Nurses’ Innovative Behaviours Inventory

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Abstract

The Nurses' Innovative Behaviours Inventory (NIBI) is an upcoming psychometric tool designed to quantify how Nurses engage in and promote innovation within healthcare settings. As modern medicine rapidly integrates advanced technologies like artificial intelligence and faces complex demographic shifts, the role of the nurse is evolving from a traditional caregiver to a frontline innovator. This instrument aims to capture the multifaceted nature of these innovative behaviors, providing a standardized metric for healthcare organizations to identify and nurture creative problem-solving among their Nursing staff.

The development of the NIBI follows a rigorous sequential exploratory mixed-methods protocol. By initially grounding the tool in qualitative insights drawn directly from clinical Nurses and supplementing this with a comprehensive literature review, the creators ensure the instrument is deeply rooted in the actual lived experiences of healthcare professionals. This foundational work is critical for establishing strong content validity before moving into the quantitative psychometric evaluation phase. Ultimately, the NIBI represents a vital step toward operationalizing Nursing innovation, offering administrators and researchers a reliable way to measure, track, and foster a culture of continuous improvement in patient care.

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Keywords
innovative behavior
Nursing
psychometrics
scale development
healthcare management
Organizational Psychology

📊 Psychometric Scorecard

Structure
Unidimensional
Validation Country
📍 Iran

Authors

👤 Elham Shahidi Delshad
🏛 Student Research Committee, Semnan University of Medical Sciences, Semnan, Iran

👤 Mohsen Soleimani
🏛 Nursing Care Research Center, School of Nursing and Midwifery, Semnan University of Medical Sciences, Semnan, Iran

👤 Armin Zareiyan
🏛 Research Center for Cancer Screening and Epidemiology & Health in Disaster & Emergencies Department, Aja University of Medical Sciences, Tehran, Iran

👤 Ali Asghar Ghods
✉ [email protected]
🏛 Nursing Care Research Center, School of Nursing and Midwifery, Semnan University of Medical Sciences, Semnan, Iran

Purpose

The primary objective behind the creation of the NIBI is to address a significant measurement gap in Nursing administration and healthcare management. While the conceptual importance of Nursing innovation is widely recognized—particularly its links to improved patient safety, organizational efficiency, and job satisfaction—there has been a distinct lack of validated, context-specific tools to measure it systematically. Existing frameworks often fail to capture the unique intersection of holistic patient care and technological adaptation that characterizes modern Nursing. By providing a scientifically sound, standardized questionnaire, the NIBI empowers healthcare leaders to baseline current innovative capacities, evaluate the effectiveness of interventions like innovation incubators, and strategically allocate resources to support professional development.

Construct

The psychological construct of 'innovative behavior' within the Nursing context is highly specialized. It goes beyond mere creativity or idea generation; it encompasses the active implementation of novel procedures, treatment strategies, and technological integrations designed to overcome clinical obstacles. The theoretical framework underpinning the NIBI conceptualizes this construct as a dynamic interplay between individual attributes, such as critical thinking and problem-solving skills, and organizational facilitators. Because Nursing inherently blends ethical, patient-centered care with interdisciplinary collaboration, the construct measured by the NIBI is expected to be multidimensional. It likely captures not only the ideation phase of innovation but also the advocacy, practical application, and navigation of institutional barriers required to bring new healthcare solutions to fruition.

Validity

Because this paper outlines a study protocol, the validity evidence is currently in the planning and execution phase. The researchers have designed a robust validation pipeline starting with qualitative content analysis and expert review to establish strong face and content validity. This ensures the generated items are both comprehensive and comprehensible to the target demographic. For construct validity, the protocol dictates a two-step factor analytic approach. First, an Exploratory Factor Analysis will be conducted using a planned sample of at least 300 Nurses to uncover the underlying latent structure of the items. Subsequently, a Confirmatory Factor Analysis will be performed on an independent sample of at least 200 Nurses to verify the stability of this factor structure. This rigorous cross-validation strategy is a gold standard in psychometrics for preventing model overfitting and ensuring the scale's dimensions are generalizable.

