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Journey of Excellence: Implementing a Shared Decision-Making Model

Murray, Karen ADN, RN, CCRN; Yasso, Sabrina BSN, RN, CNOR; Schomburg, Roberta BSN, RN, CPN; Terhune, Molly BSN, RN; Beidelschies, Marissa BSN, RN, CPN; Bowers, Devin MSN, RN, NE-BC; Goodyear-Bruch, Caryl PhD, RN, NEA-BC, CCRN-K

AJN The American Journal of Nursing: April 2016 - Volume 116 - Issue 4 - p 50–56
doi: 10.1097/01.NAJ.0000482137.12424.51
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Research has shown that nurses who participate in shared decision making (SDM) have more control over their practice and greater job satisfaction, and hospitals that have instituted SDM have lower rates of nurse turnover and better patient outcomes. The purpose of this article is to describe the implementation of an SDM structure at a pediatric hospital. The hospital's chief nurse officer charged a group of nurses with developing SDM guidelines to outline the purpose, structure, and function of unit councils. A targeted, multifaceted approach to the implementation of these guidelines led to the successful standardization of nine existing unit councils and the expansion of the SDM unit council structure to all other hospital units. Work continues with guideline refinement in response to the real-life circumstances nurses encounter on the units, and the original group of nurses continues to review literature on SDM best practices. In addition, professions other than nursing, including multidisciplinary teams in dialysis, cardiovascular surgery, respiratory therapy, and child life, have adopted the guidelines for use in their departments.

The authors describe the successful implementation of a shared decision-making structure at their pediatric Magnet hospital and discuss the lessons learned from the project.Supplemental digital content is available in the text.

Karen Murray is a nurse in the pediatric ICU at Children's Mercy Kansas City, where Sabrina Yasso is an operating room charge nurse, Roberta Schomburg is a sedation team charge nurse, Molly Terhune is an intensive care nursery charge nurse, and Marissa Beidelschies is a nurse in the pediatric ICU. Devin Bowers is Clinical Scene Investigator Academy program manager and Caryl Goodyear-Bruch is a senior director, both at the American Association of Critical-Care Nurses in Aliso Viejo, CA. At the time of this project, Bowers and Goodyear-Bruch were nursing department director, pediatric ICU, and patient care services director, professional resources and leadership development, respectively, at Children's Mercy Kansas City. Contact author: Karen Murray, kmurray@cmh.edu. The authors have disclosed no potential conflicts of interest, financial or otherwise.

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