Development and Psychometric Testing of the Nursing Culture Assessment Tool

Abstract

A valid and reliable nursing culture assessment tool aimed at capturing general aspects of nursing culture is needed for use in health care settings to assess and then reshape indicated troubled areas of the nursing culture. This article summarizes the Nursing Culture Assessment Tool's (NCAT) development and reports on a cross-sectional, exploratory investigation of its psychometric properties. The research aims were to test the tool's psychometric properties; discover its dimensionality; and refine the item structure to best represent the construct of nursing culture, an occupational subset of organizational culture. Empirical construct validity was tested using a sample of licensed nurses and nursing assistants (n = 340). Exploratory and confirmatory factor analysis (CFA) and logistical regression yielded a 6-factor, 19-item solution. Evidence supports the tool's validity for assessing nursing culture as a basis for shaping the culture into one that supports change, thereby accelerating, improving, and advancing nursing best practices and care outcomes.

Nursing culture assessment tool (NCAT): Empirical validation for use in long-term care

“…A collegial relationship between these sets of workers is the cornerstone of individualized patient care. To support implementation research in LTC settings, we extended previous work on the psychometric properties of the Nursing Culture Assessment Tool (NCAT) [3] that was conducted among nurses in multiple care settings, to now focus on its validity and reliability specifically among LTC nursing workgroups and its contribution to refining a theoretical model of nursing's organizational subculture.…”

Moral distress and the Australian aged care worker: A mixed methods study

“…Although somewhat tied to organisational structure and culture, facilitating workers to take ownership of the culture of their workplace, to become invested in how they 'do nursing', will empower gradual but sustainable change (Darbyshire, 2010;Kennerly et al, 2012). A bottom up approach to change can be generated by them; driving cultural change that is owned by the aged care worker.…”

“…Factor analysis is frequently used in health research aimed at developing new measurement instruments (Halcomb et al, 2011;Kennerly et (Corley, 1995;Corley et al, 2001) or no factor analysis (Hamric & Blackhall, 2007;Hamric et al, 2012). Exploratory factor analysis is an appropriate approach when previous exploratory factor analysis has not been performed (Burns & Grove, 2009); hence exploratory factor analysis (EFA) was used in this study.…”

“…Expert review is suggested as "the most convincing test of face validity…" (Gomm, 2008, p. 40), and is a strategy often used when designing measurement instruments (Curley, Hunsberger, & Harris, 2013;Ivankova, 2014;Kennerly et al, 2012;Kostovich, 2012;Zomorodi & Lynn, 2010). Face validity is concerned with determining through discussion that an individual measure represents the "…content of the concept"… it is intended to measure (Singh, 2007, p. 79).…”

“…As described earlier in this discussion, clinical expert review to gain consensus on amended items (with a view to ensuring face and content validity) was obtained, and is an approach consistent with other nursing research (Kennerly et al, 2012;Kostovich, 2012;Lynn, Morgan, & Moore, 2009). …”