Obstacles Encounter Head Nurse' Role Excellence: Development and Validation of a Research Instrument

Background: Head nurses play one of the most challenging roles in organizational healthcare. They directly managing the nursing staff at unit level and ensuring that they act in accordance with hospital rules and procedures. Head nurses also, have a significant managerial impact because they have the ability to influence the performance and quality of healthcare organizations. They are faced with many obstacles in their daily work that might encounter their excellence performance. Aim: The study aimed to develop an obstacles encounter head nurse' role excellence instrument.  Research design: Methodological research design was used to conduct this study involving the use of both qualitative and quantitative methods. Setting:  The study was carried out in eight hospitals at Qalyubia Governorate as follows: Benha university hospital, Benha educational hospital, and Benha fever hospital, Benha ophthalmology hospital, Sheben El Qanater fever hospital, Sheben El Qanater central hospital, Toukh central hospital, and Toukh fever hospital.  Sample: Two samples were utilized to achieve study' purpose; multistage random sample included 104 head nurse (was utilized for gathering qualitative data that was required to define the main domains and themes which make up the instrument), and convenience sample consisted of 160 head nurse (was utilized to test the reliability and construct validity of the developed instrument). Instruments: three instruments were used in this study: (a) An obstacles encounter head nurses' role excellence open-ended questionnaire, (b) obstacles encounter head nurses' role excellence version one, and (c) obstacles encounter head nurses' role excellence version two. Results: the study revealed that developed instrument has high score for content validity index (.92) deducted that sample of items for the construct being measured was appropriate, Cronbach's alpha  coefficient was calculated to be good (.93),  Kaiser-Meyer-Olkin was high (.76), Bartlett's test was highly significant, and varimex rotation extracted four components with eigenvalue  >1.0 and  accounted variances ≥ 40%. Conclusion: The final version of developed instrument is considered to be valid and reliable based on statistical analysis. It contains 46 items within four domains categorized as follows: obstacles related to working conditions, obstacles related to head nurses, obstacles related to nurse managers at middle and top levels and obstacles related to staff nurses. Recommendations: it recommends that: using the developed instrument to assess obstacles encounters head nurses' role excellence in different healthcare settings, examine obstacles encounter head nurses from senior managers and staff nurses' point of view. Furthermore, develop strategy to overcome obstacles.