The nursing home certified nurse assistant work environment, staffing and outcomes model: Development of the Nurse Assistant Work Index

This research developed a survey instrument that identified organizational attributes in the work environment that are posited to influence certified nurse assistants' (CNAs) ability to deliver quality care to nursing home residents, and that support recruitment and retention of CNAs. The conceptual framework---The Nurse Assistant Work Environment, Staffing and Outcomes theoretical model---and the survey instrument---The Nurse Assistant Work Index (NAWI)---were derived from magnet hospital studies.;Psychometric properties of the NAWI were identified using factor analysis and item reliability testing. Seven items loaded on the factor Nurse Assistant-Nurse Relationship and explained 41 percent of the factor variance. Six items loaded on the factor Resource Adequacy, accounting for 32 percent of the factor variance. Cronbach's alpha coefficients were 0.84 and 0.73 respectively. A third factor Administrative Support was eliminated because it loaded three items relating to perceived delivery of quality care.