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Measuring First-Line Nurse Manager Work: Instrument Development and Testing

Cadmus, Edna PhD, RN, NEA-BC, FAAN; Wisniewska, Edyta K. RN, BS

Journal of Nursing Administration: December 2013 - Volume 43 - Issue 12 - p 673–679
doi: 10.1097/NNA.0000000000000010

OBJECTIVE: The objective of this study was to develop and test a 1st-line nurse manager (FLNM) work instrument to measure categories of work and frequency of activities.

BACKGROUND: First-line nurse managers have been demonstrated to be key contributors in meeting organizational outcomes and patient and nurse satisfaction. Identifying the work of FLNMs is essential to help in the development of prioritization and sequence. The need for an instrument that can measure and categorize the work of FLNMs is indicated.

METHODS: The author-developed instrument was administered as a pilot study to 173 FLNMs in New Jersey. Descriptive statistics were analyzed, and validity and reliability were measured.

RESULTS: Content validity was established through 2 focus groups using 10 FLNMs and conducting a survey of 5 chief nursing officers. Reliability was assessed by 13 of 16 FLNM participants using the test/retest method and quantified using percent agreement within a 10-day period. Those items with 70% agreement or more were identified as reliable and retained on the instrument.

CONCLUSIONS: The content validity of the instrument is strong; further refinement and testing of the tool are indicated to improve the reliability and generalizability across multiple populations of leaders and settings.

Supplemental Digital Content is available in the text.

Author Affiliations: Clinical Professor, Specialty Director, Leadership Tracks (Dr Cadmus), College of Nursing, Rutgers the State University, Newark; Staff Nurse (Ms Wisniewska), Hackensack University Medical Center, New Jersey.

Partial funding of this research was made possible through the 2011 Dean’s Summer Research Development Program, Rutgers the State University, College of Nursing ($13,230), and through a Research Award from CGEAN ($2,500).

The authors declare no conflicts of interest.

Correspondence: Dr Cadmus, Rutgers College of Nursing, 180 University Ave, Newark, NJ 07102 (

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins