Department of Biostatistics, University of Kansas Schools of Medicine and Nursing, Kansas City, KS 66160, USA.
Nurs Res. 2010 Mar-Apr;59(2):147-53. doi: 10.1097/NNR.0b013e3181d1a71e.
Practice Environment Scale (PES) data are collected from RNs in nursing units in hospitals that are members of the National Database of Nursing Quality Indicators (NDNQI). Patient and RN information are collected to aid in quality improvement and research at the nursing unit level. The data were collected from the individual RN, but items are worded so that analyses can be conducted at the individual, unit, or hospital level. There is a need to examine the validity of the PES at both the individual and the unit level.
To describe multilevel confirmatory factor analysis via a case study for investigating the validity of the PES, a measure of the nursing practice environment.
The PES was administered to 72,889 RNs from 4,783 nursing units (16 unit types; e.g., critical care and obstetric) in 2007. The PES has 31 items in five different domains. A multilevel confirmatory factor analytic model was fit with a structure on the basis of the five domains. From this model, an estimate was sought between unit loadings and within unit loadings to investigate factorial, convergent, and discriminant validity at both the unit and the RN levels. To investigate criterion-related validity, the five PES domains were correlated with the seven job enjoyment items adapted from the National Database of Nursing Quality Indicators at the unit and RN levels (also using a multilevel model).
The multilevel factor analysis provides evidence of factorial, convergent, discriminant, and criterion-related validity at both the unit and the RN levels.
The PES is a valid instrument for use in quality improvement and research both at the unit and individual RN levels.
实践环境量表（PES）的数据是从加入国家护理质量指标数据库（NDNQI）的医院护理单元中的注册护士那里收集的。患者和注册护士的信息被收集起来，以帮助提高护理单元的护理质量和进行研究。数据是从单个注册护士那里收集的，但这些项目的措辞是为了能够在个人、单位或医院层面进行分析。因此，需要在个人和单位层面检验 PES 的有效性。
通过案例研究描述多层次验证性因素分析，以检验 PES 的有效性，PES 是衡量护理实践环境的一种工具。
2007 年，对来自 4783 个护理单元（16 种单元类型，如重症监护和产科）的 72889 名注册护士进行了 PES 评估。PES 共有 31 个项目，分为五个不同的领域。在基于五个领域的结构上，拟合了一个多层次验证性因素分析模型。从这个模型中，寻求单位负荷和单位内负荷之间的估计，以调查单位和注册护士层面的因子、收敛和区别有效性。为了调查效标关联效度，PES 的五个领域与从国家护理质量指标数据库改编的七个工作满意度项目在单位和注册护士层面（也使用多层次模型）进行了相关性分析。
多层次因素分析在单位和注册护士层面提供了因子、收敛、区别和效标关联有效性的证据。
PES 是一种在单位和个人注册护士层面进行质量改进和研究的有效工具。
