Practice Environment Scale-Nursing Work Index Research Articles

Exploring the influence of nurses’ demographics and hospital work environment on medical error reporting practices in Jordan: a cross-sectional study

ObjectiveNurses have a significant role in maintaining patient and healthcare safety. Thus, healthcare administrators should focus on nurse performance and create a friendly hospital work environment to ensure patient safety...

The moderating role of work environment in the relationship between proactive personality and personal growth initiative among nurses: a cross-sectional study

BackgroundsPersonal growth initiative (PGI) is regarded as a meaningful concept with potential value at both the individual and organizational levels, but little is known about the factors that contribute to nurses’ PGI. This study aimed to explore how proactive personality and hospital work environment affect PGI of clinical nurses.MethodsA cross-sectional study was conducted between September and October 2022 among 4414 nurses from 10 tertiary general hospitals in 10 cities in Sichuan, China, using a two-stage sampling method. Self-reported anonymous online questionnaires, such as sociodemographic information survey, personal growth initiative scale II, the 10-item proactive personality scale, and practice environment scale-nursing work index were used to collect data. Multiple hierarchical regression analyses were performed to examine research hypotheses.ResultsAmong the control variables in this study, nurses’ self-perceptions of general health status and professional title positively predicted PGI (β = 0.462, 95%CI = 0.272–0.653; β = 1.078, 95%CI = 0.508–1.648). After adding control variables, both proactive personality (β = 1.143, 95%CI = 1.096–1.190) and work environment (β = 3.391, 95%CI = 2.904–3.879) positively predicted PGI. The work environment positively moderated the association between proactive personality and PGI (β = 0.108, 95%CI = 0.025–0.191). These predictors jointly explained 50.3% of the variance in PGI.ConclusionsNurses with a greater tendency to have a typical proactive personality have higher levels of personal growth initiative, and this positive effect will be better highlighted in a healthier work environment. Nursing managers should prioritize the employment of people with proactive personality traits, focus on the development and stimulation of proactive personality traits in nurses, and establish a supportive work environment to maximize the personal growth initiative of nurses.

The Relationship Between Professional Quality of Life and Work Environment Among Nurses in Intensive Care Units.

Nurses in intensive care units (ICUs) face high levels of stress and emotional challenges, making it essential to understand the factors that influence their professional quality of life (ProQoL). This study aimed to investigate the relationship between work environment factors and ProQoL, particularly focusing on burnout, compassion satisfaction, and secondary traumatic stress, among ICU nurses. The Professional Quality of Life (ProQoL) Scale was used to measure these aspects, with an emphasis on the importance of a supportive work environment for enhancing staff well-being and organizational performance. This cross-sectional study was conducted between March and August 2024, involving 162 ICU nurses from hospitals in the southern West Bank. A stratified random sampling method was employed to ensure representativeness. Data collection involved surveys covering socio-demographic information, the Practice Environment Scale-Nursing Work Index (PES-NWI), and the ProQoL scale. Statistical analyses, including descriptive statistics and Pearson correlation, were performed using SPSS. The participants were predominantly young, with 61.7% less than 30 years old, and 65.4% were male. Most held a bachelor's degree (54.9%). The survey indicated that the majority reported average levels of compassion satisfaction (90.7%), burnout (91.4%), and secondary traumatic stress (85.2%). The analysis showed that a moderately positive practice environment was significantly associated with lower levels of burnout and higher levels of compassion satisfaction. Additionally, there was a significant difference in mean Compassion Satisfaction scores according to sleep hours (F = 5.475, P < .05). Nurses who slept more than 8 h had significantly higher Compassion Satisfaction compared to those who slept less than 8 h or exactly 8 h (P < .05). ICU nurses generally perceived their work environment positively, though there are opportunities to improve their professional quality of life, particularly by addressing burnout. The findings highlight the need for targeted interventions and further research to enhance job satisfaction and well-being among ICU nurses.

