Sample: 500 randomly selected registered nurses were invited to participate in the study.  Eligibility criteria included full or part time registered nurses currently working at the hospital.  Travel nurses, agency nurses, per diem nurses, and seasonally-employed nurses were excluded from participation in the study.  

Method: After approval from the Institutional Review Board (IRB) of the hospital, the Practice Environment Scale of the Nursing Work Index (Lake, 2002) was administered to subjects at three timepoints.  The first measure occurred in the first three months of a nursing organizational restructuring which consisted of restructuring the clinical coordinator role to a clinical manager role with 24/7 accountability for their unit; implementation of a collaborative council shared governance model; and the assignment of a nursing Clinical Practice Specialist or Clinical Nurse Specialist to oversee quality and safety in every nursing area.  The second measure occurred at six months post-implementation, and the third and final measure occurred at one year post- implementation.  A demographic survey was also completed at the first timepoint to look for differences in the subject’s level of education, years of experience in nursing and at the hospital, and if they held national certification.

Results: 70 registered nurses elected to participate in the study.  One-way repeated measures ANOVA demonstrated small but significant changes in three of the five subscales.  Changes were detected in Nurse Participation in Hospital Affairs subscale (p=.001); Nurse Manger Ability, Leadership and Support of Nursing subscale (p=.008), and the Collegial Nurse-Physician Relations subscale (p=.003).

Conclusions:  The use of the Practice Environment Scale of the Nursing Work Index (Lake, 2002) is a useful instrument in detecting the effects of nursing organizational change.

 Implications: The items and subscales of the Practice Environment Scale of the Nursing Work Index (Lake, 2002) can be used to assess the effectiveness of efforts to improve the professional practice environment, nurse satisfaction, and perceived quality of care by nurses in an organization.  Future research should link this measure to RN turnover and nurse-sensitive patient outcomes.