“Shared Governance equals Shared Decision, is it or is it not?”

Purpose:
This study looks at the nurses perceptions of shared decision using the Index of Professional Nursing Governance (IPNG) survey at Year 1, 2, and 3 of a newly opened hospital on its journey to Magnet designation following the implementation of a shared governance model.

Background/Significance:
Shared governance empowers nurses to be involved in decision making and gives them autonomy and responsibility over their practice. Establishing staff nurse's participation in decisions improves the workplace culture and is crucial in improving nurse, patient, and organizational outcomes. This study will strengthen evidence-based practice innovations that promote staff involvement in the realm of shared decision making as it relates to the culture of quality and safety and magnet designation.

Methods:
METHODS A cross-sectional descriptive, comparative study in a brand new hospital with the goal of reaching Magnet status within 3 years from opening; hence, it has to demonstrate formal empowerment structures, namely shared governance. An innovative shared governance model was rolled through out the hospital. Following approval from IRB, data was collected from a convenience sample of about 250 nurses through anonymous IPNG surveys in 2011, and will be repeated annually until 2013. The IPNG survey which has 6 sub themes, namely personnel, information, resources, participation, practice and goals, developed by Hess, R. (1994) was used to measure the decisional involvement of nurses.

Results:
One of the initial assumptions was that governance was going to be shared decisional involvement between the nursing management and nursing staff. In every step of the planning, development and implementation, shared governance was a focus. It was not surprising therefore to see that the IPNG scores were mostly within the “shared-governance spectrum”. To establish concurrent validity, we used the results from the NDNQI annual survey specifically the Job enjoyment scale and correlated them to the results of the IPNG, significant positive correlation exist.

Conclusions and Implications for Practice:
The data assists to target areas to further a strategic shared governance and whether it is retained over time or needs constant work.There is still room for improvement and the journey to Magnet designation warrants monitoring of this governance perception.