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  1. Huddleston, Penny PhD, RN, CCRN
  2. Gray, Jennifer PhD, RN, FAAN


BACKGROUND: The American Association of Critical-Care Nurses Healthy Work Environment Assessment tool (AACN HWEAT) was developed as a simple screening assessment for clinical units to quickly get individual feedback on the status of the nurses' work environments based on the AACN standards of a healthy work environment (HWE). Pilot studies were conducted to determine the psychometric properties of the tool after seeking permission from AACN and the Vital Smarts Company.


PURPOSES: The purposes of these research studies were to assess the psychometric properties of the AACN HWEAT and to measure the nurse leaders' and direct care nurses' perceptions of an HWE in an acute care setting.


METHODS: Nonexperimental descriptive survey designs were implemented with 3 convenience samples for a total sample of 321 nurse leaders and direct care nurses.


RESULTS: Cronbach's [alpha]s of .97 for nurse leaders and .91 for direct care nurses demonstrated strong reliability or internal consistency of the tool. Face validity demonstrated 13 of 18 items placed in the correct category. The scale content validity index score was 96.63. Concurrent validity demonstrated that items were highly correlated, ranging from 0.42, with 95% confidence interval (CI) of 0.57 to 0.69, to 0.85, with 95% CI of 0.70-0.93, P < .05. Principal component analysis revealed 2 components for the tool.


CONCLUSIONS: As a result of these findings, an opportunity was identified to develop additional tools to measure an HWE for nurses at all levels in acute care settings.