Introduce the concept, development history, implementation mode, principles, challenges and opportunities of shared governance and the enlightenment to us

1. SHARED GOVERNANCE
IN NURSING
• Shanshan Wang

2. Contents
01
02
03
04
05
Concept and Development History
Reasons and Goals
Goal models
Principles and Enlightenment
Benefits and Obstacles

3. Concept
At present, researchers have not yet reached a
consensus on the definition of shared
governance. Porter-O'Grady proposed that
shared governance is a professional practice
model based on the basic principles of
cooperation, equality, responsibility, and
ownership. This in turn creates a culturally
sensitive and empowering structural framework
that provides sustainable, responsibility-based
decision support and interdisciplinary
collaboration to deliver quality patient care.

4. Concept
• The American Nurses Credentialing Center
(AN-CC) believes that shared governance is a
participatory decision-making work model in
which clinical nurses can formally participate
in clinical practice standards, quality
improvement, professional development and
research. In decision-making, it can give
nurses more professional autonomy to control
professional practice and working environment,
improve job satisfaction, and thus solve
problems such as resource utilization
constraints and nurse shortage .

5. Development course
• Shared governance originated from the
era of human resource management in
organizational theory, emphasizing
people-oriented management, that is,
treating people as the main object of
management, respecting individual values
and developing human resources.

6. History
• Porter-O’Grady’s work brought the
concept into the nursing practice
• Titled “Shared Governance” in 1978
• Popular in the 1980’s,decreased in the
1990’s, now increasing again because of a
nursing shortage
• Developed into three models

7. Why Shared Governance?
• Traditionally speaking, hospitals are places with
a strict hierarchical system, and there is often a
shortage of nurses. How to hire excellent
nurses and retain them requires changing from
a command-and-demand management model
to support and encouragement, and giving front-
line nurses more More autonomy, respect the
professionalism of nurses, make them demand
themselves according to the standards of
masters, and continuously improve their self-
management ability, professionalism and
satisfaction.

8. Aims of shared govermance
• Empowerment of individuals within the
decision making system,this
empowerment in directed at increasing
nurse’s authority &control over their
nursing practice.
• Shared governance improves staff nurses’
perception of their job & practice
environment .(Jone,&Lucas,1993;Ludema
n,&Brown.1989).

9. Goal
• To make nurses organized
• Allows nurses to have a say in planning
and decision making
• Extends roles of leadership to nurses
• Gives empowerment
• Improve nurses’work
environment,satisfaction,and retention
• Controls the practice to result in a better
patiernt outcome

10. Three models of shared
governance
01 02 03
Councilor Administrative Congressional

11. Councilor
• The councilor model is a governance
process for building employees and
managers through multiple committees,
which is mainly applicable to the overall
medical institution in order to achieve a
continuous and long-term shared
governance state.

12. Councilor
• Clavelle found that the main governance
method of magnetic hospitals is shared
governance, and the structural
authorization as the core component of
magnetic hospitals is mainly displayed
through shared governance, which further
proves the positive relationship between
shared governance and the nursing
practice environment of magnetic hospitals.
relationship.

13. Councilor
• In this model, a council integrates the
decisions made by staff. It is the most
commonly used model by magnet
organizations .
• Five areas of accountability include:
 Practice
 Quality Improvement
 Education
 Research
 Management

14. Advantages :
• 1. Guarantee the participation of every
clinical nurse, and improve and enhance the
professional autonomy of nurses to a greater
extent.
• 2.Helping Nurses Adapt to Changing
Environments
• 3.It has a greater positive impact on
organizational change and has become the
most common mode of shared governance

15. Administrative
This model in a traditional bureaucratic
structure. There is either a management or a
clinical focus in this model.
• reflect executive level of coordination over
the activities of smaller councils.

16. Congressional
The congressional model is similar to the
decentralized structure of the federal
government. All nursing staff are subordinate
to and committed to the cabinet. They are
elected to form an elected parliament or
senate composed of clinical practice
representatives and management, and then
appoint committee members reporting to
parliament. Committee activities also need
to submit an application to the cabinet

17. Congressional
A democratic model , that empowers nurses
to vote as a group.
• Less frequent
• all nursing staff work in given to
cabinets.

18. Benefits
• Decreases nurse turnover
• Increase nurse satisfaction
• Improves decision making
• Decrease in nurse “burnout”
• Improves relationships between staff
• Decrease in medical errors
• Improves patient outcomes

19. For example:Kneflin et al implemented the
results of the best evidence-based practice
of chlorhexidine bathing through the
structural framework of shared governance,
which reduced the risk of acquired
bloodstream infections and finally

20. Obstacles
• Poor communication
• Resistance to change
• Lack of interest
• Lack of concern
• Poor planning

21. Four Parts Of Shared Governance
输入文字
Partnership
Equity
从Four Parts Of
Shared
Governance
Accountability
Ownership

22. Four Parts Of Shared
Governance
• Partnership:non-competitive,
interdisciplinary collaborative relationships
dedicated to patient-centered care and
improved patient outcomes
• Equity:emphasize the participation of all
team members, especially clinical nurses
• Accountability:having the right to make
decisions
• Ownership:value individual input or
contribution

23. Four Parts Of Shared
Governance
• These 4 parts are coordinated and
continuously integrated within the
framework provided by shared governance
application to improve the quality of
nursing care by empowering nursing staff
to become more involved in their
professional practice.

24. • In shared governance, staff nurses are
included in the highest levels of decision
making within the nursing department
through representation on various councils
that govern practice and management
issues.These councils set the standard for
staffing, promotion, and so forth. In many
cases, a change in the organizational
culture is necessary before shared
governance can work (Currie & Loftus-
Hills, 2002).

25. • Genuine sharing of decision making is
difficult to accomplish, partly because
managers are reluctant to relinquish control
or to trust their staff members to make wise
decisions. Yet genuine empowerment of the
nursing staff cannot occur without this
sharing. Having some control over one’s
work and the ability to influence decisions
are essential to empowerment (Manojlovich
&Laschinger, 2002).

26. The Enlightenment of Shared Governance
to Nursing Management
• Emphasis on the professional autonomy of
clinical nurses
• Raise caregivers' awareness of shared
governance
• Exploring the development of domestic
shared governance
• Improving the working environment for
nursing staff
• Improve the quality of nursing services

27. Conclusion
Shared governance is a dynamic process
that promotes nurses to control professional
practice, participate in decision-making, and
increase cooperation and sense of
responsibility through empowerment. Nurses
can obtain the resources, support and
information needed for work, have
opportunities for learning and development,
and fully mobilize work autonomy. sex and
agency.

28. Conclusion
• Shared governance and its good empirical
research results have gradually been
accepted and recognized by nursing staff.
Researchers should learn from the
development experience of shared
governance, further carry out research on
shared governance, and improve nursing
staff's awareness of shared governance.

29. • The characteristics of the structure Choose
different implementation models, formulate a
suitable shared governance development
strategy plan, pay attention to the cultivation of
nursing staff's professional autonomy, and
establish a scientific nursing management
mechanism, so as to improve the job
satisfaction of nursing staff, reduce the
turnover rate, and improve patient outcomes ,
with the purpose of promoting the
development and maturation of the nursing
profession.

30. summary
The characteristics of the structure Choose
different implementation models, formulate a
suitable shared governance development
strategy plan, pay attention to the cultivation of
nursing staff's professional autonomy, and
establish a scientific nursing management
mechanism, so as to improve the job
satisfaction of nursing staff, reduce the turnover
rate, and improve patient outcomes , with the
purpose of promoting the development and
maturation of the nursing profession.
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