Shared Governance and Transition into Practice: Impact on Work Engagement

Abstract

Practice Problem: High turnover rates, particularly in new graduate nurses, and poor organizational commitment and engagement negatively affect staffing, operational performance, and patient outcomes. A negative trend for nurse engagement indicators was noted in previous staff engagement surveys of this organization. PICOT: The PICOT question that guided this project was: In transition-into-practice (TIP) nurses (P), how does the implementation of shared governance (I) compared with no shared governance participation (C), affect their engagement with the hospital (O) within eight weeks (T)? Evidence: Literature has shown that nurse engagement is one of the nurse indicators positively affected by shared governance activities. The evidence supports the intervention and supplies a validated tool to assess the intended outcome. Intervention: Guided by the Johns Hopkins Evidence-based Practice Model for Nursing and the ADKAR change model, this evidence-based practice project created a shared governance council as a resource for the TIP nurse population and a platform for multidisciplinary collaboration on TIP-specific issues. Engagement in TIP nurses was measured with the Utrecht Work Engagement Scale-9 (UWES-9) at pre-and post-implementation time points. Outcome: The TIP Nurse Council was successfully implemented, with the council size increasing to eight members during the implementation period. Except for the lack of statistical significance in engagement scores and insufficient completion of pre- and post-implementation surveys by all TIP council members, all desired measures were met. Conclusion: Shared governance can be a valuable adjunct to strategies used to support early career nurses in transitioning to practice and being engaged with the organization.