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clinical autonomy, control over nursing practice, healthy work environment



  1. Berndt, Andrea E. PhD
  2. Parsons, Mickey L. PhD, MHA, RN, FAAN
  3. Paper, Bruce BA
  4. Browne, Jennifer A. MSN, RN


This article describes the development and preliminary evaluation of the Healthy Workplace Index (HWPI), a 37-item scale measuring essential components of healthy workplace (HWP) environments. The HWPI was based on Parsons' Healthy Workplace Intervention framework and is rooted in staff empowerment, shared leadership, and participatory change management. Participants were staff nurses (n = 160) at a large university teaching hospital in the southwestern United States. Preliminary analyses supported the existence of 4 factors on the HWPI, with reliability coefficients for internal consistency ranging from 0.88 to 0.93. Factor scores from the HWPI were correlated to 5 subscale scores of the Practice Environment Scale of the Nursing Work Index (PES-NWI) to determine their degree of shared relationships. Relationships between subscales of PES-NWI and the HWPI factors were strong and positive, suggesting that researchers may be able to substitute the HWPI for the PES-NWI to measure HWP characteristics. Potential advantages for HWPI substitution include the ability to measure different aspects of HWPs and the use of a tool that nurses and staff can complete.