Readiness of Staff Nurses to Implement Shared Governance Model

Purpose:

The purpose of this study was to determine if nurses at a large multi-site healthcare system were ready to participate in a shared governance structure. In addition, to examine the relationship between their perceptions of shared governance at the healthcare system and their engagement in their nursing practice. A patient centered approach to healthcare can have a positive impact on patient outcomes and improve overall patient satisfaction. When nurses feel empowered, they are more engaged and have a higher level of job satisfaction. In addition, nurses who feel empowered are more likely to be engaged in their work and patients are provided with higher quality care. According to a hospital-wide survey in 2012, more than half of the nurses were disengaged and voluntary terminations of registered nurses (RNs) were at 32%. According to previous research, shared governance offers opportunities for nurses to participate in decision making based on four principles: partnership, accountability, equity, and ownership. Shared governance has been described as a means to promote empowerment, autonomy, and decision-making among nursing staff. This study is intended to fill the gap by linking nurses’ perceptions of empowerment to engagement in their work.

Methods: A total of 260 RNs completed an online survey to measure perceptions of empowerment and engagement. The surveys, The Index of Professional Nursing Governance and the People Insight Survey, along with a short demographic survey provided data needed to address the hypotheses that RNs perceptions of shared governance at the large healthcare system was related to their levels of engagement.

Results:

Most of the RNs (46.7%) were graduates of ADN programs, with 42% indicating they had completed BSN degrees. The nurses were from all clinical specialties, including medical/surgical, behavioral medicine, surgical services, critical care, etc.  Correlations between engagement and five of the six subscales (information, resources, participation, practice, and goals) and the total score measuring perceived shared governance were statistically significant in a positive direction.

Conclusion:

The findings of this study provided support that registered nurses who perceived shared governance was not being practiced in their healthcare facility were more likely to be disengaged from their work.