Development and Validation of the Nurse Prescribing Self-Efficacy Scale

Abstract

Low self-efficacy is a barrier to effective nurse prescribing. Therefore, nurses’ self-efficacy should be assessed using validated tools. We aimed to develop and psychometrically test the Nurse Prescribing Self-Efficacy Scale (NP-SES). We conducted an observational cross-sectional study with 290 nurses between January and June 2019. We studied the NP-SES’ reliability (i.e., internal consistency and temporal stability), validity (i.e., content, criterion, and construct) and legibility. The NP-SES showed good internal consistency (Cronbach’s alpha=0.958) and temporal stability (intraclass correlation coefficient=0.783). The NP-SES also showed good content validity (scale’s content validity index=0.98) and criterion validity ( r=0.75; p<0.001). Construct validity analysis revealed the NP-SES’ three-dimensional structure and showed its ability to detect significant differences between nurses with different levels of experience. Our psychometric analysis suggests that the NP-SES is a reliable and valid instrument that could be used to assess nurses’ self-efficacy in nurse prescribing.

Translation, Cross-Cultural Adaptation, and Validation of the Galician Version of the Nurse Prescribing Self-Efficacy Scale

“…NP-SES was developed by Galiana–Camacho et al [ 8 ] in 2021. The researchers designed a questionnaire of 19 items that were scored on a 100-point scale (0 = totally sure I cannot do it to 100 = totally sure I can do it) with a minimum score of 0 points and a maximum of 190 points.…”

“…An average of all items is obtained to calculate total and dimensions scores, which are then converted to a 100-point scale, in order to facilitate the interpretation of nurses’ self-efficacy in NP. Internal consistency of the original scale was 0.958 for global composite score, 0.864 for clinical assessment and pharmacological knowledge, 0.914 for supplementary prescribing and evidence-based practice, and 0.951 for independent prescribing and patient education dimension [ 8 ]. G-NP-SES was the terminology used to refer to the Galician version ( Supplementary Materials, Table S1 ).…”

“…The former encompasses, among other things, gender-associated constraints [ 5 ]—as well as the opposition of physicians, since it might compromise patient safety [ 6 ]. No less important are the barriers specific to nurses, such as nurses’ uncertainty about their educational preparation [ 7 ], or their lack of self-efficacy to perform NP [ 8 ]. These latter barriers explain why sometimes nurses have refused to use their legal prescribing rights on the work floor [ 9 ].…”

“…Several scales have been used to evaluate the self-efficacy of nurses [ 14 , 15 , 16 ]; however, to the best of our knowledge, the Nurse Prescribing Self-Efficacy Scale (NP-SES), developed by Galiana–Camacho et al [ 8 ], is the only reliable and valid instrument for the assessment of nurses’ self-efficacy to prescribe. NP-SES comprises three dimensions which are in line with international competency frameworks for prescribers and are considered central to NP: clinical assessment and pharmacological knowledge, supplementary prescribing and evidence-based practice, and independent prescribing and patient education.…”

“…NP-SES comprises three dimensions which are in line with international competency frameworks for prescribers and are considered central to NP: clinical assessment and pharmacological knowledge, supplementary prescribing and evidence-based practice, and independent prescribing and patient education. The assessment of the level of confidence that nurses have about their pharmacological knowledge, diagnostic ability, and clinical decision-making capacity allows us to determine their self-efficacy for all the main actions of the NP process [ 8 , 17 ].…”