Nurse Engagement in Shared Governance and Patient and Nurse Outcomes

Abstract

Objective The objective of this study was to examine differences in nurse engagement in shared governance across hospitals and to determine the relationship between nurse engagement and patient and nurse outcomes. Background There is little empirical evidence examining the relationship between shared governance and patient outcomes. Methods A secondary analysis of linked cross-sectional data was conducted using nurse, hospital, and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey data. Results Engagement varied widely across hospitals. In hospitals with greater levels of engagement, nurses were significantly less likely to report unfavorable job outcomes and poor ratings of quality and safety. Higher levels of nurse engagement were associated with higher HCAHPS scores. Conclusions A professional practice environment that incorporates shared governance may serve as a valuable intervention for organizations to promote optimal patient and nurse outcomes.

Nurses’ lived experience serving on unit-based councils: A literature review

“…It influences nurses' perceptions and sup-port of SG. [25][26][27] A major component of job satisfaction that mainly concerns SG is the degree of nurses' participation in point of care decisions. Staff who perceive an opportunity to speak up for their issues and concerns and be involved in decision-making about issues affecting their work will be more likely to express satisfaction at work.…”

“…The autonomous participation in decision-making processes contributes to frontline staff to achieve job satisfaction. [25][26][27] Engagement in decision-making offered nurses a sense of having control over their practice and having a voice in their patients' care planning. Further, the autonomy nurses had in their work and the extent of their interactions with other nurses and physicians have also been reported to play a significant role in their job satisfaction.…”

“…[27] 3.4 Improved patient care High levels of nurse engagement in SG activities such as participating in hospital policy decisions affecting nurses' daily work has been associated with quality and safety outcomes. [26] The higher the engagement, the higher the quality and safety outcomes. Staff nurses hold vital knowledge of their patients' needs and can easily identify enablers in the care delivery process.…”

The nexus of nursing leadership and a culture of safer patient care

“…Globally, there is a push for nurses to receive leadership education at undergraduate level, at entry level to the profession and through ongoing leadership programmes within their work environments so as to grow and nurture leaders at all levels for succession planning (Sherman & Pross, ; Squires et al., ). Shared governance frameworks have placed patient safety as the responsibility of all healthcare workers and serve to empower staff to participate in organisational decision‐making to enhance patient outcomes (Kutney‐Lee et al., ). These frameworks also promote leadership education and development programmes for all nursing levels, including new graduate nurses (Hendricks et al., ).…”

Care management and nursing governance in a maternity ward: grounded theory

“…It consists of a decentralized approach that promotes the active participation of nurses in decision-making processes, lending them greater autonomy and control over the work environment. It also fosters quality of care and patient safety (6)(7) . Thus, nursing shared governance is based on shared decision-making, which considers partnership, equity, participation, and co-responsibility for actions (8) .…”