Shared governance in nursing is an innovative management approach that enhances professional autonomy, decision-making participation, and job satisfaction among nursing staff. It operates on principles of cooperation, equality, responsibility, and ownership, with various implementation models including committee, parliamentary, and ward-based approaches. Currently, shared governance is recognized as a crucial method for improving nursing practice, staff satisfaction, and overall healthcare quality.

1. Shared governance in nursing
Reporter: WU QING
Teacher: David H. De Jesus

2. • 1.What is shared governance in nursing？
• 2.Principles of nursing sharing governance
• 3.Implementation mode of shared governance
• 4.Factors affecting shared governance
• 5.Application status and effect
• 6.Conclusion
Content

3. Part 1
What is shared governance in nursing？

4. What is shared governance in nursing？ WU QING
• Shared governance is an innovative management method, which can
promote nursing staff to control professional practice, participate in decision-
making, increase cooperation and sense of responsibility through employee
authorization, maximize the professional autonomy of nursing participants,
and help improve nursing staff's job satisfaction and work efficiency. Shared
governance has been internationally recognized and widely used in clinical
field.

5. WU QING
• At present, there is no consensus on the definition of shared
governance. The American Nurse Certification Center believes that
shared governance is a work mode of participating in decision-making.
This work mode can enable nursing staff to participate in the process of
clinical quality improvement, practice standards, career development
and research, and give nursing staff more professional autonomy to
regulate professional practice and work environment, so as to improve
their job satisfaction, Solve the shortage of nurses and resource
utilization restrictions.
What is shared governance in nursing？

6. Part 2
Principles of nursing sharing governance

7. Principles of nursing sharing governance WU QING
• Although there is no uniform definition, the basic principles of shared governance
have been basically established after more than 40 years of research, including
four basic principles of cooperation, equality, sense of responsibility and
ownership.

8. WU QING
Cooperation
• Cooperation refers to interdisciplinary collaboration and non-competitive
relationship. Nurses focus on patient-centered care and are committed to
improving the prognosis of patients; Equality means emphasizing the participation
of all team members, including clinical nursing staff.
Principles of nursing sharing governance

9. • Responsibility refers to the right of nursing staff to make decisions.
WU QING
Responsibility
Equality
• Equality means emphasizing the participation of all team members,
including clinical nursing staff
• Ownership refers to attaching importance to the input or contribution
of individual personnel.
Ownership
Principles of nursing sharing governance

10. Part 3
Implementation mode of shared governance

11. • Although the principle of shared governance is universal, due to the different core
values, objectives and concepts of medical institutions, four shared governance
models have gradually developed, including committee model, parliamentary
model, ward based model and administrative model, of which committee
model, parliamentary model and ward based model are the most commonly used.
WU QING
Implementation mode of shared governance

12. WU QING
Committee model
Implementation mode of shared governance
• The committee model refers to the governance process of managers and
employees through multiple committees,It is applicable to the whole medical
institution with continuous and long-term shared governance. The specific
implementation process is to divide the whole hospital into multiple practice areas,
and each area has representatives serving on each committee.

13. WU QING
Committee model
Implementation mode of shared governance
• First, the principle of shared governance can be comprehensively and
comprehensively applied. In the field of clinical care and management practice,
the participation of clinical nursing staff can be guaranteed, and the professional
autonomy of nursing staff can be improved and enhanced to the maximum extent.
• Second, it can integrate and sum up the points and aspects of nursing staff,
which is helpful to extend the application of new concepts and knowledge to the
model, and help nursing staff adapt to environmental changes.

14. WU QING
Committee model
Implementation mode of shared governance
• Third, it has a great impact on organizational change, which can win more attention
of nursing staff through dynamic and continuous characteristics.

15. WU QING
Parliamentary model
Implementation mode of shared governance
• The parliamentary model refers to the formation of a democratically elected
parliament or senate, whose members include clinical practice and management,
and then the democratically elected parliament or senate appoints committee
members to report to the parliament. The committee activities submit applications
to the democratically elected parliament or senate

16. WU QING
Ward-based model
Implementation mode of shared governance
• The shared governance model based on wards refers to the setting of a single
nursing unit or ward, which is applicable to the trial and application of the
concept of shared governance at the initial stage. Through the establishment of
a shared governance steering committee to manage the ward, set up work
objectives, formulate work plans, and constantly complete tasks, gradually
formed a number of subcommittees composed of clinical nursing staff, and finally
formed a shared governance unit led by employees and based on the ward.

