# Development and Validation of a Nurse‐Specific Scale to Assess Influencing Factors in Clinical Practice Guideline Implementation: An i‐PARIHS‐Based Study

## TL;DR

This study created a reliable tool to assess factors affecting nurses' use of clinical guidelines in China.

## Contribution

A new nurse-specific scale was developed and validated for evaluating clinical guideline implementation factors.

## Key findings

- The CPGIF-N scale showed high content validity and strong psychometric properties.
- Confirmatory factor analysis confirmed the scale's validity and reliability among nurses.
- The tool is practical for evaluating guideline implementation in nursing practice.

## Abstract

Clinical practice guideline (CPG) is essential for improving the quality and consistency of care. However, gaps between guideline recommendations and nursing practice remain, contributing to adverse patient outcomes. A theory‐based tool is needed to systematically assess factors that influence nurses’ implementation of CPG.

To develop and validate the Clinical Practice Guideline Implementation Influencing Factors for Nurses (CPGIF-N) scale for identifying factors affecting CPG implementation among nurses.

Items were generated through a scoping review and refined via two‐round Delphi reviews. A pilot survey with 40 nurses and a cross‐sectional survey with 1005 nurses from eight tertiary hospitals were conducted. Both classical test theory (CTT) and item response theory (IRT) analyses were performed.

A total of 637 valid responses were analyzed. Content validity indices were high (I‐CVI: 0.93–1.00; S‐CVI/Ave: 0.99). The IRT analysis indicated that the final items demonstrated good discrimination (a = 1.278–4.579), ordered threshold parameters (b
1 to b
4), and acceptable to excellent average information (range: 0.700–2.161). Confirmatory factor analysis revealed acceptable‐fit indices (χ
2
/df = 1.956, RMSEA = 0.055, CFI = 0.935, TLI = 0.929). Average variance extracted values (0.818, 0.632, and 0.815) and composite reliability values (0.973, 0.941, and 0.982) confirmed convergent validity. The scale demonstrated excellent internal consistency (Cronbach’s α = 0.972; McDonald’s Omega = 0.982).

The CPGIF-N scale is a reliable and valid instrument, with strong psychometric properties, offering a practical tool to evaluate factors influencing CPG implementation among nurses in China.