Date of Conferral



Doctor of Nursing Practice (DNP)




Diane D. Whitehead


AbstractShared governance (SG) has been defined as a style of management in which frontline staff and managers work together to improve clinical practice. Guided by the PLAN-DO-STUDY-ACT cycle, the purpose of this project was to evaluate the implementation of the SG model for pediatric services in a US acute care hospital. The practice question explored whether the implementation of the SG model would demonstrate improvements in nurse satisfaction using the culture of safety survey, a change in nurse staff turnover reported as numbers hired, retired, resigned, or transferred, and changes in patient satisfaction measured by survey scores from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey data. Data were analyzed using descriptive statistics for 1 year before the November 2018 implementation and for 1-year postimplementation. Over the analyzed period, nurse turnover was rare with retirement noted as the main reason for leaving the organization. Although not statistically significant, except for nurses’ concern for privacy, all HCAHPS subscale scores decreased. Statistically significant changes were detected on 5 out of 12 domains of nurse satisfaction. Respondents’ perception that the management was concerned about patient safety and perceptions of staff shortages changed in an unfavorable direction. Positive changes were noted in overall perceptions of safety, manager expectations, and actions for promoting safety. Recommendations for continued review of SG as a focus of positive social change and nurse empowerment were given to the nurse administrators. The findings from this project will further support the use of SG to promote positive social change through improvements in the work environment and nurse empowerment.

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