Enhancing Council Effectiveness: Implementing a Nursing Shared Governance Toolkit Tailored to the Needs of Council...

Evidence-based practice is essential to high quality healthcare. Shared governance (SG) is vital to integrate evidence-based practice findings into practice and empower frontline nurses through shared decision making. Research supports that SG fosters nurse engagement and satisfaction. This article outlines the first phase of a project aimed at improving council effectiveness, focusing on a current state analysis and development of a Nursing SG Toolkit (NSGT).

To assess the current state of nursing SG at a Veteran Affairs Medical Center and create a toolkit targeting identified gaps.

The project team utilized both quantitative and qualitative data. They distributed the Council Health Survey (CHS) to 20 of 31 active councils to assess council effectiveness through a five-point Likert scale (higher score favorable). They followed with focused discussions. The team created the NSGT to address identified gaps and shared an early iteration with Nurse Practice Council before re-distributing the "Membership" subscale of the CHS. The team disseminated a refined NSGT to all councils and administered the CHS 14 months later to 23 of 31 active councils.

In the current state analysis, the lowest subscale of the CHS was "Membership" (M = 2.82). The project team created the NSGT with a focus on this subscale. Mann-Whitney U tests were used to evaluate pre and post scores. After Nurse Practice Council received NSGT education, its scores improved in all five "Membership" questions, with three out of the five questions statistically significant (p < 0.05). 14 months post implementation of the NSGT, overall CHS scores significantly increased (M = 3.62 to 3.83, z = -8.37, p < 0.001) with statistically significant increases in Nurse Practice Council scores in four of the five "Membership" questions. When data were filtered by those who indicated they used the NSGT, scores improved even more (M = 3.63-4.0, z = -10.27, p = < 0.001).

SG councils simply existing is not enough; they must be effective in supporting the shared decision-making processes critical for evidence-based changes. Developing a toolkit to address lower scoring CHS areas (e.g., Membership) demonstrates a successful strategy for promoting council effectiveness.