Translation and validation study of the Indonesian version of the practice environment scale of the nursing work index

ObjectivesThis study aimed to translate and validate the Practice Environment Scale - Nursing Work Index (PES-NWI) among nurses in Indonesia. MethodsA scale translation and cross-sectional validation study was conducted. The English version was translated into Indonesian, which involved five steps: forward translation, compare the translation, backward translation, compare the translation, and pilot testing with a dichotomous scale (clear or unclear). Thirty inpatient department nurses were involved in checking readability and understandability. A cross-sectional study was conducted from August to October 2022 at 17 hospitals across Indonesia, involving 350 nursing professionals. The validity test included structural validity and convergent validity. The internal consistency reliability was tested by Cronbach’s α coefficient, item-total correlation, and composite reliability. ResultsConfirmatory factor analysis (CFA) showed an acceptable fit. The correlation of all dimensions was between 0.70 and 0.88, and all items had item loading higher than 0.6. Convergent validity of each dimension ranged from 0.61 to 0.74, internal consistencies with Cronbach’s α coefficient was 0.97, corrected item-to-total correlation ranged from 0.62 to 0.85, and composite reliability of each dimension was higher than 0.89. ConclusionsGood homogeneity and construct validity have been demonstrated for the Indonesian version of the PES-NWI, nursing management can use it to measure the work environment.

Exploring the relationship between nursing work environment and medical error reporting among Jordanian nurses: a cross-sectional study

Abstract Objectives This study was conducted to explore the relationship between the nursing work environment and medical error reporting practices among Jordanian nurses. Methods This study was a cross-sectional survey of 334 participants who were conveniently selected from three types of hospitals (private, teaching and public) in Amman city, Jordan. The data were collected using a standardized questionnaire which was adopted from previous studies and consisted of three main sections including demographics, nursing work environment (The Practice Environment Scale-Nursing Work Index) and medical error reporting practices (incident reporting practice scale). SPSS version 26 was used for data analysis. Key findings The study findings detected a strong positive relationship between the nursing work environment and medical error reporting practices. ‘Nurse’s participation in hospital affairs’ showed the highest impact on medical error reporting practices among nurses. Based on the regression model, the nursing work environment explained 65.1% of variations in nurses’ medical error reporting practices. It was found that medical error reporting practices were statistically different across marital status and hospital type. Conclusions Based on data analysis findings, the nursing work environment was statistically strongly correlated to medical error reporting practices. To improve medical error reporting practices among nurses, decision-makers and hospital administrators should redesign their nursing work environment to create a more positive and favourable work environment.

The effects of nursing work environment on patient safety in Saudi Arabian hospitals.

PurposeThis study aims to investigate the impact of the nursing work environment on patients’ safety in Saudi Arabian hospitals.MethodsThis study used a cross-sectional design for collecting the data related to the nursing work environment and patients’ safety from nursing staff in Saudi Arabian hospitals. The survey questionnaire included in this study has two pre-validated questionnaires including practice environment scale-nursing work index questionnaire and hospital’s survey on patients’ safety developed by Surveys on Patients Safety Culture. The survey link was forwarded to HR administrators of 96 hospitals in Saudi Arabia, which included 72 public hospitals, 23 private hospitals, and one public-private hospital. Three hundred sixty-nine responses were received. After removing the incomplete responses, 357 responses were considered for the data analysis, in which t-tests and Pearson’s correlation techniques were adopted.ResultsStrongest correlations were identified between resource adequacy and work area (r = 0.763, p < 0.01), “participation in management and leadership” and work area (r = 0.712, p < 0.01), “participation in management and leadership” and supervisor/managers’ approaches (r = 0.731, p < 0.01), and “nursing care and inter-disciplinary relationships and frequency of events” (r = 0.701, p < 0.01).ConclusionThe nursing work environment factors, especially participation, management and leadership, nursing care, inter-disciplinary relationships, and resource adequacy have to be improved in order to improve the patients’ safety.

