Development of the Nursing Quality Improvement in Practice Tool: Advancing Frontline Nursing Practice

Dana Tschannen, Catherine Alexander, Elizabeth G. Tovar, Bidisha Ghosh, Cindy Zellefrow, Kerry A. Milner

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


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 α 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.

Original languageEnglish
Pages (from-to)372-379
Number of pages8
JournalJournal of Nursing Care Quality
Issue number4
StatePublished - Oct 1 2020

Bibliographical note

Publisher Copyright:
Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.


  • nurse engagement in quality improvement
  • nursing
  • quality improvement
  • quality improvement competencies
  • tool development

ASJC Scopus subject areas

  • Nursing (all)


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