Staff Perceptions of Decision-Making in a Shared Governance Culture

Area of Science:

• Nursing Practice and Healthcare Management
• Organizational Science

Background:

• Shared decision-making (SDM) is crucial for empowering clinical nurses, enhancing their engagement, and improving retention.
• Established shared governance models aim to provide nurses with a voice in practice-related decisions.

Purpose of the Study:

• To compare clinical nurses' perceptions of shared decision-making (SDM) at the initial implementation of a shared governance model.
• To evaluate changes in SDM perceptions 3 years later, after the shared governance model had matured.

Main Methods:

• A prospective, 2-group comparative study design was employed.
• The Index of Professional Nursing Governance, a validated tool, was used to assess SDM perceptions.
• Univariate comparisons and multivariable linear regression were utilized to analyze data and control for nurse characteristics.

Main Results:

• Initially, no significant increase in mean overall SDM scores or domain scores was observed between 2012 and 2015.
• After adjusting for nurse characteristics, significant improvements were noted in the overall SDM score (P = .017).
• Three specific domains showed improvement: professional control of work, decision-making structures, and access to information (P values between .005 and .031).

Conclusions:

• Shared decision-making scores among clinical nurses increased as the shared governance model became more established.
• The maturation of shared governance positively impacted nurses' perceptions of control, decision-making processes, and information access.