理工作指数执业环境量表(PES-NWI)被认为是最有用的工具。其内容、长度和传播情况最符合所设定的标准。研究人员应使用PES-NWI来生成一致且可比的证据;扩展内容以反映所有概念领域;开发简版;在不同护理环境中测试该工具;扩展关于执业环境对患者结局影响的证据;并测试改善执业环境的干预措施。