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Enhancing and Advancing Shared Governance Through a Targeted Decision-Making Redesign

Dechairo-Marino, Ann E., PhD, RN, NEA-BC; Collins Raggi, Mara E., MSN, RNC-NIC PHN; Mendelson, Sherri Garber, PhD, RNC, CNS, IBCLC; Highfield, Martha E.F., PhD, RN; Hess, Robert G. Jr, PhD, RN, FAAN

JONA: The Journal of Nursing Administration: September 2018 - Volume 48 - Issue 9 - p 445–451
doi: 10.1097/NNA.0000000000000647

OBJECTIVE The study aim was to determine if a targeted redesign of shared decision making improved shared governance (SG).

BACKGROUND Nursing SG is collaborative decision making between nurses at every level; it improves quality of care, empowers nurses, and enhances nurse satisfaction.

METHODS Using a quasi-experimental, pretest/posttest design, researchers electronically distributed the Index of Professional Nursing Governance (IPNG) to an inclusive, convenience sample of RNs in a Magnet®-designated 377-bed community medical center. Preintervention scores were used to tailor a redesign of shared decision making, and postintervention data were collected within 1 year to measure outcomes.

RESULTS IPNG overall score and 5 of 6 subscale scores significantly increased after the redesign.

CONCLUSIONS Changes to an SG structure can take 2 to 5 years to be realized. Our findings corroborate that the IPNG is a valuable tool in promoting setting-specific SG.

Author Affiliations: Former Chief Nursing Officer (Dr Dechairo-Marino), Manager of Neonatal Intensive Care Unit (Ms Raggi), Director of Nursing Research, Magnet Program, and Professional Role Development, Magnet Department (Dr Mendelson), and Advisor, Nursing Research Fellowship (Dr Highfield), Providence Holy Cross Medical Center, Mission Hills, California; Professor Emeritus (Dr Highfield), Nursing Department, California State University, Northridge; Executive Vice President, Chief Clinical Executive (Dr Hess), OnCourse Learning, Healthcare, Brookfield, Wisconsin; and Founder and Chief Executive Officer (Dr Hess), Forum for Shared Governance, Hobe Sound, Florida.

The authors declare no conflicts of interest.

Correspondence: Dr Dechairo-Marino, Providence Holy Cross Medical Center, PO Box 1497, Monrovia, CA 91017 (

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