Brianna Berg and Katreena Merrill, College of Nursing

Introduction

This project is phase two of a larger intervention study on the function, effectiveness and group power of nursing shared governance councils. In 2011, three hospitals (Dixie Regional Medical Center, Garfield Memorial Hospital and Valley View Hospital) implemented nursing shared governance councils. As part of this restructure, each council appointed a chairman and developed a charter outlining the council’s scope and accountability. In phase one of this implementation research study council function, effectiveness and attainment of group power were measured for three years. To foster improvement, all council chairman were required to attend an on-site council orientation.

Despite the success of these educational interventions, some barriers to implementing this important education were identified. Council chairman orientation was delivered on-site making it difficult for every nurse to attend at a specified time. All three hospitals needed the training and it was difficult to schedule speakers for repeated classes at multiple locations or to have the attendees travel. In addition, no mechanism to evaluate the feasibility or effectiveness of the orientation was implemented. As a result of these barriers, it was determined that a secondary study be conducted evaluating the feasibility and effectiveness of creating on-line learning modules to teach nurses shared governance principles.

Participatory nursing is a term used to describe an environment where staff nurses are involved in the decision making at the unit level. Other terms that define this include shared governance or shared decision making. This type of decision making decreases the hierarchical approach to management and has been found to increase quality of care and staff satisfaction. One method of shared decision making is through nursing councils. Several models of shared decision making have been suggested in the literature. However, the basic tenets include councils made up of staff nurses who are empowered by the organization to make changes related to nursing operations, quality of care and patient safety.

Creating a nursing council, however, will not result in improved outcomes unless the council understands their role and are given the tools to perform successfully (Swihart, 2011). Further, successful implementation of shared governance requires flexibility and periodic assessment in order to hardwire effective change over the long term (Porter-O’Grady, 2009).

Methodology

1^st quarter

• Develop the following on-line modules based upon the previously developed on-site materials; 1) Message from nursing leadership; 2) Council Structure; 3) Decision Rights; 4) How to run an effective meeting; 5) Tools for meeting management; 6)Transformational Leadership
• Develop a mechanism to track completed modules and an evaluation tool to measure feasibility and effectiveness.

2^nd quarter

• Deploy on-line modules with the evaluation tool

3^rd quarter

• Analyze feedback from the evaluation of the on-line modules including the number of participants and feedback on the evaluation tool.
• Update modules if needed

4^th quarter

• Report findings to nursing leadership of the three hospitals.
• Present in October 2015 at the annual BYU nursing scholarly works conference
• Prepare abstracts for other conferences as applicable

Results

The project of developing electronic modules is ongoing. The student has spent over two hundred hours this year outlining twelve teaching modules and developing three of the twelve electronically using Articulate Studio ‘13. The three completed modules include critical thinking quizzes by which the researchers can evaluate nursing leaders understanding of shared governance principles. The electronic teaching modules and accompanying quizzes have been reviewed and tested by the student’s mentor and peers. The student has created a website through which she can deploy the modules for public access upon completion of the project. The student anticipates deploying of all twelve lessons by April 2016. The student’s understanding of shared governance principles has greatly increased through her personal study of the lessons and supplementary online materials. The student presented her project and one of the modules at the annual BYU nursing scholarly works conference in October 2015. Feedback from the on-line modules’ quizzes will be evaluated by the mentor after the student’s graduation.

Conclusion

Further research is needed to evaluate the effectiveness of the electronic shared governance teaching modules. Distribution of the modules to three Intermountain Utah Hospitals will allow a sufficient sample size to determine the effectiveness of the training modules. The student plans to use shared governance principles in her future career as a nurse.

Scholarly Sources

• Anthony, M.K. (2004). Shared governance models: The theory, practice, and evidence. Online Journal of Issues in Nursing, 9(1), 138-153.
• Bogue, R.J., Joseph, M.L., & Sieloff, C.L. (2009). Shared governance as a vertical alignment of nursing power and nurse practice council effectiveness. Journal of Nursing Management, 17(1), 4-14.
• Porter-O’Grady, T. (2009). Interdisciplinary shared governance: Integrating practice, transforming health care. 2nd ed. Sudbury, MA: Jones and Bartlett.
• Swihart, D. (2011). Shared governance: A practical approach to reshaping professional nursing practice. 2 nd ed. Marblehead, MA: HCPro Inc.