Reliability

The reliability evaluation for the NIBI is structured to assess both internal consistency and temporal stability. The protocol specifies the use of Cronbach's alpha to evaluate how well the items within each identified subscale correlate with one another, ensuring that they consistently measure the same underlying facet of innovative behavior. Additionally, the researchers plan to conduct test-retest reliability assessments. This is a crucial step for a trait-like construct such as innovative behavior, as it demonstrates that the instrument yields stable scores over time when administered to the same individuals under similar conditions. By evaluating these metrics alongside responsiveness and interpretability, the development team aims to produce a highly dependable tool for longitudinal research and practical administrative use.

Factor Analysis

The planned factor analytic strategy for the NIBI relies on a classic split-sample design to rigorously test the scale's dimensionality. Initially, the researchers will utilize Exploratory Factor Analysis to allow the latent factors to emerge naturally from the data without imposing a preconceived theoretical structure. This is particularly appropriate given the exploratory nature of the qualitative phase. Following the exploratory phase, Confirmatory Factor Analysis will be applied to a separate cohort. While specific fit indices are not yet reported in this protocol, the use of confirmatory modeling will ultimately allow the researchers to statistically evaluate how well the empirical data fits the hypothesized model. The researchers also noted potential challenges, such as ensuring an acceptable Kaiser-Meyer-Olkin measure of sampling adequacy, which they plan to mitigate through meticulous item generation and content validation prior to the quantitative phase.

Instrument

Test Type Self-report questionnaire
Language Persian
Population Nurses
Age Group Adults
Administration Online

Nurses' Innovative Behaviours Inventory Items

📋 Items are currently not available

The individual items of this scale are not publicly available. Researchers interested in using this instrument should contact the original authors directly to request the scale materials.

Sample

The protocol outlines a sequential mixed-methods sampling strategy. The qualitative phase will utilize maximum variation purposive sampling of clinical Nurses in Tehran, Iran. The subsequent quantitative phase aims to recruit a nationwide sample of over 500 Nurses via online platforms, split into at least 300 participants for Exploratory Factor Analysis and at least 200 participants for Confirmatory Factor Analysis.

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Cite This Paper

Elham Shahidi Delshad, Mohsen Soleimani, Armin Zareiyan, Ali Asghar Ghods (2024). Nurses' Innovative Behaviours Inventory. BMJ open. https://doi.org/10.1136/bmjopen-2023-077056

