Shared governance is a model in which staff collaborate through a decentralized decision-making structure, sharing ownership and accountability and partnering to make decisions about clinical practice, professional development, patient experience, quality improvement, and research. The hospital shared governance project team aligned its shared governance model with the American Nurses Credentialing Center Pathway to Excellence standards. The purposes of this project were to do a process evaluation of shared governance implementation at one 64-bed community hospital in central Florida and make recommendations for continuous quality improvement. The project followed the plan-do-study-act methodology developed by Deming. Through the collection of meeting minutes and other shared governance documents, semi structured interviews with nurse leaders, and the results of an anonymous survey through SurveyMonkey, the process of shared governance implementation was evaluated. The major themes included the hospitals need to establish an effective communication system to ensure all 185 RNs are aware of its shared governance, restructure of the Nurse Practice Council, and a reinitiating of shared governance. Limitations of the project included the immaturity of the hospital at the time of implementation, nursing lack of knowledge about shared governance, lack of dedicated resources and competing priorities, and nursing leadership and unit turnover, which were barriers to shared governance implementation. Supporting shared governance contributes to social change by creating a nursing culture that promotes quality, nursing excellence, professional decision making, and a healthy work environment, ultimately improving outcomes for all stakeholders.

Shared governance is a practice model that supports shared decision making between direct care nurses and their leaders. Developed from Kanter's theory of structural empowerment, shared governance allows employees to influence decisions made in an organization. Shared governance has been shown to increase nursing satisfaction, positively impact outcomes, and reduce nursing turnover. The purpose of this project was to examine the relationship between implementation of a system-wide, multihospital shared governance structure and registered nurse (RN) satisfaction, turnover, and perceptions of shared governance. The 3 sources of evidence used in the study were 2016-2017 organizational RN engagement survey results, 2016-2017 organizational RN turnover data, and RN perceptions of shared governance as measured by the Index of Professional Nursing Governance (IPNG) tool. Two similar hospitals within the system were selected for administration of the IPNG survey. Results showed that introduction of a multihospital shared governance structure had an impact on nursing turnover. The biggest change was in new nurse turnover, which reduced from a high of 32.10% to 27.30%. This 4.8% decrease translated in approximately $2 million in savings. A comparison of IPNG survey results showed that the hospital with lower turnover had higher perceptions of shared governance. The potential implications of these finding for social change could be an expansion of shared governance in the organization and social change in the region. Due to the relationship between shared governance and improved patient outcomes, a reduction in mortality and improvement in overall health could be seen for the 1 million patients served in these hospitals.

The purpose of this quantitative study was to assess the status of institutional stakeholders’ perceptions and application of shared governance on an American higher education campus and a counterpart in China and determine if there were differences among the groups of stakeholders both within and between the institutions. A 2-inventory researcher-developed survey of shared governance was used to measure each factor. The data analysis found significant differences among the 4 categories of participants at the Chinese institution. For the General Acceptance dimension of the Perceptions of Shared Governance Inventory (PSGI) the Chinese staff members reported significantly higher scores than all the other 3 categories. For the Implementation dimension of the PSGI the staff members and the students scored significantly higher than the administrators and the faculty members. For the 2 dimensions of the Application of Shared Governance Inventory (ASGI) the administrators reported significantly higher scores than the other categories. At the participating American university a significant difference was found between the students and the administrators in the General Acceptance dimension of the PSGI. However, no other significant differences were found. Comparisons between the American institution and the Chinese institution found that the Chinese faculty members scored significantly higher than their American counterparts in the General Acceptance dimension of the PSGI, but the American faculty members scored significantly higher in both the General Acceptance and the Implementation dimensions of the ASGI than the Chinese faculty members. The Chinese staff members and the Chinese students scored significantly higher than their American counterparts in both the General Acceptance and the Implementation dimensions of the PSGI, but the American staff members and the American students scored significantly higher in both the General Acceptance and the Implementation dimensions of the ASGI than their Chinese counterparts. Results of this study also indicate gender differences play no significant role in the reported scores of either the General Acceptance dimension or the Implementation dimension of the 2 inventories, and that years of service differences play a significant role only in two Chinese groups: the Chinese 31-or-more group in the PSGI and the 11-to-20 group in the ASGI.

