Nurses in a modern hospital setting, with digital displays showing work environment scores.

Is Your Hospital a Magnet? Validating the Korean PES-NWI

Elliot Brynn in Health & Wellness December 2025 • 4 min read.

"New Research Confirms the Reliability and Validity of the Korean Version of the Practice Environment Scale of Nursing Work Index (PES-NWI)"

The work environment in hospitals significantly affects nurses' job outcomes, retention, and overall well-being. Recognizing this critical link, a 1981 study by the American Academy of Nursing identified hospitals with positive work environments to understand how these conditions could be fostered elsewhere.

This initiative led to the identification of 41 hospitals recognized as 'Magnet Hospitals,' known for attracting and retaining top nursing talent. These institutions shared common characteristics such as decentralized decision-making, effective nurse leadership, professional autonomy, accountability, and a strong commitment to quality patient care.

In light of increasing nurse attrition and concerns about the nursing environment, the need for accurate and reliable assessment tools has become crucial. A new study focuses on validating the Korean version of the Practice Environment Scale of Nursing Work Index (PES-NWI), a widely recognized instrument for measuring nursing work environments. This article delves into the study's methodology, findings, and implications for improving hospital environments in Korea.

PES-NWI: A Tool for Assessing Nursing Work Environments

Nurses in a modern hospital setting, with digital displays showing work environment scores.

Originally developed in the 1980s by Kramer and Hafner, the Nursing Work Index (NWI) was a comprehensive tool designed to evaluate various factors influencing job satisfaction and quality of care among nurses. Consisting of 65 items, the NWI was used to explore how factors such as decentralization of decision-making, nurse leadership, and professional autonomy impacted nurses' professional lives.

As research evolved, Aiken and Patrician revised the NWI in 2000, creating the NWI-R. This 57-item version more effectively captured the organizational aspects of nursing practice that influence patient outcomes. Key elements included nurse autonomy, professional status, nurse-physician relations, and organizational support.

NWI (Nursing Work Index): The original 65-item tool developed by Kramer and Hafner.
NWI-R (Revised Nursing Work Index): A 57-item revision by Aiken and Patrician focusing on organizational aspects.
PES-NWI (Practice Environment Scale of Nursing Work Index): A streamlined 29-item tool developed by Lake.

To address the length and complexity of the NWI-R, Lake developed the PES-NWI in 2002. This concise, 29-item instrument retained the essential elements of its predecessors, offering a psychometrically sound and reliable measure of nursing work environments. PES-NWI has proven useful in predicting critical outcomes such as needlestick injuries and nurse turnover.

Implications and Future Directions

This study confirms that the Korean version of the PES-NWI exhibits satisfactory construct validity and reliability, making it a valuable tool for measuring nursing work environments in Korean hospitals. The standardized PES-NWI provides a foundation for future research, both in Korea and in comparison with international studies. By understanding and improving these environments, healthcare institutions can foster nurse retention, enhance the quality of care, and ultimately improve patient outcomes.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.4040/jkan.2011.41.3.325, Alternate LINK

Title: Construct Validity And Reliability Of The Korean Version Of The Practice Environment Scale Of Nursing Work Index For Korean Nurses

Subject: General Nursing

Journal: Journal of Korean Academy of Nursing

Publisher: Korean Society of Nursing Science

Authors: Eunhee Cho, Mona Choi, Eun-Young Kim, Il Young Yoo, Nam-Ju Lee

Published: 2011-01-01

Everything You Need To Know

What is the PES-NWI?

The PES-NWI, or Practice Environment Scale of Nursing Work Index, is a 29-item tool developed by Lake in 2002. It is designed to measure the quality of nursing work environments. It's a streamlined version of earlier tools like the NWI-R, aiming to efficiently assess factors important to nurses' job satisfaction and patient care quality. It includes essential elements from the NWI-R, focusing on areas like nurse autonomy and support.

Why is the PES-NWI considered important?

The PES-NWI is important because it helps hospitals understand and improve the conditions in which nurses work. Positive work environments, as measured by tools like the PES-NWI, are linked to better nurse retention, which in turn leads to higher quality patient care and improved patient outcomes. This tool helps hospitals identify areas needing improvement, fostering environments that attract and retain skilled nurses.

What are the differences between the NWI, NWI-R, and PES-NWI?

The NWI, or Nursing Work Index, was the original assessment tool developed by Kramer and Hafner. It had 65 items and was designed to explore the factors influencing job satisfaction and quality of care among nurses. The NWI-R, a revised version with 57 items by Aiken and Patrician, focused more on organizational aspects of nursing practice. The PES-NWI, a shorter, more focused version of the NWI, was then developed by Lake, containing 29 items.

What are the implications of using the Korean version of the PES-NWI?

The implications of using the Korean version of the PES-NWI are significant. The study validates that the tool can accurately measure nursing work environments in Korean hospitals. This provides a basis for healthcare institutions to evaluate and enhance their work environments. By using this standardized tool, hospitals can identify areas to improve, leading to better nurse retention, enhanced quality of care, and improved patient outcomes. It also opens doors for comparisons with international studies.

What are Magnet Hospitals and why were they identified?

Magnet Hospitals were identified by the American Academy of Nursing to recognize hospitals with positive work environments. These hospitals share characteristics like decentralized decision-making, effective nurse leadership, and a strong commitment to quality patient care. The identification of Magnet Hospitals highlighted the link between positive work environments and better nurse retention and patient outcomes. The initiative helped define what a supportive environment looks like for nurses, driving improvements across the healthcare sector.