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Abstract

Relationships between nurse practice environment (NPE) characteristics and patient and nurse outcomes have been the focus of a growing body of healthcare research worldwide, including in Canada. Validated instruments which measure NPE factors are important for better understanding their associations to patient and nurse outcomes, yet there is a lack of evidence for such validated instruments in British Columbia (BC), Canada. The Practice Environment Scale of the Nursing Work Index (PES-NWI) is a commonly used survey instrument to measure NPEs in the published nursing research literature (Lake et al., 2024; Lake et al., 2019; Lee & Scott, 2018). The original PES-NWI was described as a 31-item, 5-factor model (Lake, 2002). The primary objective of this study was to evaluate the validity the PES-NWI in the BC nursing context using a sample of BC acute care registered nurses (RN), using confirmatory factor analysis methods and Mplus statistical software. An additional objective for this study was respecify the PES-NWI factor structure to optimize model fit for the BC nursing context using recommended model respecification procedures (Brown, 2015). This was a secondary analysis study which used data from the British Columbia Nurses’ Workload Impact Study (BCNWIS) collected during 2014. This thesis study findings yielded a second-order 32-item, 8-factor model reflecting the NPE, which showed a moderately good fit to the BC nurse data. Contributions include a validated, second-order 32-item, 8-factor PES-NWI model recommended for use in the BC nursing context. Findings also showed statistical validity to support the theoretical associations between PES-NWI factors. In addition, second-order models also provide options for instrument scoring (i.e., use of a single “total score) and evaluation (i.e., testing and comparing first-and second-order models across different contexts) (Brown, 2015; Furr, 2022).