The changes in the nursing practice environment brought by COVID-19 and improvement recommendations from the nurses’ perspective: a cross-sectional study

BackgroundThe COVID-19 pandemic has brought an opportunity to increase investment in the nursing practice environment, which has greatly impacted patients, nurses, and organizations. However, there were limited studies concerning the changes in the practice environment since the COVID-19 pandemic and the way to improve it from nurses’ perspectives.MethodsA cross-sectional study was conducted among 460 nurses from seven hospitals in Sichuan, China. Both the quantitative and qualitative data were collected from an online questionnaire. The quantitative data were collected using the Chinese version of the Practice Environment Scale-Nursing Work Index and compared with available norms in 2010. The qualitative data were collected through an open question following the scale and analyzed by content analysis.ResultsThe mean of the score of the practice environment scale was 3.44 (SD = 0.56) out of 4.00. The score of the total scale and the dimensions were significantly higher than the norms, apart from nurse-physician relations and nurse participation in hospital affairs. The qualitative findings revealed positive changes in nursing foundations for quality of care, nurse participation in hospital affairs and nurse-physician relations, and poor staffing and resource adequacy. The improvement in the working model and ward environment is the primary concern of nurses.ConclusionsThe COVID-19 pandemic brought some positive changes in the nursing practice environment, but more efforts are needed to solve those nagging and important problems, such as staff shortages and low participation. Nursing managers and hospital leaders were encouraged to listen to nurses’ concerns and value this suitable opportunity for changing and improving to achieve better health services and coping ability to deal with emergency events going forward. Improving the ward environment and taking a professional model instead of sticking to the tedious process might be worthwhile.

Nurses’ Perception of the Nursing Practice Environment and Quality Improvement Initiatives in a Tertiary Hospital, Kingdom of Bahrain- an Observational Longitudinal Study

Introduction:In order to promote patient safety, the organization began a systematic approach to monitor, assess, and improve the quality of the nursing practice environment. The purpose of the study was to learn about registered nurses' general perceptions of the practice environment and to develop quality improvement efforts to improve patient safety. Materials and Methods: An observational longitudinal study was done for four years by using the Practice Environment Scale – Nursing Work Index (PES-NWI). The sample size of 370 was calculated and data were collected from registered nurses working in all patient care areas by using convenience sampling. Each year, the items scored less than 2.5 were identified, discussed with the nursing stakeholders and quality improvement measures were designed and implemented. Results: Over the four-years, nurses’ perception of the nursing work environment was found favorable with mean values above 2.5 for all the subscales. However registered nurses perceived concerns with their participation in hospital affaires, staffing and resource adequacy. The PES-NWI mean scores improved significantly over the four years because of the quality improvement initiatives such as registered nurses' participation in hospital committees, transformational leadership training, the Quality Link Nurse (QLN) program, and staffing based on dependency assessment and skill mixing. Conclusion: According to the registered nurses in this study, the tertiary hospital provides a favorable working environment. The nurses' opinions of the working environment improved as a result of regular monitoring and quality improvement measures, as well as the involvement of registered nurses in new policies.

Predictors of disaster preparedness among registered nurses in Saudi Arabia: A structural equation modelling analysis

BackgroundThe evaluation of the present state of disaster preparedness among nurses in developing countries is not very well elucidated. Therefore, it is crucial to identify the adequacy of disaster preparedness among nurses in such countries and to examine the factors that influence the preparedness of nurses with regard to disaster management. MethodsA cross-sectional methodological design was used. A convenient sampling method was used to recruit 370 registered nurses from two hospitals in Saudi Arabia. Data were collected using valid and reliable self-reported questionnaires, including the Disaster Preparedness Evaluation Tool, Practice Environment Scale-Nursing Work Index, and Self-Regulation Scale. ResultsThe final model, with good fit indices, revealed that the disaster preparedness of nurses was significantly influenced by nurses’ skills, knowledge, leadership ability and support, self-regulation, nursing quality of care, disaster training, disaster experience, and workplace participation. Altogether, these factors explained 68% of the total variance. ConclusionThe factors influencing the preparedness of nurses for disaster are more complex than previously understood. Our model, created and tested using structural equation modelling, merits further research to extend our understanding of how nurses’ perception of disaster management is influenced by organizational characteristics in the hospital work environment.

