Testing of the Factor Structure of the Nursing Work Index-Revised

Background: Recent research has questioned the reliability and validity of the Nursing Work Index-Revised (NWI-R) instrument, raising the possibility that managers reconfiguring hospitals in line with the factors derived from the NWI-R may be misdirecting resources.Aim: To test the factor structure of the NWI-R.Approach: A population of 864 acute hospital nurses was surveyed using the NWI-R, and a response rate of 449 (52%) was achieved. The statistical factor model was examined using SPSS 11.5 and based on guidelines of successful factor analysis. Measures of internal consistency were calculated for each of the factors to emerge from the data.Findings: The findings confirm appropriateness of conducting a factor analysis on the NWI-R. A core three-factor structure emerged from the findings that are generic to all but one of the studies exploring the factor structure of the NWI-R. These factors were adequate staffing and resources, nurse management, and the doctor–nurse relationship. The factors suggested good measures of internal consistency.Implications: The composition of the factors shares similarities with the original factors of the NWI-R. The authors recommend that the factors be renamed and the data reinterpreted in light of the new findings. The findings also raise interesting questions about the role a nurse's practice environment plays in a nurse's work life.