Nursing practice models (NPMs) provide a framework for the organization and delivery of nursing care to residents in long-term care (LTC) facilities. Given the national nursing home work force shortage, it is crucial that intensive efforts to ensure the limited supply of nursing staff is used in the most effective and efficient manner to achieve optimal outcomes for residents. This instrument development study will identify and validate the components of NPMs in LTC facilities. This initial study will contribute to the long-term objective which is to test a conceptual model relating the components of NPMs, influencing factors, and resident staff and organizational outcomes and provide nurse administrators in LTC facilities a decision making tool to characterize and diagnose their NPM and modify aspects of the NPM to improve resident, staff and organizational outcomes. Operationalizing NPM components for LTC facilities will include developing theoretical definitions, observable indicators, a means for measuring the indicators and evaluating the adequacy of the operational definitions. This will be followed by pilot testing the instrument that operationalizes the measures to estimate the reliability and validity of the measure. Focus groups will be used to validate the NPM components and associated theoretical definitions and to also identify potential measurement indicators for the components. The measurement items associated with the NPM components will be evaluated for content validity through the use of nurse experts. The revised measurement items will be assessed for feasibility, clarity and burden by nurse administrator experts and pre-testing the instrument in one facility. Following revisions, the instrument will be pilot tested in 10 randomly selected LTC facilities stratified according to proprietary status and bed size within a 50 mile radius of the University of Minnesota-Minneapolis. There will be approximately 40 nursing units in these ten facilities with a total of 1,200 nursing staff. The proposed instrument that will be developed for this study measuring NPM components will be a questionnaire to be completed by nursing staff on nursing units. The psychometric properties of the instrument will be evaluated through the pilot study by assessing construct validity through factor analysis and the contrasted groups approach and assessing the internal consistency of the NPM subscales comprising the instrument.
|Mueller, Christine; Savik, Kay (2010) Identifying and validating the components of nursing practice models for long-term care facilities. Res Gerontol Nurs 3:270-81|