Contribution of students to nursing practice settings during clinical training: Design and validation of a questionnaire.

A validated questionnaire to measure the contributions of nursing students to clinical settings could potentially assist in the improved management of students in healthcare institutions. To develop and test the psychometric properties of the questionnaire 'Nursing Student Contributions to Clinical Settings' (CEEEC, Spanish acronym for 'Contribuciones de los Estudiantes de Enfermería a los Entornos Clínicos'). Instrument design and psychometric testing. A multicentre study involving 1,098 nursing professionals from three universities and five hospitals of Spain, between January 2019 and March 2020. The study was carried out in two phases. Phase 1 involved the questionnaire design by experts (n=28), which required a review of the available literature, cognitive interviews and Delphi rounds, and a preliminary validity study, which included a pilot test with responses from a sample of nurses (n=143). Phase 2 involved a formal validation with a wider sample of nurses (n=927), including factor analysis and a study of convergent validity with the Practice Environment Scale-Nursing Work Index and Health Sciences-Evidence Based Practice. Experts selected 42 items on student contributions. After cognitive interviews, three items were eliminated and seven failed to reach the minimum content validity index (78%). Based on the remaining 32 items, the discrimination index of each item was calculated, and those with <0.3, eight items were sequentially eliminated. The resulting questionnaire contained 24 items grouped into a single factor, which explained 41% of the variance. The internal consistency was excellent (Cronbach's alpha: 0.94), and the convergent validity was confirmed. A 24-item questionnaire was designed and validated to measure the contributions of nursing students to clinical practice settings. Most hospitals are also teaching centres where nursing students undergo clinical practice. The application of this test will provide insight into the nursing professionals' perception of the students' role.

Newly graduated nurses' perceptions of work environment: A cross-sectional study in China.

To assess the attitudes of newly graduated nurses in China toward their work environment and identify the factors affecting their perception. Newly graduated nurses are the primary supply to cover the nursing shortage, but their stressful transition into clinical work has contributed to high turnover for decades. Although serving as a source of stress, the work environment can also be a source of support for new nurses. A total of 2361 new nurses at 31 tertiary hospitals in 20 provinces were surveyed from June to November 2018, using the Chinese version of the Practice Environment Scale-Nursing Work Index. Basic information and their perception about work environment were collected. New nurses rated their work environment with an overall score of 84.67 (12.85). Multiple linear regression identified that education level, monthly income, hospital type and location, participation (or not) in standardized training programmes and having (or not) a mentor/preceptor were factors significantly associated with their perception of the work environment. The perception of newly graduated nurses in China was mainly positive overall. Nursing managers may take full advantage of factors affecting the perception of work environment to support newly graduated nurses better, to help their retention and transition.

Nursing Practice Environment and the Nurse Manager Intervention: Critical Review

The Nursing Practice Environment (NPE) influences the quality of nursing care. Studies show far better outcomes for clients, with positive results on nursing teams’ satisfaction and patients with improvements in the outcomes of patients and healthcare organizations. The Practice Environment Scale-Nursing Work Index (PES-NWI) is an instrument that measures the nursing practice environment and is currently the most used at a global scale. The analyzed article proves the instrumentsreliability in the assessment of the NPE, despite needing further investigation at a psychometric level; and its applicability in different care settings – Other countries besides the US. However, it is emphasized the need to carry out further experimental and longitudinal studies to potentially identify the mechanisms that influence the NPE.

