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Development and Validation of a Nurse-Specific Scale to Assess Influencing Factors in Clinical Practice Guideline
Lu Liu1, Namuna Dallakoti1, Wei Cui2
1School of Nursing, Capital Medical University, Beijing, CN 100069, China, ccmu.edu.cn.
Background:
Clinical practice guideline (CPG) is essential for improving the quality and consistency of care. However, gaps between guideline recommendations and nursing practice remain, contributing to adverse patient outcomes. A theory-based tool is needed to systematically assess factors that influence nurses' implementation of CPG.
Objective:
To develop and validate the Clinical Practice Guideline Implementation Influencing Factors for Nurses (CPGIF-N) scale for identifying factors affecting CPG implementation among nurses.
Methods:
Items were generated through a scoping review and refined via two-round Delphi reviews. A pilot survey with 40 nurses and a cross-sectional survey with 1005 nurses from eight tertiary hospitals were conducted. Both classical test theory (CTT) and item response theory (IRT) analyses were performed.
Results:
A total of 637 valid responses were analyzed. Content validity indices were high (I-CVI: 0.93-1.00; S-CVI/Ave: 0.99). The IRT analysis indicated that the final items demonstrated good discrimination (a = 1.278-4.579), ordered threshold parameters (b 1 to b 4), and acceptable to excellent average information (range: 0.700-2.161). Confirmatory factor analysis revealed acceptable-fit indices (χ 2 /df = 1.956, RMSEA = 0.055, CFI = 0.935, TLI = 0.929). Average variance extracted values (0.818, 0.632, and 0.815) and composite reliability values (0.973, 0.941, and 0.982) confirmed convergent validity. The scale demonstrated excellent internal consistency (Cronbach's α = 0.972; McDonald's Omega = 0.982).
Conclusions:
The CPGIF-N scale is a reliable and valid instrument, with strong psychometric properties, offering a practical tool to evaluate factors influencing CPG implementation among nurses in China.
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