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References
77 references
  1. Yoder-Wise PS , Sportsman S . Leading and Managing in Nursing E-Book. Elsevier Health Sciences, 2022.
  2. Figueroa CA , Harrison R , Chauhan A , et al . Priorities and challenges for health leadership and workforce management globally: a rapid review. BMC Health Serv Res 2019;19:239. doi:10.1186/s12913-019-4080-7 🔗 https://doi.org/10.1186/s12913-019-4080-7
  3. Greenhalgh T , Wherton J , Papoutsi C , et al . Beyond adoption: a new framework for theorizing and evaluating Nonadoption, abandonment, and challenges to the scale-up, spread, and Sustainability of health and care Technologies. J Med Internet Res 2017;19:e367. doi:10.2196/jmir.8775 🔗 https://doi.org/10.2196/jmir.8775
  4. Younger (2020). Leveraging advanced practice Nursing in complex health care systems. Nurs Adm Q, 44 127. 🔗 https://doi.org/10.1097/NAQ.0000000000000408
  5. Afsar (2018). Do Nurses display innovative work behavior when their values match with hospitals’ values. EJIM, 21 157. 🔗 https://doi.org/10.1108/EJIM-01-2017-0007
  6. Wang (2019). The mediating role of inclusive leadership: work engagement and innovative behaviour among Chinese head Nurses. J Nurs Manag, 27 688. 🔗 https://doi.org/10.1111/jonm.12754
  7. Dy Bunpin (2016). Differences in innovative behavior among hospital-based registered Nurses. JONA, 46 122. 🔗 https://doi.org/10.1097/NNA.0000000000000310
  8. Zuber (2018). Creativity and innovation in health care. Nurs Adm Q, 42 62. 🔗 https://doi.org/10.1097/NAQ.0000000000000267
  9. Albert (2018). Operationalizing a Nursing innovation center within a health care system. Nurs Adm Q, 42 43. 🔗 https://doi.org/10.1097/NAQ.0000000000000266
  10. Alsadaan (2023). Impact of nurse leaders behaviors on Nursing staff performance: A systematic review of literature. INQUIRY, 60 469580231178528. 🔗 https://doi.org/10.1177/00469580231178528
  11. Dan (2018). Innovative behaviour and career success: mediating roles of self-efficacy and colleague solidarity of Nurses. Int J Nurs Sci, 5 275.
  12. Singh (2019). Role of psychological empowerment in the relationship between structural empowerment and innovative behavior. MRR, 42 521. 🔗 https://doi.org/10.1108/MRR-04-2018-0158
  13. Lateef A . Innovative strategies in Nursing practice: new perspectives. Nurs Commun 2022;6:e2022008. doi:10.53388/IN2022008 🔗 https://doi.org/10.53388/IN2022008
  14. Irani (2022). Evolving with technology: machine learning as an opportunity for operating room Nurses to improve surgical care—A commentary. J Nurs Manag, 30 3802. 🔗 https://doi.org/10.1111/jonm.13736
  15. Dykes (2021). Now more than ever, Nurses need to be involved in technology design: lessons from the COVID‐19 pandemic. J Clin Nurs, 30 e25. 🔗 https://doi.org/10.1111/jocn.15581
  16. Glover WJ , Nissinboim N , Naveh E . Examining innovation in hospital units: a complex adaptive systems approach. BMC Health Serv Res 2020;20:554. doi:10.1186/s12913-020-05403-2 🔗 https://doi.org/10.1186/s12913-020-05403-2
  17. Clipper B . The Innovation Handbook: A Nurse Leader’s Guide to Transforming. Nursing: Sigma Theta Tau, 2023.
  18. von Gerich (2022). Artificial intelligence-based Technologies in Nursing: A Scoping literature review of the evidence. Int J Nurs Stud, 127 104153. 🔗 https://doi.org/10.1016/j.ijnurstu.2021.104153
  19. Kagan O , Littlejohn J , Nadel H , et al . Evolution of nurse-led Hackathons, Incubators and accelerators from an innovation Ecosystem perspective. Online J Issues Nurs 2021;26. doi:10.3912/OJIN.Vol26No03Man03 🔗 https://doi.org/10.3912/OJIN.Vol26No03Man03
  20. Zhou (2021). Interdisciplinary collaboration between Nursing and engineering in health care: a Scoping review. Int J Nurs Stud, 117 103900. 🔗 https://doi.org/10.1016/j.ijnurstu.2021.103900
