Development and Psychometric Evaluation of Registered Nurses' Clinical Leadership Scale (RN-CLS) in Bangladesh

Abstract

For nurses as the largest and frontline healthcare workforce, effective clinical nurse leadership (CNL) is vital to ensure cost-effective high-quality patient care and implement positive change in improving the standard of clinical care. However, there was no any instrument existed in Bangladesh to assess leadership skills of clinical nurses. This study aimed to develop and evaluate the psychometric properties of a Registered Nurses' Clinical Leadership Scale (RN-CLS) in the context of healthcare in Bangladesh. In developing RN-CLS, the scale development guidelines of DeVellis (2017) were used that comprised two phases including development phase and evaluation phase. The study participants were selected from two medical college hospitals in Bangladesh using a purposive sampling method. A total 627 clinical RN's data were used to examine the factor structure of the RN-CLS. The construct validity was examined by exploratory factor analysis (EFA) and known group techniques. The internal consistency reliability was examined by Cronbach's alpha coefficient and stability reliability was ensured by test-retest methods. The EFA confirmed the RN-CLS with 9 (nine) factors for 92 items with a total percentage of accounted variance 52.06%. The extracted factors were: assessment and evaluation; patient-centered intervention; imply quality and safety; caring relationship; interdisciplinary collaboration; skills of communication; professional values in caring; decision-making and problem-solving; and professional development. The overall internal consistency Cronbach's alpha was 0.96 and across the factors ranged from 0.84 to 0.92. The result of the contrasted group validity found a significant mean difference on the scores of RN-CLS between low and high-performance groups (p<.01). A significantly high correlation (r=0.92, p<.001) was found between the two tests scores on the RN-CLS, indicated a high stability reliability. In conclusion, RN-CLS demonstrated the acceptable level of construct validity and reliability. These results supported the usefulness of RN-CLS as a valid and reliable measure for assessing the clinical leadership skills of the RNs in Bangladesh.