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Problem: While shared governance (SG) literature is present in practice, minimal literature exists addressing SG in nursing education. Using principles of quality improvement one College of Nursing (CON) transformed its hierarchal, paternalistic model to a SG model for its governance structure. Purpose: This discussion will introduce the SG model and the CON’s stages of transformation by blending quality improvement approaches with Prochaska’s change theory.Method: Frustration during the pre-contemplation stage with the college administration’s perceived communication deficits was an initial barrier to SG. This deficit was a primary reason that faculty wanted SG. As faculty began to look inward, it became apparent that administration was not solely responsible. The governing model was ineffective as well. During the contemplation stage, faculty explored the CON governance structure. Many faculty were ambivalent about these explorations which resulted in faculty turnover and instability in the classroom. Concurrently, during this tumultuous time, many faculty banded together, held meetings, gathered facts, weighed options, and began exploring SG. The preparation stage involved faculty embracing a vision of SG for the CON. The CON hired a mediator to address faculty anxieties and administration’s ineffective attempts to appease faculty requests. Mediation resulted in a change in CON top administration and departmental structure. The lengthy action stage had some faculty and staff disillusioned that SG was not in the best interest of the CON. Transforming the governance model had mishaps and setbacks. These misfortunes led the employees charged with designing the SG model insight into how all CON employees would have representation. Perseverance of formal and informal CON leadership prevailed. Evaluation: Currently, the CON faculty, staff and administration are adjusting to the SG model. During this year, evaluation of the SG model will occur. Providing an example of how methods associated with quality improvement and Prochaska’s change theory can be applied to a CON governance will assist organizations in how transformation occurs.

The purpose of this study was to assess the status of institutional stakeholders’ perceptions and application of shared governance on an American higher education campus and a counterpart in China and determine if there were differences among the groups of stakeholders both within and between the institutions. Significant differences were found among the four categories of participants at the Chinese institution. For the General Acceptance dimension of the Perceptions of Shared Governance Inventory (PSGI) the Chinese staff members reported significantly higher scores than all the other three categories. For the Implementation dimension, staff members and the students scored significantly higher than the administrators and the faculty members. For the two dimensions of the Application of Shared Governance Inventory (ASGI), administrators reported significantly higher scores than the other categories. At the participating American university, a significant difference was found between the students and the administrators in the General Acceptance dimension. Comparisons between the American institution and the Chinese institution found that the Chinese faculty members scored significantly higher than Americans in the General Acceptance dimension, but the American faculty members scored significantly higher in both the General Acceptance and the Implementation dimensions. Chinese staff members and the Chinese students scored significantly higher than Americans in both the General Acceptance and the Implementation dimensions, but the American staff members and the American students scored significantly higher in both the General Acceptance and the Implementation dimensions. Also, years of service plays a significant role in two Chinese groups.

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The purpose of this study is to examine the status of academic freedom and, more specifically, intramural and extramural speech at universities in the U.S. since 2000. Court opinions and briefs from benchmark court cases and the faculty's perspective of current academic freedom issues are analyzed to determine dominant trends and themes that have evolved since 2000. While others have studied the relationship between the First Amendment and academic freedom, this analysis brings current the discourse concerning the effect First Amendment court decisions have on the faculty speech. The central research question is to determine the effect court decisions have on the intramural and extramural speech of faculty and specifically to study how federal, state, and local events since 2000 have affected (a) the academic freedom of faculty in general, (b) the way universities handle faculty intramural speech, (c) the way universities handle faculty extramural speech when they speak both as a citizen and a public university employee, and (d) the ability of faculty to defend their academic freedom. Using post-modern theory, the two-phased mixed methods study deconstructs and analyzes (a) the six First Amendment court opinions and briefs and (b) the 19 interviews of public university faculty members. The first phase identified 11 dominant themes, which were used as the basis for the coding and the 19 interviews of public university faculty members. The interview coding and analysis identified 15 themes. Based on the Pearson Correlation Coefficient, four themes were identified in the court opinions and six in the interviews are discussed. The second phase also included surveys of the faculty interviewed and a quantitative analysis of the responses in order to classify the sample. The study found that public universities have complete control over academic freedom, and that it is a privilege granted to faculty based on their scholarly association with the university, not a right. Public university administrators, general counsels, deans, department chairs, and faculty will benefit from the study as it provides an intensive analysis of post-2000 court case logic and the current perceptions and apprehensions that faculty have concerning their intramural and extramural speech rights. / text