  21. Olsson (2019). Organizational climate for innovation and creativity–a study in Swedish retail organizations. The International Review of Retail, Distribution and Consumer Research, 29 243. 🔗 https://doi.org/10.1080/09593969.2019.1598470
  22. Asurakkody (2018). innovative behavior in Nursing context: A concept analysis. Asian Nurs Res (Korean Soc Nurs Sci), 12 237.
  23. Pittman P . Activating Nursing to address unmet needs in the 21st century; 2019.
  24. Almeida F . Strategies to perform a mixed methods study. European Journal of Education Studies 2018.
  25. Pedersen B , Grønkjaer M , Delmar C . Existential Phenomenology as a unifying philosophy of science for a mixed method study. Nurs Philos 2022;23:e12376. doi:10.1111/nup.12376 🔗 https://doi.org/10.1111/nup.12376
  26. Maarouf (2019). Pragmatism as a supportive paradigm for the mixed research approach: Conceptualizing the ontological, Epistemological, and axiological stances of pragmatism. IBR, 12 1. 🔗 https://doi.org/10.5539/ibr.v12n9p1
  27. Li (2016). A review of employee innovative behavior in services. IJCHM, 28 2820. 🔗 https://doi.org/10.1108/IJCHM-04-2015-0214
  28. Campbell (2020). Purposive sampling: complex or simple? research case examples. J Res Nurs, 25 652. 🔗 https://doi.org/10.1177/1744987120927206
  29. Hammarberg, K., Kirkman, M., de Lacey, S. (2016). Qualitative research methods: when to use them and how to judge them. Human Reproduction, 31(3), 498-501. 🔗 https://doi.org/10.1093/humrep/dev334
  30. Holloway I , Wheeler S . Qualitative research in Nursing: Wiley-Blackwell; 2002.
  31. Speziale HS , Streubert HJ , Carpenter DR . Qualitative research in Nursing: Advancing the humanistic imperative. Lippincott Williams & Wilkins, 2011.
  32. Kallio, H., Pietilä, A., Johnson, M., Kangasniemi, M. (2016). Systematic methodological review: developing a framework for a qualitative semi‐structured interview guide. Journal of Advanced Nursing, 72(12), 2954-2965. 🔗 https://doi.org/10.1111/jan.13031
  33. DeJonckheere M , Vaughn LM . Semistructured interviewing in primary care research: a balance of relationship and rigour. Fam Med Community Health 2019;7:e000057. doi:10.1136/fmch-2018-000057 🔗 https://doi.org/10.1136/fmch-2018-000057
  34. Roberts RE . Qualitative interview questions: guidance for novice researchers. TQR 2020;25. doi:10.46743/2160-3715/2020.4640 🔗 https://doi.org/10.46743/2160-3715/2020.4640
  35. Zhang Y , Wildemuth BM . Applications of social research methods to questions in information and library science; 2009.
  36. Graneheim, U., Lundman, B. (2004). Qualitative content analysis in Nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Education Today, 24(2), 105-112. 🔗 https://doi.org/10.1016/j.nedt.2003.10.001
  37. Hsieh, H., Shannon, S. (2005). Three Approaches to Qualitative Content Analysis. Qualitative Health Research, 15(9), 1277-1288. 🔗 https://doi.org/10.1177/1049732305276687
  38. Lincoln, Y., Guba, E. (1986). But is it rigorous? Trustworthiness and authenticity in naturalistic evaluation. New Directions for Program Evaluation, 1986(30), 73-84. 🔗 https://doi.org/10.1002/ev.1427
  39. Creswell JW , Creswell JD . Research design: Qualitative, quantitative, and mixed methods approaches: Sage publications, 2017.
  40. Eckhardt AL , DeVon HA . The MIXED framework: A novel approach to evaluating Mixed‐Methods rigor. Nurs Inq 2017;24. doi:10.1111/nin.12189 🔗 https://doi.org/10.1111/nin.12189
  41. Gries K , Berry P , Harrington M , et al . Literature review to assemble the evidence for response scales used in patient-reported outcome measures. J Patient Rep Outcomes 2017;2:41. doi:10.1186/s41687-018-0056-3 🔗 https://doi.org/10.1186/s41687-018-0056-3
