Reliability and validity of an instrument assessing nurses' attitudes about healthy work environments in hospitals

To examine the psychometric properties of an instrument used to evaluate the work environment of direct care nurses employed in hospital settings.

Healthy work environments are associated with increased retention and high-quality patient care.

Items for the instrument were based on the American Association of Critical Care Nurses' standards for a healthy work environment. Six items measured the individual's contribution to the work environment and six measured co-workers' contributions. Each item was graded on a scale from 'A=well above average' to 'F=failing'. The instrument was administered by nurse leaders to 210 direct care nurses in six hospitals.

The Cronbach α was 0.75 for the self-rating subscale and 0.89 for the co-workers rating subscale. Administrators rated their co-workers significantly higher [n=32, mean (M)=2.69, standard deviation (SD)=0.63] than direct care nurses rated theirs (n=209, M=2.31, SD=0.83, P=0.03). Direct care nurses intending to stay in nursing rated co-workers significantly higher (n=170, M=2.35, SD=0.81) than those not intending to stay (n=22, M=1.87, SD=0.81, P=0.01).

The instrument is a feasible, reliable and valid method for assessing the work environment.

The instrument can be used to assess the relationship of the work environment to nurse retention in hospitals.