Date of Conferral

2018

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Linda Matheson

Abstract

Shared governance is a practice model that supports shared decision making between direct care nurses and their leaders. Developed from Kanter's theory of structural empowerment, shared governance allows employees to influence decisions made in an organization. Shared governance has been shown to increase nursing satisfaction, positively impact outcomes, and reduce nursing turnover. The purpose of this project was to examine the relationship between implementation of a system-wide, multihospital shared governance structure and registered nurse (RN) satisfaction, turnover, and perceptions of shared governance. The 3 sources of evidence used in the study were 2016-2017 organizational RN engagement survey results, 2016-2017 organizational RN turnover data, and RN perceptions of shared governance as measured by the Index of Professional Nursing Governance (IPNG) tool. Two similar hospitals within the system were selected for administration of the IPNG survey. Results showed that introduction of a multihospital shared governance structure had an impact on nursing turnover. The biggest change was in new nurse turnover, which reduced from a high of 32.10% to 27.30%. This 4.8% decrease translated in approximately $2 million in savings. A comparison of IPNG survey results showed that the hospital with lower turnover had higher perceptions of shared governance. The potential implications of these finding for social change could be an expansion of shared governance in the organization and social change in the region. Due to the relationship between shared governance and improved patient outcomes, a reduction in mortality and improvement in overall health could be seen for the 1 million patients served in these hospitals.

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