17. Part 4
Factors affecting shared governance

18. • With the rise of the professional title of nursing staff, the ability of nursing staff to
participate in shared governance has gradually improved. The reason is that the
evaluation of professional title needs continuous assessment and evaluation.
• Married nurses' ability level is higher than that of unmarried, divorced or widowed
nurses, which may be related to more support or care that married nurses can get
from their spouses.
• The cognitive level of clinical nursing staff on shared governance is closely
related to the ability level of shared governance. Clinical nursing staff generally
lack knowledge of shared governance.
WU QING
Factors affecting shared governance

19. WU QING
Factors affecting shared governance
• Because shared governance empowers clinical nursing staff to build nursing
practice management structure through authorization, it requires nursing
staff to exert professional autonomy and coordinate all resources to realize
nursing practice.
• Therefore, it is necessary for nursing staff to clarify the care needs of
patients and their own, and coordinate the relationship between nurses and
patients, nurses and doctors and nurses. Therefore, it is necessary for
nursing staff to perform outstanding in communication and coordination,
organization and management, and professional practice.

20. Part 5
Application status and effect

21. WU QING
• At present, shared governance has become a key path for hospitals to meet the
certification requirements of magnetic hospitals, and also an important method for
medical institutions to achieve specific goals. It has become a normative
expectation for the implementation of professional practice and discipline
management. It has developed into a shared governance model of
multidisciplinary collaboration. Members include nursing staff, doctors,
pharmacists and other members of the care team, and more emphasis is placed
on joint governance, The empirical research in the field of nursing is gradually
becoming mature.
Application status and effect

22. WU QING
• First, it can increase the authorization of nursing staff, improve professional
autonomy, and share governance to provide specific conceptual framework for
work practice, work environment and staff.
• Second, it can improve the job satisfaction of nursing staff and reduce the turnover
rate. The satisfaction of nursing staff is an important standard to measure the
results of shared governance. Autonomy is the key factor to affect the job
satisfaction of nursing staff. Shared governance can meet the autonomy needs of
nursing staff, give nursing staff professional freedom, make nursing staff fully
participate in clinical nursing practice, and thus create a more suitable working
Application status and effect

23. WU QING
• Third, it can improve the quality of nursing services, share the framework provided
by governance, attach importance to the participation of clinical nursing staff, make
nursing staff have ownership, put nursing staff in the best position of clinical
practice, and influence professional practice by identifying the focus of work
improvement and areas needing improvement.
Application status and effect

24. WU QING
• Fourth, it is beneficial to promote the development of nursing profession. Shared
governance can provide nursing staff with opportunities to change and control the
working environment, professional practice and policy, improve the degree of
cooperation and decision-making participation of medical staff, promote the
coordinated development of clinical practice and the sharing of best practices, and
form a working atmosphere to enhance staff's sense of value and play professional
potential, thus promoting professional development.
Application status and effect

25. Part 5
Enlightenment

26. • We need to be soberly aware that to achieve the state of nursing management with
joint participation requires multiple efforts. First, management behavior and shared
decision-making must be highly unified, and second, clinical nursing staff should
have independent decision-making ability finally requires a safe, trusted and good
working environment to finally form a truly effective shared governance.
WU QING
Enlightenment

27. Part 6
Conclusion

28. • In clinical nursing work, China should learn from the development experience of
foreign shared governance, select different implementation modes according to
the specific situation of the hospital, continuously improve the cognition of
nursing staff on shared governance, formulate the development plan of shared
governance suitable for China's national conditions, actively try the "bottom-up"
management mode, encourage nursing staff to actively participate in
management, and actively find out the problems of nursing management and
quality improvement
WU QING
Conclusion

29. • Through brainstorming, put forward opinions and suggestions, formulate a
standard well to implement, monitor and evaluate the improvement results, pay
attention to the cultivation of professional autonomy of nursing staff, and take
personalized training measures for clinical nursing staff with different professional
titles, which is conducive to increasing the attention to the emotional support of
nursing staff, and can focus on improving the cognition of nursing staff on shared
governance, improving the job satisfaction of nursing staff, and reducing the
turnover rate, So as to continuously improve the quality of nursing.
WU QING
Conclusion

30. Thank you