Shared governance is an innovative model used to provide direction for the professional practice of nursing. This model is used to direct nurses to participate in unit-based decision making that allow nurses to demonstrate accountability and ownership for their practices. The goal of the model is to improve quality patient care contain costs, and retain nursing staff. According to Marquis and Houston (2012), “In shared governance, the organization’s governance is shared among board members, nurses, physicians, and management” (p. 270-271). Shared governance is imperative in the healthcare institutions. “Shared governance, which gives nurses control over their professional practices, is an essential element of a professional practice nursing model, providing structure and context for health care delivery” (cite shared governance article). This allows each healthcare worker to have a voice in the decision making and encourage input that will expand the business and healthcare. The four principles of shared governance are equity, accountability, ownership, and partnership. Equity is a foundation that focuses on services, staff, and patients and is essential in providing safe and effective care. No one role is more important than the other. “Each …show more content…
Some benefits of shared governance include increased team cohesiveness, communication, and decision making. According to Wilson, Speroni, Jones, and Daniel (2014), “Shared governance activities give direct care nurses an opportunity to partner with nursing management to achieve optimal patient outcomes and to increase nurse job satisfaction, nurse productivity, and nurse retention” (p.19). “Challenges of shared governance identified by staff nurse included decrease staffing, budget concerns, lack of knowledge, generational issues and issue with delegation of tasks” (Ott and Ross, 2014 p. 767). These challenges poses a threat to providing quality patient
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Nurse’s role has a unique contribution in the interprofessional team. The interprofessional team are group of individuals in a various healthcare disciplines communicating and working together towards common goals to provide quality, individualized care for patients. Each team members from different profession and occupation collaborates, supports, enhances, and provides knowledge, skills, and attitudes to coordinate processes and interventions. Nurse’s offers specialized service to society to meet the health care needs of their clients.
Nurses’ participation in decision making using the team work practice model improves the quality of care patients receive, increases the patient and family’s satisfaction, and adds to overall nursing contentment all of which increases nursing engagement, retention and recruitment (2013). I feel that the interprofessional collaboration model and the shared governance models are very similar in achieving quality care and improving nurses' work environment, satisfaction, and retention. Either of these models would work for our nursing team. American Nurses Association (2017). Collaborative Health Care: How Nurses Work in Team-Based Settings.
As we have been noted the role and the scope of practice of the nurse practitioners in the healthcare system are unmeasurable. The nurse practitioners (NPs) play a tremendous role in providing healthcare to the people in the United States. Their presence has been recognized in developing the health care industry not only in the US but also globally. Despite the role that the NPs have played into the healthcare system, they still encounter some challenges that can impact their practice. One of these challenges is the NP autonomy of practice.
The nursing profession plays a vital role at the policy table in implementing full practice autonomy for Nurse Practitioners. Nurse Practitioners are contributing experts of the health care system. They have the education and skills needed to be a resource and partake in the policy process and political implementation. This particular policy development will require not just one nursing representative, but many, to push for and symbolize the dire need of full practice autonomy for Nurse Practitioners. In fact, the National Council of State Boards of Nursing [NCSBN] (2017) has formed the Advanced Practice Registered Nurse (APRN) Consensus Model, which streamlines the education, regulation, licensure, accreditation, and certification across the nation.
(2008). I would like to challenges Chief Nurse Executives (CNEs) to lead the journey and highlights how patients, their families, and health care organizations would benefit immeasurably if CNEs stepped forward and accepted this leadership role, then and only then can the best practice changes begin to improve what we as nurses already know. The processes of leading are intended to enable more people to develop into leaders and more people to share the roles of leading, to enhance the quality and safety of patient care (Stone P. Hughes R, Dailey M.
Nursing administration on a national level is best described by The National Center for HealthCare Leadership (NCHL). This is a non profit organization that exemplifies quality care and leadership in the 21 st century. The goal of this organization is to improve healthcare on a national level through efficient and effective management that is in accordance with it’s mission. In keeping with it ’s mission, NCHL embarked upon an ambitious initiative with the support of the Robert Wood Johnson Foundation, examining the role of the senior leadership team in promoting quality and safety in his/her organization (Disch, Dreher, Davidson, Sinioris, & Wainio, 2011).
Transformational leaders, who empower nurses to advocate, understand that communication and professional collaboration are the core ingredients to foster safe nursing care and to collectively advocate for improved health care policies. Of interest, due to communication and collaborative efforts among state hospital associations and the ANA along with the state nurses associations, seven states have enacted safe staffing legislation using the Registered Nurses Safe Staffing Act’s committee approach (ANA, n.d.). Conclusion The essence of an effective nurse leader lies in the ability to inspire and motivate others to action, which begins with communication and professional collaboration skills.
