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Nursing intellectual capital theory: testing selected propositions


  • Christine L. Covell PhD RN,

    Postdoctoral Fellow
    1. Institute of Gender and Health, Canadian Institutes of Health Research, Faculty of Health Sciences, University of Ottawa, Ontario, Canada
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  • Souraya Sidani PhD RN

    Professor and Canadian Research Chair-Health Interventions
    1. School of Nursing, Ryerson University, Toronto, Ontario, Canada
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Correspondence to C.L. Covell:




To test the selected propositions of the middle-range theory of nursing intellectual capital.


The nursing intellectual capital theory conceptualizes nursing knowledge's influence on patient and organizational outcomes. The theory proposes nursing human capital, nurses' knowledge, skills and experience, is related to the quality of patient care and nurse recruitment and retention of an inpatient care unit. Two factors in the work environment, nurse staffing and employer support for nurse continuing professional development, are proposed to influence nursing human capital's association with patient and organizational outcomes.


A cross-sectional survey design.


The study took place in 2008 in six Canadian acute care hospitals. Financial, human resource and risk data were collected from hospital departments and unit managers. Clearly specified empirical indicators quantified the study variables. The propositions of the theory were tested with data from 91 inpatient care units using structural equation modelling.


The propositions associated with the nursing human capital concept were supported. The propositions associated with the employer support for nurse continuing professional development concept were not. The proposition that nurse staffing's influences on patient outcomes was mediated by the nursing human capital of an inpatient unit, was partially supported.


Some of the theory's propositions were empirically validated. Additional theoretical work is needed to refine the operationalization and measurement of some of the theory's concepts. Further research with larger samples of data from different geographical settings and types of hospitals is required to determine if the theory can withstand empirical scrutiny.