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Nurses’ Perception of Shared Decision-Making Processes

Quantifying a Shared Governance Culture

Gerard, Sally O. DNP, RN CDE, CNL; Owens, Deborah L. MSN, RN, NE-BC; Oliver, Patricia MS

JONA: The Journal of Nursing Administration: September 2016 - Volume 46 - Issue 9 - p 477–483
doi: 10.1097/NNA.0000000000000378

OBJECTIVE: The aim of this study is to describe how measuring the perceived and desired decision-making capacity of nurses in a model of shared governance (SG) can be beneficial.

BACKGROUND: Shared governance (SG) increases nurse’s control over professional practice. Engagement in SG can be impacted by how much decision-making power nurses desire. This concept related to decision making has been termed decisional involvement (DI). Few studies exist that examine the concept of DI.

METHODS: Using the Decisional Involvement Scale, acute care nurses were sampled concerning desired and perceived decision making on 21 topics related to nursing practice.

RESULTS: Analysis of the data identified different governance priorities for several areas. Of particular interest was that those nurses on SG councils for more than 5 years did not report higher satisfaction with decision involvement.

CONCLUSIONS: A comprehensive evaluation of shared decision making was a valuable tool to establish a baseline of data and seek opportunities for improvement. A well-integrated model of SG requires continuous improvement and analysis to be sustained. Measuring and evaluating staff nurses desire to control varied aspects of DI can allow organizations to make focused efforts to strengthen SG.

Author Affiliations: Adjunct Professor (Dr Gerard), School of Nursing, Fairfield University; Magnet Program Director (Ms Owens), Magnet Program, St Vincent’s Medical Center, Bridgeport; President (Ms Oliver), Pat Oliver Consulting, Newtown, Connecticut.

The authors declare no conflicts of interest.

Correspondence: Dr Gerard, School of Nursing, Fairfield University, 1073 N Benson Rd, Fairfield, CT 06824 (

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