Using the Nursing Culture Assessment Tool (NCAT) in Long-Term Care: An Update on Psychometrics and Scoring Standardization
Abstract
:1. Introduction
2. Experimental Section
2.1. Design
2.2. Setting and Participants
2.3. Power Analysis
2.4. Measurement—Survey Instrument
2.5. Data Collection/Methods/Procedures
2.6. Data Analysis
3. Results and Discussion
3.1. NCAT’s Dimensionality Supported
Statistical Procedure (n = 1025) | Finding |
---|---|
Comparative Fit Index (CFI) | 0.932 |
Standardized Root Mean Square (SRMR) | 0.048 |
Cronbach’s Alpha Reliability Coefficients: | |
NCAT Total Score | 0.94 |
NCAT Subscale Scores: | |
• Expectations | 0.85 |
• Behaviors | 0.71 |
• Teamwork | 0.91 |
• Communication | 0.79 |
• Satisfaction | 0.82 |
• Professional Commitment | 0.91 |
Subscale | Item # | Factor Loading | Standard Error |
---|---|---|---|
Expectations | 1 | 0.869 | 0.011 |
2 | 0.873 | 0.011 | |
3 | 0.727 | 0.018 | |
Behaviors | 4 | 0.631 | 0.021 |
5 | 0.746 | 0.018 | |
6 | 0.676 | 0.020 | |
Teamwork | 7 | 0.780 | 0.014 |
8 | 0.859 | 0.010 | |
9 | 0.863 | 0.010 | |
10 | 0.861 | 0.010 | |
Communication | 11 | 0.740 | 0.017 |
12 | 0.685 | 0.019 | |
13 | 0.809 | 0.014 | |
Satisfaction | 14 | 0.804 | 0.014 |
15 | 0.869 | 0.013 | |
Commitment | 16 | 0.855 | 0.010 |
17 | 0.772 | 0.014 | |
18 | 0.912 | 0.008 | |
19 | 0.852 | 0.010 | |
Overall Culture Scale | Expectations | 0.820 | 0.016 |
Behaviors | 0.962 | 0.015 | |
Teamwork | 0.831 | 0.014 | |
Communication | 0.965 | 0.011 | |
Satisfaction | 0.891 | 0.013 | |
Commitment | 0.398 | 0.029 |
3.2. NCAT’s Normative Scores
Nursing Culture Total Score | |||||
---|---|---|---|---|---|
Total Score | Cumulative % Rank | Total Score | Cumulative % Rank | Total Score | Cumulative % Rank |
76 | 100 | 57 | 30.9 | 38 | 0 |
75 | 100 | 56 | 25.5 | 37 | 0 |
74 | 100 | 55 | 12.7 | 36 | 0 |
73 | 100 | 54 | 9.1 | 35 | 0 |
72 | 100 | 53 | 3.6 | 34 | 0 |
71 | 100 | 52 | 3.6 | 33 | 0 |
70 | 100 | 51 | 3.6 | 32 | 0 |
69 | 98.2 | 50 | 1.8 | 31 | 0 |
68 | 96.4 | 49 | 0 | 30 | 0 |
67 | 96.4 | 48 | 0 | 29 | 0 |
66 | 92.7 | 47 | 0 | 28 | 0 |
65 | 90.9 | 46 | 0 | 27 | 0 |
64 | 89.1 | 45 | 0 | 26 | 0 |
63 | 87.3 | 44 | 0 | 25 | 0 |
62 | 81.8 | 43 | 0 | 24 | 0 |
61 | 72.7 | 42 | 0 | 23 | 0 |
60 | 58.2 | 41 | 0 | 22 | 0 |
59 | 43.6 | 40 | 0 | 21 | 0 |
58 | 38.2 | 39 | 0 | 20 | 0 |
19 | 0 |
Cumulative Rank Percentage | ||||||
---|---|---|---|---|---|---|
Total Score | Expectations | Behaviors | Teamwork | Communication | Satisfaction | Professional Commitment |
16 | 100 | 100 | ||||
15 | 100 | 92.7 | ||||
14 | 100 | 52.7 | ||||
13 | 92.7 | 9.1 | ||||
12 | 100 | 100 | 87.3 | 100 | 1.8 | |
11 | 98.2 | 100 | 58.2 | 98.2 | 0 | |
10 | 94.5 | 92.7 | 25.5 | 90.9 | 0 | |
9 | 50.9 | 58.2 | 3.6 | 56.4 | 0 | |
8 | 12.7 | 10.9 | 0 | 10.9 | 100 | 0 |
7 | 1.8 | 0 | 0 | 0 | 98.2 | 0 |
6 | 0 | 0 | 0 | 0 | 92.7 | 0 |
5 | 0 | 0 | 0 | 0 | 27.3 | 0 |
4 | 0 | 0 | 0 | 0 | 1.8 | 0 |
3 | 0 | 0 | 0 | 1.8 | ||
2 | 1.8 |
3.3. Using the NCAT to Guide Change
Steps | Planned Change Exemplar | ||
---|---|---|---|
Administer and score the NCAT to establish baseline | All RNs, LPNs, CNAs at your Facility | ||
Compare unit/facility performance to Normative NCAT Total Score | Facility Mean Score = 60 (Cumulative Rank 58.2%) | ||
Compare facility mean subscale score to Cumulative Rank Percentage for respective subscale. | Subscale | Mean | Cum % |
Behaviors | 9.8 | 92.7% | |
Expectations | 9.44 | 50.9% | |
Teamwork | 10.78 | 58.2% | |
Communication | 9.7 | 90.9% | |
Satisfaction | 6.33 | 92.7% | |
Prof Commitment | 14.39 | 52.7% | |
Identify dimension(s) for targeted improvement | Clarify Expectations; strengthen Teamwork | ||
Engage in improvement planning | Develop and implement plan:
| ||
Re-administer NCAT | Prior to introducing change and 3 to 6 month intervals as indicated | ||
Evaluate progress | Revise improvement plan accordingly |
4. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
References and Notes
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Kennerly, S.; Heggestad, E.D.; Myers, H.; Yap, T.L. Using the Nursing Culture Assessment Tool (NCAT) in Long-Term Care: An Update on Psychometrics and Scoring Standardization. Healthcare 2015, 3, 637-647. https://doi.org/10.3390/healthcare3030637
Kennerly S, Heggestad ED, Myers H, Yap TL. Using the Nursing Culture Assessment Tool (NCAT) in Long-Term Care: An Update on Psychometrics and Scoring Standardization. Healthcare. 2015; 3(3):637-647. https://doi.org/10.3390/healthcare3030637
Chicago/Turabian StyleKennerly, Susan, Eric D. Heggestad, Haley Myers, and Tracey L. Yap. 2015. "Using the Nursing Culture Assessment Tool (NCAT) in Long-Term Care: An Update on Psychometrics and Scoring Standardization" Healthcare 3, no. 3: 637-647. https://doi.org/10.3390/healthcare3030637