The purpose of this study was to explore how public elementary school principals develop teacher leadership capacity within their schools, as well as the effect of this effort on a school's performance. After examining a variety of sources, such as journal articles and web-based search engines, the researcher determined that there was scant information explaining the process principals undergo to create teacher leadership roles in an effort to develop a high-performing school. To accomplish the goals of this study, salient reports in the field of teacher leadership were reviewed. The insights afforded from these reports guided the researcher in developing a field-based investigation focusing on school leaders and teachers employed in three high-performing elementary schools in central Florida. The researcher explored features of teacher leadership that were evident in high-performing schools and sought to discover the characteristics principals seek in selecting new teachers. Also investigated were the teacher leadership opportunities created by the principals and the ways in which these roles helped to sustain the elementary schools' high performance. Furthermore, recent school-based decisions made by the school leaders were studied. Throughout the data, school administrators provided opportunities for teacher leadership within their schools, primarily by forming school-based committees. The results showed that principals solicited opinions from teachers, especially when it came to curriculum and instructional concerns. In addition, when sharing best practices or participating in staff-development opportunities with colleagues, teachers felt satisfied with their work environments. School leaders and teachers understood the roles they played in the overall success of their schools. Based on the results of this qualitative study, principals can build leadership capacity at schools by first establishing a culture of trust, honesty, and professionalism between themselves and the teachers. Next, school leaders provide and support opportunities for leadership by aligning teacher strengths and roles. The researcher recommends that future research in teacher leadership examine whether the principal's impact on teacher leadership has an affect on retention at the school level.

Control over nursing practice (CONP) is a participatory process through which nurses have input and engage in decision making about the context of practice and unit operations related to nursing practice. CONP has been associated with a number of positive outcomes related to nurse satisfaction, nurse status, effectiveness of patient care, and quality of patient outcomes. However, no comprehensive model has been created nor comprehensive analysis been conducted related to approaches for increasing CONP. This study tested a hypothesized model of antecedents to CONP developed from a review of the literature in nursing, psychology, and organizational management using a complexity theory perspective.The study used a nonexperimental, comparative design. The sample for data analysis consisted of 28 nurse managers and 583 staff nurses from 32 units in 10 hospitals. Existing instruments were used in a paper and pencil format to collect demographic and perceptual data on CONP and the hypothesized antecedent variables. Data were aggregated to provide an analysis of organizational and unit level contextual and variable effects related to CONP.Contextual regression indicated a greater influence of unit-level variables than organizational-level variables on nurses' perceptions of CONP. Regression analyses and revised model testing demonstrated that nurse manager supportiveness, implementation of a formal structure for CONP, and information flow consisting of open and accurate communication were positively related to CONP. Hierarchy of authority was negatively related to CONP. The relationship between CONP and job codification and autonomy varied based upon the measurement of the dependent variable. Manager's perception that participative decision making enhances organizational effectiveness; manager's perception that participative decision making does not reduce their power; nurses' experience, expertise, and educational preparation; and nurses' desire for control did not significantly relate to CONP as hypothesized.This study contributes to nursing research and clarifies strategies for improving the work environment for nurses by delineating antecedents to CONP in the acute care hospital setting. These data will be useful to nurses, nurse managers, and hospital administrators who want to improve patient safety, reduce patient mortality, increase nurse satisfaction, and increase nurse retention.