  42. Taherdoost (2019). What is the best response scale for survey and questionnaire design; review of different lengths of rating scale/attitude scale/Likert scale. Hamed Taherdoost, 2019 1.
  43. Colquhoun, H., Levac, D., O'Brien, K., Straus, S., Tricco, A., Perrier, L., … et al. (2014). Scoping reviews: time for clarity in definition, methods, and reporting. Journal of Clinical Epidemiology, 67(12), 1291-1294. 🔗 https://doi.org/10.1016/j.jclinepi.2014.03.013
  44. Munn Z , Stern C , Aromataris E , et al . What kind of systematic review should I conduct? A proposed typology and guidance for systematic reviewers in the medical and health sciences. BMC Med Res Methodol 2018;18:5. doi:10.1186/s12874-017-0468-4 🔗 https://doi.org/10.1186/s12874-017-0468-4
  45. Arksey, H., O'Malley, L. (2005). Scoping studies: towards a methodological framework. International Journal of Social Research Methodology, 8(1), 19-32. 🔗 https://doi.org/10.1080/1364557032000119616
  46. Allen (2023). Face validity. Eur J Psychol Assess, 39 153. 🔗 https://doi.org/10.1027/1015-5759/a000777
  47. Ebadi A , Zarshenas L , Rakhshan M , et al . Principles of scale development in health science. Jame-e-negar: Tehran, 2017.
  48. Almanasreh (2019). Evaluation of methods used for estimating content validity. Res Social Adm Pharm, 15 214. 🔗 https://doi.org/10.1016/j.sapharm.2018.03.066
  49. LAWSHE, C. (1975). A QUANTITATIVE APPROACH TO CONTENT VALIDITY<sup>1</sup>. Personnel Psychology, 28(4), 563-575. 🔗 https://doi.org/10.1111/j.1744-6570.1975.tb01393.x
  50. Polit D , Beck C . Essentials of Nursing research: Appraising evidence for Nursing practice. Lippincott Williams & Wilkins, 2020.
  51. Polit DF , Yang FM . Measurement and the measurement of change: a primer for the health professions. Wolters Kluwer Philadelphia, 2016.
  52. Roebianto (2023). Content validity: definition and procedure of content validation in psychological research. TPM, 30 5.
  53. Cristobal E , Flavian C , Guinaliu M . Perceived E‐Service quality (Pesq): measurement validation and effects on consumer satisfaction and web site loyalty managing service quality. An International Journal 2007. doi:10.1108/09604520710744326 🔗 https://doi.org/10.1108/09604520710744326
  54. Flake (2022). Construct validity and the validity of replication studies: A systematic review. Am Psychol, 77 576. 🔗 https://doi.org/10.1037/amp0001006
  55. Plichta SB , Kelvin EA . Munro’s statistical methods for health care research; 2013.
  56. Boateng GO , Neilands TB , Frongillo EA , et al . Best practices for developing and validating scales for health, social, and behavioral research: a primer. Front Public Health 2018;6:149. doi:10.3389/fpubh.2018.00149 🔗 https://doi.org/10.3389/fpubh.2018.00149
  57. Kyriazos (2018). Applied psychometrics: sample size and sample power considerations in factor analysis (EFA, CFA) and SEM in general. PSYCH, 09 2207. 🔗 https://doi.org/10.4236/psych.2018.98126
  58. Pahlevan Sharif S , Sharif Nia H . Factor analysis and structural equation modeling with SPSS and AMOS. Jame-e-Negar: Tehran, 2020.
  59. Norman GR , Streiner DL . Biostatistics: the bare essentials: PMPH USA. BC Decker, 2008.
  60. Çokluk Bökeoğlu Ö , Koçak D . Using horn’s parallel analysis method in exploratory factor analysis for determining the number of factors. Educ Sci Theory Pract 2016;16.
  61. Hahs-Vaughn DL . In: Applied multivariate statistical concepts. New York, NY : Routledge, 2017: Taylor & Francis, 2016. doi:10.4324/9781315816685 🔗 https://doi.org/10.4324/9781315816685
  62. IBM Corp N . IBM SPSS statistics for windows. IBM corp Armonk, NY, 2017.
  63. JL A . Amos (version 26.0)[computer program]. chicago. IL, USA: IBM SPSS, 2019.
  64. Mayers A . Introduction to statistics and SPSS in psychology; 2013.
  65. Mohammadbeigi (2015). Validity and reliability of the instruments and types of Measurments in health applied researches. Journal of Rafsanjan University of Medical Sciences, 13 1153.
