The Psychometric Properties of the Chinese Version of the Revised Professional Practice Environment Scale (RPPE): Utilized in Assessing Quality Control

It is axiomatic that an effective Professional Practice Environment (PPE) enhances nurses’ performance that leads to superior patient care. The PPE is defined as the organization’s culture that advances clinical practice of nurses by acknowledging agreement of purpose and organizational alignment [1]. An effective PPE will support nurses’ professional judgment, knowledge and skill while providing patient centered, quality care [1]. The research literature documents that improving the nurses’ PPE, positively effects job satisfaction, decreases burnout, lowers turnover, and improves patient care [2]. Consequently, the chief nurse is the primary architect in developing an effective PPE. Farley and Nyberg [3] highlighted the importance for organizations to describe and analyze nurses’ PPE and the relationships among the environments to help organizations identify areas for quality improvements.

To assess the dynamics of the PPE, Ives-Erickson, Jones & Ditomassi [1] developed the Professional Practice Environment Scale (PPES) that later evolved to the Revised Professional Practice Environment Scale (RPPES) (Table 1). The scales have been employed in myriad studies and have become the standard for PPE assessment and have demonstrated excellent psychometric properties across countries. While nursing PPE has been a vital area of research in western countries for the last decade, this concept has only recently gained global attention [4]. One recent development was the translation of the RPPE to Chinese. The aim of this research was to assess the psychometric properties of the Chinese version of the RPPE so it could be utilized as a quality control instrument.

Table 1: The Revised Professional Practice Environment Scale (RPPES).

Participants

Instrumentation

Statistical analyses

Although the chi-square test was significant, p<.01, the model yielded acceptably high goodness of fit indices (.923 and .945) for both the CFI and the TLI respectively. The RMSEA achieved a value of .08 indicating an acceptable fit of the model in relation to the degrees of freedom. With the single exception of one item on the motivation scale (item 7), all items loaded significantly on their respective factors, p<.01. The item factor loadings are provided in Table 2.

These initial findings support the construct validity of the Chinese’s version of the Revised Professional Practice Environment (RPPE) Scale to be utilized reliably as an instrument to assess quality control. To address some of the limitations of this study, data were collected one organization, which limited the sample size. However, this hospital is committed to deliver westernized evidence based medicine. To produce more accurate Standard Errors (SE) and confidence intervals of measured item, we employed the bootstrap procedure to compensate for the sample size. Future research will need to be conducted to determine if these findings are generalized to other settings and hospitals. Nonetheless, these findings contribute to the present knowledge of assessing the PPE and supports the utility of evaluating quality control in foreign hospitals committed to deliver westernized evidence based medicine.

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