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Published on: February 2, 2020
Nursing Home Administrator Quality Improvement Self-Efficacy Scale.
Elena O Siegel1, Anna Zisberg, Debra Bakerjian
1Elena O. Siegel, PhD, RN, is Assistant Professor, Betty Irene Moore School of Nursing, University of California, Davis, Sacramento, California. E-mail: eosiegel@ucdavis.edu. Anna Zisberg, RN, MA, PhD, is Head of the BA Program, The Cheryl Spencer Department of Nursing, Faculty of Social Welfare and Health Science, Haifa University, Mount Carmel, Israel. Debra Bakerjian, PhD, APRN, FAAN, FAANP, is Senior Director of NP/PA Clinical Education and Practice and Associate Adjunct Professor, Betty Irene Moore School of Nursing, University of California, Davis, Sacramento, California. Leehu Zysberg, PhD, Graduate School, Gordon College of Education, Haifa, Israel.
A new instrument measures nursing home administrator self-efficacy in quality improvement (QI). This tool helps identify leaders
Area of Science:
- Gerontology
- Healthcare Management
- Organizational Psychology
Background:
- Nursing home (NH) quality improvement (QI) initiatives face significant challenges.
- Effective leadership is crucial for successful QI in NHs, yet assessment tools for administrator capabilities are limited.
- Licensed NH administrators' self-efficacy in QI requires a validated measurement instrument.
Purpose of the Study:
- To develop and preliminarily validate an instrument assessing NH administrator self-efficacy in QI.
- To provide a tool for identifying strengths and weaknesses in QI leadership capabilities.
Main Methods:
- Mixed-methods cross-sectional design incorporating qualitative interviews and quantitative surveys.
- Item generation from 39 NH leader interviews; content validity established by 8 subject matter experts.
- Exploratory and confirmatory factor analyses on data from 211 NH administrators, stratified by Centers for Medicare and Medicaid Services (CMS) Five-Star Quality ratings.
Main Results:
- A 32-item, five-subscale instrument was finalized with strong psychometric properties.
- Confirmatory factor analysis supported the factorial structure with good fit indices.
- The measure demonstrated convergent, discriminant, and known-groups validity, correlating with established self-efficacy and locus of control measures and differentiating based on objective and subjective quality outcomes.
Conclusions:
- The developed instrument effectively measures NH administrator self-efficacy in QI.
- This tool can diagnose individual and organizational professional development needs for QI.
- Targeted professional development can enhance QI implementation success in nursing homes.
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