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Staff Perceptions of Decision-Making in a Shared Governance Culture
Tina Di Fiore1, Antoinette Zito, Amy Berardinelli
1Author Affiliations: Clinical Nurse Specialist of Advance Practice Nursing (Mss Di Fiore and Kennedy), Perioperative Educator (Ms Zito), Nurse Manager of Perioperative Unit and Digestive Health Center (Dr Berardinelli), and Clinical Nurses (Mss Keck and Stibich), Nursing Institute, Cleveland Clinic Hillcrest, Mayfield Heights; Biostatistician (Mr. Bena) and Statistical Programmer (Ms Morrison), Quantitative Health Sciences, Cleveland Clinic; and Associate Chief Nursing Officer of Nursing Research and Innovation (Dr Albert), Nursing Institute, Cleveland Clinic, Ohio.
Objective:
To evaluate differences in the shared decision-making perceptions of clinical nurses between initial implementation of a shared governance model and perceptions 3 years later after the model has matured.
Background:
Shared decision-making empowers nurses to have a voice in their practice and supports engagement and retention.
Methods:
A prospective, 2-group comparative design was conducted using the Index of Professional Nursing Governance, a validated, reliable tool. After comparing data univariately, a multivariable linear regression model was used to evaluate the impact of nurse characteristics on shared decision-making responses.
Results:
Mean overall shared decision-making score (P = .23) and domain scores (P values between .055 and .63) did not increase in 2015 compared with 2012. After adjusting for differences in nurse characteristics between groups, overall score (P = .017) and 3 of 6 domain scores improved: professional control of work, structures for decisions and access to information (all P values between .005 and .031).
Conclusion:
As shared governance became established, shared decision-making scores increased.
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