Nurse-Nurse Collaboration: A Reliable Scale to Describe Collaboration Among Clinical Nurses

Sunday, 29 October 2017: 4:35 PM

Cynthia Ann Leaver, PhD
Department of Nursing, Mertus Medical Center, Hagerstown, MD, USA
Roxann Rosendale, BSN
Department of Nursing, Meritus Medical Cen, Hagerstown, MD, USA
Sarah Harne-Britner, DNP
Department of Nursing, Meritus Medical Center, Hagerstown, MD, USA

Purpose: To describe the level of collaboration among clinical nurses in a semi-rural, MidAtlantic, hospital.

Background and significance:

Collaboration among nurses has been recommended to reduce errors, improve patient care outcomes, and increase job satisfaction. Previously nurse to nurse collaboration had been measured as a component of organizational structure. The Nurse-Nurse Collaboration Scale (NNC) (Dougherty, Larson, 2010) is a valid and reliable instrument developed to measure the level of collaboration among intensive care nurses. NNC measures the 5 domains of collaboration: conflict management, communication, shared process, coordination, and professionalism.  This project adapted, piloted, and utilized the Nurse-Nurse Collaboration Scale-Hospital Wide (NNC-HW) to describe the level of collaboration among clinical nurses hospital-wide.

Design: This descriptive-correlational study implemented the electronic survey method to implement the NNC-HW. Data was collected from 136 clinical nurses working in acute care settings at a semi-rural, MidAtlanic region hospital.

Methods: First, the NNC-HW was piloted using Cronbach’s alpha for reliability testing. Then, NNC-HW was implemented hospital wide. Again, Cronbach’s alpha was used for reliability testing. ANOVA was calculated to test differences among means of 5 subscales. Pearson Correlations coefficients were used to test for existence of relationships between the 5 subscales.

Findings: Reliability was identified as excellent for subscales communication, shared process, coordination, and professionalism (a=.94-.98). reliability was identified as good for subscale conflict management (a=.88). Nurses described the highest levels of collaboration existed between the subscales shared process and communication (r=.80), and coordination and professionalism (r=.81). However, nurses descried the lowest levels of collaboration among all subscale correlation with conflict management (r=.41-.47).


The NNC-HW was established as a reliable instrument for describing clinical nurse to nurse collaboration in the hospital setting. Conflict management was revealed as a subscale of collaboration that warrants further investigation and is an opportunity for intervention.

Clinical relevance:

An intervention addressing conflict management may support collaboration, therefore decreasing errors, improving patient outcomes, and increasing clinical nursing satisfaction.