Examining the measurement invariance of the Practice Environment Scale-Nursing Work Index in the United States.

The increasingly diverse nursing workforce in the United States often creates challenges for researchers in meaningfully interpreting survey data from large samples of nurses with heterogeneous cultural backgrounds. Considering this, the purpose of this study was to determine the measurement invariance of the Practice Environment Scale-Nursing Work Index (PES-NWI) between registered nurses (RNs) reporting as Asian/Pacific Islander and those reporting as White. Data from the National Database of Nursing Quality Indicators®, collected in 2018 from RNs (N = 27,619) providing direct patient care, were used in this study. Multi-group confirmatory factor analysis was used to determine measurement invariance. Interpretation of the fit indices across models (configural, metric, and scalar) provides support for measurement invariance of the PES-NWI across the two groups. There is empirical support for pooling PES-NWI data and comparing it across these two groups.

Qualitative Analysis by Experts of the Essential Elements of the Nursing Practice Environments Proposed by the TOP10 Questionnaire of Assessment of Environments in Primary Health Care.

Background: A short TOP10 scale based on the Practice Environment Scale-Nursing Work Index questionnaire measures the characteristics of nursing work environments. Positive environments result in better quality care and health outcomes. Objective: To identify a small number of core elements that would facilitate more effective interventions by nurse managers, and compare them with the essential elements proposed by the TOP10. Method: Qualitative research by a nominal group of eight experts. The content analysis was combined with descriptive data. Results: Ten most important items were selected and analyzed by the expert group. A high level of consensus in four items (2, 15, 20, 31) and an acceptable consensus in five items was reached (6, 11, 14, 18, 26). The tenth item in the top ten was selected from content analysis (19). The expert group agreed 90% with the elements selected as essential to the TOP10. Conclusion: The expert group achieved a high level of consensus that supports 90% of the essential elements of primary care settings proposed by the TOP10 questionnaire. Organizational changes implemented by managers to improve working environments must be prioritized following our results, so care delivery and health outcomes can be further improved.

Impact of Nursing Staff Perception of Work Environment on Turnover Rate in Hemodialysis Unit

Abstract Background: The nursing work environment is complex with many variables affecting the nurses' perception and work satisfaction. The strongest predictor of nurse's job dissatisfac-tion and intent to leave a job is personal stress related to the practice environment. Negative work environments demoralize nurses and contribute to the development of unsafe working conditions, which are unhealthy and highly associated with nursing job dissatisfaction, low productivity, and high turnover. High nurse turnover in healthcare facilities can negatively affect the ability of hospitals to meet patient needs, provide quality care and increases both direct and indirect labor costs. Aim of Study: To explore the impact of nursing staff perception of work environment on turnover rate in hemodi-alysis unit. Subjects and Methods: A descriptive correlational design was utilized to collect data from A convince sample of nursing staff working in the selected unit (hemodialysis unit) during the time of data collection (from May to September 2017) at a governmental University hospital. Data was collected by using two tools: The Practice Environment Scale-Nursing Work Index (PES-NWI) questionnaire and turnover rate sheet. Results: There were no significant relation between nursing staff perception of work environment and educational level, there were a high positive relation between nurses perception of work environment and years of experience and there were dramatically increase of turnover rate over the years. Conclusion: Poor nurse work environment is the under-lying factor of nursing turnover. Recommendation: Improving nurse work environment should be emphasized through policy to retain nurses in the workforce; Further research is needed to investigate the tools, guidelines and interventions used by managers in the nursing field to create healthy and welcoming working conditions.

