The senior nurse leaders of Emmanuel Hospital Association in India identified the need to improve nursing practice and patient outcomes through the institution of a shared governance (SG) structure. As a result, a study was designed to describe the level of Nurse leader’s perceptions of the current state of SG within the organization. In addition, the researchers seek to test the following hypothesis:
- Developing contextualized decision-making structures and processes will improve Nurse Leader perception of SG
Relevance/Significance:
Shared Governance (SG) has been widely accepted and reported to promote professional practice environments and provide nurses the autonomy and control over their practice to positively impact patient outcomes (Allen-Gilliam J, Kring D, Graham R, et al, 2016; Kneflin N, O’Quinn L, Geigle G, Mott B, Nebrig D, Munafo J, 2016).
Research studies have demonstrated the successful development of a shared governance structure resulting from using the Index of Professional Nursing Governance (IPNG) tool (Hess, 2011; Mouro G, Tashjian H, Bachir R, and et al., 2013; Di Fiore T, Zita A, Berardinelli A, and et al., 2018; Dechairo-Marino A, Collins Raggi M, Garber Mendelson S, et al., 2018).
In India, there have been no published studies providing an understanding of nurses perceptions of shared governance. However, the author assisted in the institution of a SG Council in India in the year 2000 which facilitated the nurse leaders to develop Nurse Job Descriptions, Standards of Nursing Care, and provide for Professional development opportunities for nursing staff across the organization. All of these projects completed in the SG structure were noted by the participants to the author to positively impact their ability to have control over their nursing practice and a feeling of empowerment to make decisions related to their nursing practice and development.
Strategy and Implementation:
In April 2019, the EHA nurse leaders (nursing superintendents) from all 21 hospitals will be attending at the annual nursing leadership workshop. During the workshop, a research tool will be conducted using the IPNG tool that will be provided to the workshop participants to obtain their perceptions of shared governance. The author will evaluate the results and return to India in July to meet with the sr. EHA nursing leaders to begin the work on developing a contextualized SG structure for the nursing leaders. This structure will be proposed to the Sr. Executives of EHA at their annual meetings in July for buy-in and support for the implementation.
The initial SG implementation will include the institution of the EHA Nursing Coordinating Council (ENCC) made up of all the sr. nurse leaders across the organization with the first meeting to be held by the end of 2019. This SG Council (the ENCC) will assist in developing a study to use the IPNG tool to assess the nursing staff’s perceptions of shared governance in their respective hospitals and to be completed in 2020. The author will assist with data analysis and provision of results to the nursing leaders for future planning for the implementation of a shared governance structure in each of the 21 hospitals.
Evaluation/Outcomes:
The initial research study using the IPNG tool with the EHA sr. nursing leaders will guide the development of a contextualized shared governance structure for the nursing leaders. The second study that will be proposed to be presented at a future Sigma conference (2021) will include the using the IPNG tool to guide the development of a shared governance structure for the staff nurses of EHA. In addition, in 2020, the sr. nurse leaders will again be surveyed after a year from the time of implementation of the ENCC (SG for Sr. Nursing Leaders) to test the study hypothesis of whether the development of a contextualized decision-making structure and processes will improve Nurse Leader perception of SG.
Implications for Practice:
The author previously assisted in the institution of a SG Council in EHA in the year 2000 which facilitated the nurse leaders to develop Nurse Job Descriptions, Standards of Nursing Care, and provide for Professional development opportunities for nursing staff across the organization. This work provided the nurses in EHA a sense of empowerment and provided them with opportunities to have a significant impact in their nursing practice of which had been reported to be minimal up until the SG structure was in place. Despite the SG being dissolved with a change in Executive leadership, the nursing leaders recognize the value of the previous SG structure and are committed to work towards seeing it implemented once again to ensure positive nurse and patient outcomes.
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