(Finkelman, et al, 2013). The importance to having all health care members working together in leadership roles is imperative to positive changes within the health care setting. Nurses can give an insight on matters that only a nurse can, and this is an important viewpoint that needs to be included when
As we transition into the new role of NPs, our scope of practice expands. Moreover, as our responsibilities increase, we later become policy makers, and develop autonomy and decision–making skills. NPs are responsible for providing safe nursing care with more specialized knowledge and advanced education. We are also responsible for pursuing continuing education and advanced knowledge to remain competent quality providers, and meet the needs of the community. With our acquired repertoire of skills, it is essential that we utilize them to make informed decisions and collaborate with our community to promote wellness and healthy living.
Acting as a liaison between the nursing staff and other members of the administrative staff, they are often in high-level management roles. Though not in a direct patient contact role, they are often involved in the policy making within an organization affecting patient care (Ferguson-Pare, 2003). The nurse administrator meets the same competencies in the nine essential areas, but have additional competencies in organizational and system leadership, communication and relationship management, knowledge of health care environment, as well as business skills and principles (AONE,
I agree with you Walter. Nursing is a teamwork. In an acute hospital setting, an RN is assigned a set of patient to deliver care that means RN has full responsibility about these patients. In this case, RN who is the primary care nurse can complete her task by herself or delegate some of the task to the nursing assistant according to their scope of practice. The abilities to delegate, and supervise other healthcare workers is not an easy job.
An analysis of recent literature on the effect of healthcare leadership revealed that nursing leadership was the primary barrier to establishing best practices in the clinical setting (2011). Furthermore, nursing leadership is shown to define clinical organisational culture, collaboration, and lateral violence which are all shown to impact patient outcomes indirectly (2015). A meta-analysis of 20 individual studies revealed nursing units with reported poor leadership had significantly higher adverse events, including the incidence of urinary tract infections, pneumonia, and higher patient mortality. Comparatively, nursing units with reported strong leadership had significantly less adverse events, including fewer medication errors, falls, pressure areas, and lower patient mortality (2013). Therefore, a strong correlation between effective nursing leadership and improved patient safety is shown to exist and vice
Transactional Leadership Frequently referred to as a managerial approach to leadership, the transactional leadership style is centered on improving efficiencies within an organization or team (McShane & Von Glinow, 2015). Leaders practicing the transactional approach focus on the details of the step by step processes and workflows using a reward and punishment system to encourage workgroup production (Dartey-Baah, 2015). As errors and inconsistent results are part of the expected norm, transactional leaders succumb to the belief that employees require ongoing monitoring and supervision to ensure compliance with the expected work practices. When used with an experienced high performing staff, the constant supervision and punitive nature of the transactional leadership style can be counterproductive, causing a decrease in production and satisfaction among some groups. In contrast, when used with newly formed production units, the transactional style has been known to improve employee engagement and response (Breevaart et al., 2014).
For this assessment, I will be reflecting on what clinical governance looks like in my workplace, with a critique of the framework used within the organization. During the reflection I will discuss what pillars and principles were found, while describing my fellow team members’ understanding of clinical governance and how it is reflected in their practice. Finding the clinical governance framework for my workplace was challenging and time consuming without computer access in place of hard copy policy and procedure manuals. I found clinical governance summerised through the manuals, ensuring compliance of the 44 accreditation standards (Australian Aged Care Quality Agency, 2014) but as Knight, Kenny and Endacott (2015) discuss, while the concept is accepted, there is a gap between theory and practice, which is visual where I work. Pillars and principles such as risk management, efficiency, effectiveness, patient centric and equity are seen throughout the policies, and to analyse more specifically, clinical governance is articulated under categories, consisting of “education and training, clinical audit, clinical effectiveness, research and development and role clarity” (Davies, Chapman & Boyd, 2015 p.45).
They are able to connect, communicate and coordinate across multiple departments, professional opinions and voices, and the daily schedules of patients. Advocating and designing care with the patient and family is a true skills set and cultural attribute that adds tremendously to a culture of safety and patient – centeredness but requires the most able leadership to build these bridges across the many professionals engaged in care. Building this culture is a leadership challenge and there is no one in my experience better able to make these changes than nursing leaders ( Maureen Bisognano, 2009). Nurses should not just be at the bedside or within the nursing community but must be involved as leaders and decision – makers throughout the healthcare system. As Maureen Bisognano (2009) points out, the best nurses are accomplished envoys among different players and interests involved in direct patient care, which is a skill needed throughout organizations and businesses, not just in hospitals or