Unit Practice Councils Utilize Evidence-Based Practice to Improve Patient Care in a Shared Governance Environment

Thursday, 15 July 2010: 10:30 AM

Ann-Lynn Denker, ARNP, PhD
Center for Nursing Excellence, Jackson Health System, Miami, FL
Beverly Fray, BA, RN, MSN, APRN-BC
Nursing Administration - Center for Nursing Excellence, Jackson Health System, Miami, FL

Learning Objective 1: The learner will be able to identify three indicators for successful outcomes for evidence based practice in a shared governance practice environment.

Learning Objective 2: The learner will be able to describe characteristics and behaviors of successful Unit Practice Councils for improving unit based clinical practice.

            We examined the effects of Shared Governance and Unit Practice Councils (UPCs) utilizing evidence based practice on patient care outcomes in a public, teaching health system. The UPC is the grassroots where clinical nurses have a voice making decisions about nursing practice.
            Ninety UPCs were established to provide nurses with decision making authority. With the support of a community foundation, UPCs were organized, educated in evidence based practice, decision making, and mentored on the work of improving practice over two years. Trained facilitators mentored UPCs made up of multi-disciplinary staff. A data based was established to document and trend UPC projects and outcomes.
            UPCs developed team relationships, held regular meetings, collected data, and identified practice improvement projects.  Many variables influence the success of the UPC, including administrative support, educational preparation, facilitator expertise, and scheduled meeting times. Projects produced improved outcomes, cost savings, system improvements and patient/staff satisfaction. Projects varied in complexity and sophistication from simple improvement projects to the utilization of advanced research procedures.  Eighty% of the UPCs implemented projects to improve practice. Twenty UPCs implemented projects that were exceptional sustainable, and generalizable. These outcomes were presented at the organization wide shared governance structure where the President and CEO and executives participate.
When provided with appropriate resources and environment to make decisions regarding  practice, there is increased engagement, enthusiasm and success. Although the structure and foundation is important, resources and mentoring must be present to produce positive outcomes. Nurses will identify significant projects when provided with opportunity and pertinent data to facilitate decision making. There will be performance variations among UPCs across the organization related to their speed in organizing, bonding as a team, and work product. Support should be customized to facilitate each UPC’s individual growth and success.