Perception of the professional nursing environment in Primary Care in the Valencian Community, in departments with public and private management

Nursing practice environments (NPE) improve the quality of care, satisfaction and heath results; there are no studies that compare the Primary Health Care (PHC) environments according to their management model. Our aim is to estimate and compare the perception of the quality of the NPE in the PHC in Health Departments (HD) of the Valencian Community (Spain) with management model public or indirect-private (Administrative concession). Transversal study on PHC nurses from three HD, one with direct public management and two with indirect-private management. The Practice Environment Scale-Nursing Work Index questionnaire, validated in Spain, was administered. Sociodemographic and professional variables were recorded. Variables related to test score were analyzed by multiple linear regression. Two hundred and sixty-nine answers (80.3%). All HD perceived NPE quality in a positive way, both globally and for the different dimensions (except D4). Indirect private management model HD obtained higher global scores, the same tendency was observed for D1 and D2, and the opposite for D4. Global score was related to age, professional experience, being a coordinator and management model; only the age of the nurses and being a coordinator showed a significant relationship with the score in the multivariate regression model. The NPE of the PHC of the Valencian Community are of good quality, without significant differences according to different management models of the HD. Being a coordinator and, particularly, the age of the nurses are variables that are independently related to the global score obtained.

Development of a short questionnaire based on the Practice Environment Scale-Nursing Work Index in primary health care.

BackgroundProfessional nursing environments determine the quality of care and patient outcomes. Assessing the quality of environments is essential to improve and obtain better health outcomes. Simplifying and shortening the way to evaluate environments reliably is also important to help nurses better understand the strengths and weaknesses of their environments. In that sense, identifying essential elements of nursing environments would allow the construction of short assessment tools to improve such environments.ObjectiveTo construct a short tool to assess primary health care (PHC) nursing environments based on the Practice Environment Scale-Nursing Work Index (PES-NWI) questionnaire.MethodsObservational, cross-sectional, analytical study (data collection February–April 2015). Tool: PES-NWI (31 items). Population: PHC nurses (three health districts in Valencia, Spain) with more than 3 months in the organization. The nurses were asked to select the 10 elements of the questionnaire (items) that they considered key to facilitate and improve professional care, establishing as a final selection criterion that they obtain a global election >40%. Variables: sociodemographic and 31 questionnaire items. Analysis: descriptive statistics, reliability, multidimensional scaling (ALSCAL), factor analysis, multiple linear regression. Finally, we have analyzed the concordance between both measurements (TOP10 score on the full scale score) using the Bland–Altman method.ResultsStudy sample = 269 (Response rate = 80.29%). A total of 10 elements were identified based on selection frequency of the questionnaire PES-NWI. A factorial analysis explained 62.1% of variance, internal structure of three dimensions: (1) Participation in leadership and management, (2) Nursing foundations for quality of care, (3) Adequacy of resources, with Accumulate Variance explained: Component (1): 24%; Component (2): 43.1%; Component (3): 62.1%. Reliability (Cronbach’s Alpha) was 0.816 for short questionnaire, and >0.8 for all measurements. Stress = 0.184 and RSQ = 0.793. Bland–Altman method: the scaling tends to be 1.92 points higher (equivalent to a maximum deviation of 1.54%) than the full-scale PES-NWI score (max score on PES-NWI = 124 points).ConclusionsIt is possible to identify essential elements of environments to construct a short tool that simplifies the study of PHC environments. Conducting rapid studies of environments will provide managers with information about specific elements that require prioritization to enhance quality of care and safety.

Midwifery pre-registration education and mid-career workforce participation and experiences

