Development and Testing of the Nurse Manager EBP Competency Scale

BACKGROUND: Nurse managers are ideally situated within an organization to influence implementation and use of evidence-based practices (EBP) (Birken, Lee, & Weiner, 2012; Stetler, Ritchie, Rycroft-Malone, & Charns, 2014). Although EBP competency is one of five core competencies espoused by the Institute of Medicine, nurse managers report a lack of confidence in EBP (Gifford, Lefebre, & Davies, 2014). Few studies have examined the role of nurse managers in promoting EBPs and no instruments are available to measure nurse manager EBP competencies. To explicate the relationship among the role of nurse managers, the practice culture that fosters application of evidence, and patient outcomes, it is imperative that a valid and reliable instrument to measure nurse manager EBP competencies is developed for use in future research. The purpose of this study was to develop a reliable and valid tool to measure competencies of nurse managers regarding EBP.

METHODS: Items for the Nurse Manager EBP Competency Scale were premised on the Promoting Action on Research Implementation in Health Services’ (PARIHS) context domain and developed from prior research, resulting in 16-items on a Likert response scale (0= not competent; 1= somewhat competent; 2= fully competent; 3= expertly competent). After eight EBP experts analyzed face and content validity, the scale was pilot tested with four nurse managers from medical-surgical units. For this study, 130 inpatient and ambulatory nurse managers from one academic medical center and two community hospitals were invited to participate. A gift card lottery drawing and email reminders encouraged response. Cronbach’s alpha was used to evaluate reliability and exploratory factor analysis with Varimax rotation evaluated validity of the Nurse Manager EBP Competency Scale.

RESULTS: 83 nurse managers (n=49 inpatient; n=34 ambulatory) completed the scale resulting in a 63.8% overall response rate. Cronbach’s alpha for the entire scale was .95. Exploratory factor analysis resulted in a 16-item scale with two subscales, EBP Knowledge (n= 6 items, α=.90) and EBP Activity (n= 10 items, α=.94).

CONCLUSION: The Nurse Manager EBP Competency Scale is a brief, psychometrically sound measure of nurse manager EBP competency. As the first measure of this context element, the scale can enhance our understanding in future studies regarding how nurse manager EBP competency effects EBP implementation.