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Nurse Engagement in Shared Governance and Patient and Nurse Outcomes

Kutney-Lee, Ann PhD, RN, FAAN; Germack, Hayley PhD, RN; Hatfield, Linda PhD, NNP-BC; Kelly, Sharon BSN, RN-BC; Maguire, Patricia BSN, RN, CMSRN; Dierkes, Andrew BSN, RN; Del Guidice, Mary MSN, RN, CENP; Aiken, Linda H. PhD, RN, FAAN

JONA: The Journal of Nursing Administration: November 2016 - Volume 46 - Issue 11 - p 605–612
doi: 10.1097/NNA.0000000000000412

OBJECTIVE: The objectives of this study were to examine differences in nurse engagement in shared governance across hospitals and to determine the relationship between nurse engagement and patient and nurse outcomes.

BACKGROUND: There is little empirical evidence examining the relationship between shared governance and patient outcomes.

METHODS: A secondary analysis of linked cross-sectional data was conducted using nurse, hospital, and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey data.

RESULTS: Engagement varied widely across hospitals. In hospitals with greater levels of engagement, nurses were significantly less likely to report unfavorable job outcomes and poor ratings of quality and safety. Higher levels of nurse engagement were associated with higher HCAHPS scores.

CONCLUSIONS: A professional practice environment that incorporates shared governance may serve as a valuable intervention for organizations to promote optimal patient and nurse outcomes.

Author Affiliations: Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing (Drs Kutney-Lee, Germack, Hatfield, and Aiken and Mr Dierkes); and Pennsylvania Hospital (Dr Hatfield; Mss Kelly, Maguire, and Del Guidice; and Mr Dierkes), Philadelphia.

This project was supported by NINR R01-NR-014855 and T32-NR-007104 (Aiken, PI), the Rita & Alex Hillman Foundation, and Pennsylvania Hospital. The content is solely the responsibility of the authors and does not necessarily represent the official views of the funders. The funders had no role in the study design, data collection, analysis, interpretation, or writing of the report.

The authors declare no conflicts of interest.

Correspondence: Dr Kutney-Lee, University of Pennsylvania School of Nursing, 418 Curie Blvd, Room 385, Philadelphia, PA 19104 (

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