BackgroundMidwives in Australia are educated through a range of routes providing flexible ways to become a midwife. Little is known about whether the route to registration impacts on mid-career experiences, in particular, whether the pathway (post-nursing pathway compared with ‘direct-entry’) makes any difference. AimThe aim of this study was to explore the midwifery workforce experiences and participation in graduates six to seven years after completing either a post-nursing Graduate Diploma in Midwifery (GradDip) or an undergraduate degree, the Bachelor of Midwifery (BMid), from one university in New South Wales, Australia. MethodsData were collected from mid-career midwives having graduated from one NSW university from 2007–2008 using a survey. The survey included validated workforce participation instruments — the Maslach Burnout Inventory (MBI), the Practice Environment Scale-Nursing Work Index (PES-NWI) and the Perceptions of Empowerment in Midwifery Scale (PEMS). ResultsThere were 75 respondents: 40% (n=30) Bachelor of Midwifery and 60% (n=45) GradDip graduates. The age range was 27–56 years old (mean age=36 years) Bachelor of Midwifery graduates being on average 7.6 years older than Graduate Diploma in Midwifery graduates (40 vs 33 years; p<0.01). Almost 80% (59), were currently working in midwifery. Nine of the 12 not working in midwifery (75%) planned to return. There were no differences in workforce participation measures between the two educational pathways. Working in a continuity of care model was protective in regards to remaining in the profession. ConclusionMost mid-career graduates were still working in midwifery. There were no differences between graduates from the two pathways in relation to burnout, practice experiences or perceptions of empowerment.

The Effects of Nursing Satisfaction and Turnover Cognitions on Patient Attitudes and Outcomes: A Three-Level Multisource Study.

To explore antecedents and outcomes of nurse self-reported job satisfaction and dissatisfaction-based turnover cognitions, theorizing (using Self-Determination Theory) that leaders can foster work conditions that help fulfill innate needs, thereby fostering satisfaction of nurses and patients, and reducing adverse events. Primary and secondary data were collected within a 4-month period in 2015, from 2,596 nurses in 110 Army treatment facilities (hospitals and clinics) across 35 health care systems. We collected individual nurse responses to the Practice Environment Scale-Nursing Work Index, in addition to aggregated archival data from the same timeframe, including both facility-level patient satisfaction records (the Army Provider Level Satisfaction Survey) and health care system-level adverse events records (provided by the Army Programming, Analysis, and Evaluation office). Five predictors of nurse satisfaction and turnover cognitions emerged-supportive leadership, staffing levels, nurse-physician teamwork, adoption of nursing care practice, and advancement opportunities. Aggregated nurse satisfaction was the most consistent predictor of both patient satisfaction and adverse events. These findings provide evidence of the importance of nurse attitudes in improving perceived and actual performance across facilities and health care systems; in addition to practical steps, managers can take to improve satisfaction and retention.

Multisite Studies Demonstrate Positive Relationship Between Practice Environments and Smoking Cessation Counseling Evidence-Based Practices.

High-quality smoking cessation counseling guidelines for people who use tobacco are not fully integrated in acute-care services presenting missed opportunities to improve health outcomes. The role of the practice environment on enhancing or inhibiting guideline use is unknown. To examine the relationship between the nurse practice environment and nurses' use of smoking cessation counseling practices, and to evaluate the effect of the individual nurse and organization characteristics on nurse smoking cessation counseling practices. Cross-sectional secondary analysis of survey data from two multisite studies. The sample included responses from registered nurses (N = 844) in 45 hospitals (22 rural hospitals from the Eastern United States and 23 Magnet hospitals across the United States). Linear mixed model was used to adjust intradependency among the responses of individual nurses nested within hospitals. Data were abstracted from survey responses including nurse characteristics, the Smoking Cessation Counseling Scale (SCCS), and the Practice Environment Scale-Nursing Work Index (PES). Increasing positive relationships exist between PES and SCCS total and subscales scores. Also, SCCS total scores were significantly related with favorable PES total scores (SCCS score difference of 0.26 between favorable and unfavorable PES scores, SE = .08, p = .002) controlling for other covariates. Non-White respondents (vs. White) demonstrated a positive association with SCCS total scores (difference of .18, SE = .07, p = .010), but not in advanced counseling. Nurse practice environments are positively associated with the use of evidence-based smoking cessation practices by nurses. As practice environments become more favorable, higher level counseling practices occur more often. Healthcare leaders should focus on enhancing the practice environment using a quality improvement approach and framework for evidence translation. Quality improvement initiatives should be prioritized in which high-quality evidence is available to support nursing processes.