  66. Chenani (2021). Guideline for selecting types of Reliability and suitable intra-class correlation coefficients in clinical research. Journal of Biostatistics and Epidemiology, 7 305.
  67. Huang, S., Hsieh, C., Wu, R., Tai, C., Lin, C., Lu, W. (2011). Minimal Detectable Change of the Timed “Up & Go” Test and the Dynamic Gait Index in People With Parkinson Disease. Physical Therapy, 91(1), 114-121. 🔗 https://doi.org/10.2522/ptj.20090126
  68. Lai (2018). Estimating standardized SEM parameters given Nonnormal data and incorrect model: methods and comparison. Struct Equ Model: A Multidisciplinary Journal, 25 600. 🔗 https://doi.org/10.1080/10705511.2017.1392248
  69. Mokkink, L., Terwee, C., Patrick, D., Alonso, J., Stratford, P., Knol, D., … et al. (2010). The COSMIN checklist for assessing the methodological quality of studies on measurement properties of health status measurement instruments: an international Delphi study. Quality of Life Research, 19(4), 539-549. 🔗 https://doi.org/10.1007/s11136-010-9606-8
  70. Shirinabadi Farahani (2015). Index for selecting an appropriate instrument to conduct research in health sciences: introducing the COSMIN checklist. Journal of Health Promotion Management, 4 1.
  71. Esposito Vinzi V , Chin WW , Henseler J , et al . Handbook of partial least squares: Concepts, methods and applications. Berlin, Heidelberg: Springer, 2010. doi:10.1007/978-3-540-32827-8 🔗 https://doi.org/10.1007/978-3-540-32827-8
  72. Lenz ER . Measurement in Nursing and health research. Springer publishing company, 2010.
  73. Nourollahpour Shiadeh (2020). Reproductive health issues in female patients with beta-Thalassaemia major: A narrative literature review. J Obstet Gynaecol, 40 902. 🔗 https://doi.org/10.1080/01443615.2019.1692802
  74. Barzanji, A., Zareiyan, A., Nezamzadeh, M., Mazhari, M. (2019). Evaluation of Observational and Behavioural Pain Assessment Tools in Nonverbal Intubated Critically Adult Patients after Open – Heart Surgery: A Systematic Review. Open Access Macedonian Journal of Medical Sciences, 7(3), 446-457. 🔗 https://doi.org/10.3889/oamjms.2019.103
  75. Moudi (2022). The development and validation of an obstetric triage acuity index: a mixed-method study. The Journal of Maternal-Fetal & Neonatal Medicine, 35 1719. 🔗 https://doi.org/10.1080/14767058.2020.1768239
  76. Jazi (2020). Designing and Psychometric evaluation of Nurses' social responsibility instrument: A mixed-method study. Iran J Nurs Midwifery Res, 25 166. 🔗 https://doi.org/10.4103/ijnmr.IJNMR_145_19
  77. Mokhtarinia (2021). Cross-cultural adaptation, validity, and reliability of the Persian version of the upper limb functional index. Hand Ther, 26 43. 🔗 https://doi.org/10.1177/1758998320986832

Cite this article

Mohammed looti (2026). Nurses’ Innovative Behaviours Inventory. PSYCHOLOGICAL SCALES. Retrieved from https://scales.arabpsychology.com/s/nurses-innovative-behaviours-inventory/

Mohammed looti. "Nurses’ Innovative Behaviours Inventory." PSYCHOLOGICAL SCALES, 14 Aug. 2026, https://scales.arabpsychology.com/s/nurses-innovative-behaviours-inventory/.

Mohammed looti. "Nurses’ Innovative Behaviours Inventory." PSYCHOLOGICAL SCALES, 2026. https://scales.arabpsychology.com/s/nurses-innovative-behaviours-inventory/.

Mohammed looti (2026) 'Nurses’ Innovative Behaviours Inventory', PSYCHOLOGICAL SCALES. Available at: https://scales.arabpsychology.com/s/nurses-innovative-behaviours-inventory/.

[1] Mohammed looti, "Nurses’ Innovative Behaviours Inventory," PSYCHOLOGICAL SCALES, vol. X, no. Y, ص Z-Z, August, 2026.

Mohammed looti. Nurses’ Innovative Behaviours Inventory. PSYCHOLOGICAL SCALES. 2026;vol(issue):pages.

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