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

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