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  1. Tschannen, Dana PhD, RN
  2. Alexander, Catherine DNP, MPH, RN
  3. Tovar, Elizabeth G. PhD, APRN
  4. Ghosh, Bidisha MS
  5. Zellefrow, Cindy DNP, MSEd, RN, LSN, PHNA-BC, EBP-C
  6. Milner, Kerry A. DNSc, RN


Background: Frontline nurse engagement in quality improvement (QI) improves nurse-sensitive outcomes; yet research suggests frontline nurses are not engaging in QI.


Purpose: The purpose of this study was to develop, refine, and psychometrically evaluate the Nursing Quality Improvement in Practice (N-QuIP) tool to measure nurses' competency, engagement, and barriers/facilitators to QI engagement.


Methods: Item development was guided by an expert panel and literature review. Factor analysis and reliability indices were assessed through 681 surveys completed by nurses at one medical center.


Results: Cronbach [alpha] coefficients were 0.97 (Skill Scale) and 0.90 (Attitude Scale). Kuder-Richardson Formula 20 (KR-20) for knowledge was 0.36. Exploratory factor analysis identified 4 (Skill) and 3 (Attitude) subscales respectively, aligning well with QI competencies.


Conclusions: Preliminary data suggest that the N-QuIP is a valid and reliable tool for assessing nurse QI competence and engagement. Understanding current knowledge, skills, and attitudes and identified barriers/facilitators can help the development of strategies aimed at increasing QI engagement.