Learning Objective #1: discuss the Practice Envionment Scale (Lake, 2002) and how the instrument's measuremnt properties behave when used among a military nurse population.

Learning Objective #2: describe the validity of using the Practice Environment Scale to measure the Army hospital nurse practice environment.

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Aim: Investigators use numerous instruments to measure the hospital nurse practice environment. However, all were developed for use with civilians, not military populations. The aim of this study was to test to what extent the Practice Environment Scale (Lake, 2002) was valid for use among  U.S. Army and Department of the Army civilian (DAC) nurses.

  Research Design, Sample, Methods:  A secondary data analysis examined Army (n = 333) and DAC inpatient staff nurses (n = 408) who participated in a cross-sectional study examining the Army hospital work environment.  Measurement models were constructed based on the Practice Environment Scale’s 29 items and 5 subscales.
 
Data Analysis Procedure:  Multi-sample structural equation modeling was used to test similarities and differences in the Practice Environment Scale's psychometric properties when used among the two groups of nurses. Confirmatory factor analysis was used to test construct validity.
           
Results:  Findings support the instrument’s construct validity (x²/df = 2.59 [x² = 1062.17, df 409, p < .05]; RMSEA = .066 [90% CI = .061, .071]; CFI = .99, Critical N = 333; RMR = .015).  However, sub set analysis suggest that Army and DAC nurses responded differently to the instrument’s indicators related to the foundations for quality of care, management’s leadership ability and physician nurse relationships.
 
Discussion:  Despite evidence of construct validity, the Practice Environment Scale may need modification to capture the full meaning of the hospital nurse practice environment for Army nurses. Investigators must consider these differences when drawing conclusions about how the perception of Army and civilian nurses is influenced by the hospital nurse practice environment.