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Instrument development for NEAT: Nurse's Environmental Awareness Tool
Western Institute of Nursing Annual Communicating Nursing Research Conference (2014)
  • Elizabeth Schenk, Providence St. Joseph Health
Purpose/Aims: No psychometrically analyzed instrument that measures nurse awareness of the environmental impacts of nursing practice is available in the literature. The NEAT: Nurse’s Environmental Awareness Tool has been developed and analyzed in two testing cycles. The tool consists of 6 scales measuring nurses’ awareness of the environmental impacts of nursing practice and mitigating factors that may influence nurses’ behaviors at home and work. The results from two cycles of exploratory factor analysis of the six scales will be described. Conceptual Basis/Background: The study was guided by two conceptual frameworks: The Integrated Change Model which links awareness to behavior change and the EWTE Wheel which describes the four domains of environmental impacts addressed (energy, waste, toxic chemicals, engagement). There is an increasing awareness that health care delivery may pose long-term health risks to the public through environmental impacts stemming from excessive energy use, the creation of large volumes of waste, and the generation and use of toxic chemicals. Nursing is a major stakeholder in the health delivery system; thus it is critical to understand nurses’ awareness of and engagement with the environmental impact of their practice. Methods: A pool of items (160) was developed based on the two conceptual frameworks. The pool of items linked awareness to behavior in the four domains (energy, waste, toxic chemicals, engagement). After item development, the draft scales were tested in two cycles, using a web-based electronic survey format. The pilot phase queried 306 registered nurses from four hospitals in California and Washington. The study phase queried 389 registered nurses in three hospitals in Oregon and Washington. Using the responses from each phase, analysis was performed using descriptive statistics, exploratory factor analysis, and by measuring Cronbach’s alpha. After each phase the scale was refined. Results: Six 1-factor scales of 9 to 11 items each were derived. Five of the six scales had Cronbach’s alphas over 0.700, ranging from 0.785 to 0.934. The sixth scale had a Cronbach’s alpha of 0.676, which merits further examination and refinement to strengthen the scale. Next steps in development of NEAT will include Confirmatory Factor Analysis and ongoing testing of each of the constructs in different samples. Implications: The Nurses Environmental Awareness Tool is the first psychometrically analyzed instrument to measure nurses’ awareness of the environmental impacts of nursing practice. The NEAT will provide opportunities for further research, including studying differences in nurse awareness across demographic features, and studying links between awareness of environmental impacts of nursing practice and behaviors to mitigate those impacts. The scale gives researchers an opportunity to study professional ecological behaviors: actions nurses can take at the work place to decrease their environmental impacts. By having a tool to objectively study this issue, nurses in acute care settings can begin to examine their practice and advance toward meeting their professional standard to practice in an environmentally safe and healthy manner.
Publication Date
April, 2014
Seattle, WA, United States
Citation Information
Elizabeth Schenk. "Instrument development for NEAT: Nurse's Environmental Awareness Tool" Western Institute of Nursing Annual Communicating Nursing Research Conference (2014)
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