The Nursing Performance Instrument: Exploratory and Confirmatory Factor Analyses in Registered Nurses

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Abstract

Background:

The optimal performance of nurses in healthcare settings plays a critical role in care quality and patient safety. Despite this importance, few measures are provided in the literature that evaluate nursing performance as an independent construct from competencies. The nine-item Nursing Performance Instrument (NPI) was developed to fill this gap.

Purpose:

The aim of this study was to examine and confirm the underlying factor structure of the NPI in registered nurses.

Method:

The design was cross-sectional, using secondary data collected between February 2008 and April 2009 for the “Fatigue in Nursing Survey” (N = 797). The sample was predominantly dayshift female nurses working in acute care settings. Using Mplus software, exploratory and confirmatory factor analyses were applied to the NPI data, which were divided into two equal subsamples. Multiple fit indices were used to evaluate the fit of the alternative models.

Results:

The three-factor model was determined to fit the data adequately. The factors that were labeled as “physical/mental decrements,” “consistent practice,” and “behavioral change” were moderately to strongly intercorrelated, indicating good convergent validity. The reliability coefficients for the subscales were acceptable.

Conclusions/Implications for Practice:

The NPI consists of three latent constructs. This instrument has the potentialto be used as a self-monitoring instrument that addressesnurses’ perceptions of performance while providing patient care.

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