Enhancing and Advancing Shared Governance Through a Targeted Decision-Making Redesign.

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The Journal of nursing administration


California; Clinical Governance; Community Health Services; Cooperative Behavior; Cross-Sectional Studies; Decision Making; Humans; Job Satisfaction; Nursing Staff, Hospital; Power (Psychology); Quality of Health Care; Reproducibility of Results


OBJECTIVE: The study aim was to determine if a targeted redesign of shared decision making improved shared governance (SG).

BACKGROUND: Nursing SG is collaborative decision making between nurses at every level; it improves quality of care, empowers nurses, and enhances nurse satisfaction.

METHODS: Using a quasi-experimental, pretest/posttest design, researchers electronically distributed the Index of Professional Nursing Governance (IPNG) to an inclusive, convenience sample of RNs in a Magnet®-designated 377-bed community medical center. Preintervention scores were used to tailor a redesign of shared decision making, and postintervention data were collected within 1 year to measure outcomes.

RESULTS: IPNG overall score and 5 of 6 subscale scores significantly increased after the redesign.

CONCLUSIONS: Changes to an SG structure can take 2 to 5 years to be realized. Our findings corroborate that the IPNG is a valuable tool in promoting setting-specific SG.