Dunagan Pamela B
Division of Nursing, Berry College, Mt. Berry, GA, USA.
J Clin Nurs. 2017 Dec;26(23-24):5113-5120. doi: 10.1111/jocn.14054. Epub 2017 Oct 8.
To report the development of a tool to measure nurse's attitudes about quality improvement in their practice setting and to examine preliminary psychometric characteristics of the Quality Improvement Nursing Attitude Scale.
Human factors such as nursing attitudes of complacency have been identified as root causes of sentinel events. Attitudes of nurses concerning use of Quality and Safety Education for nurse's competencies can be most challenging to teach and to change. No tool has been developed measuring attitudes of nurses concerning their role in quality improvement.
A descriptive study design with preliminary psychometric evaluation was used to examine the preliminary psychometric characteristics of the Quality Improvement Nursing Attitude Scale. Registered bedside clinical nurses comprised the sample for the study (n = 57).
Quantitative data were analysed using descriptive statistics and Cronbach's alpha reliability. Total score and individual item statistics were evaluated. Two open-ended items were used to collect statements about nurses' feelings regarding their experience in quality improvement efforts.
Strong support for the internal consistency reliability and face validity of the Quality Improvement Nursing Attitude Scale was found. Total scale scores were high indicating nurse participants valued Quality and Safety Education for Nurse competencies in practice. However, item-level statistics indicated nurses felt powerless when other nurses deviate from care standards. Additionally, the sample indicated they did not consistently report patient safety issues and did not have a feeling of value in efforts to improve care.
Findings suggested organisational culture fosters nurses' reporting safety issues and feeling valued in efforts to improve care. Participants' narrative comments and item analysis revealed the need to generate new items for the Quality Improvement Nursing Attitude Scale focused on nurses' perception of their importance in quality and safety and their power to enact principles.
The Quality Improvement Nursing Attitude Scale-Revised edition was designed to help in understanding nurses' attitudes and values. It can be used to further explore broad concepts of quality improvement efforts.
报告一种用于衡量护士对其实践环境中质量改进态度的工具的开发情况，并检验质量改进护理态度量表的初步心理测量特征。
诸如自满的护理态度等人为因素已被确定为警讯事件的根本原因。护士对于将质量与安全教育用于护士能力培养的态度，在教学和改变方面可能极具挑战性。尚未开发出用于衡量护士对其在质量改进中角色态度的工具。
采用带有初步心理测量评估的描述性研究设计，以检验质量改进护理态度量表的初步心理测量特征。注册床边临床护士构成研究样本（n = 57）。
使用描述性统计和克朗巴哈α信度对定量数据进行分析。评估总分和单个项目统计数据。使用两个开放式项目收集关于护士对其质量改进工作经历感受的陈述。
发现对质量改进护理态度量表的内部一致性信度和表面效度有有力支持。量表总分较高，表明护士参与者重视质量与安全教育在实践中的护士能力培养。然而，项目层面的统计数据表明，当其他护士偏离护理标准时，护士会感到无力。此外，样本表明他们并未始终报告患者安全问题，且在改善护理的努力中没有价值感。
研究结果表明组织文化促进护士报告安全问题并在改善护理的努力中感到被重视。参与者的叙述性评论和项目分析表明，需要为质量改进护理态度量表生成新的项目，重点关注护士对其在质量和安全方面重要性的认知以及他们践行原则的能力。
修订版质量改进护理态度量表旨在帮助理解护士的态度和价值观。它可用于进一步探索质量改进工作的广泛概念。
