Background: Little research exists on the context within which nursing care is delivered or of the dimensions of context, which promotes evidence based practice.  The research to be presented identified the contextual indicators that enabled or hindered effective evidence based continence care in rehabilitation settings for older people.
Aims: To develop, psychometric evaluate and test the utility of the CAI.Methods: Two study sites - an 80-bed rehabilitation unit in Southern Ireland and a 78-bed rehabilitation unit in Northern Ireland participated. A case study comprising of 2 phases was conducted.  In Phase 1 the Royal College of Physician instrument measured prevalence and management of incontinence (n= 220), a staff knowledge questionnaire (n=97) the Nursing Work Index (n=133) semi structured observations (16 hours) of practice and focus groups (n=26) were used to develop statements of context.  In phase 2 a 54 item questionnaire was devised and completed by 960 RNs.  Principal components analysis, exploratory factor analysis, varimax rotated extraction, internal consistency reliability and test retest for reliability, stability and homogeneity were used to construct the resulting 40 item scale – the CAI.

Results: Five factors – collaborative practice, evidence informed practice, respect for persons, practice boundaries and evaluation explained 64% of the variance.  The internal consistency reliability of the CAI was 93, and ranged for subscales from 78 to 91.
Conclusions: Context is a multidimensional phenomenon.  The CAI has initial reliability and validity.  It has extended knowledge on practice context and will continue to be tested within diverse practice context areas Context is a multidimensional phenomenon.  The CAI has initial reliability and validity.  It has extended knowledge on practice context and will continue to be tested within diverse practice context areas