Assigment .Apa seven . All instructions attached.

2

Topic: Professional Practice, Safety, and Workforce Issues – Shared Governance and Nurse Participation in Decision Making

Shared Governance and Nurse Participation in Decision Making

Natalia Gomez

Florida National University

Decision Making-DAX-DL01

Dr. Nora Hernandez-Pupo

May 21, 2026

Shared Governance and Nurse Participation in Decision Making

I. Introduction

1. Background

Shared governance is a nursing practice that encourages collaborative decision-making among bedside nurses, nurse leaders, and organizational administration. It encourages nurses to be actively involved in decisions that affect patient care, work policies, and professional practice standards. Shared governance is becoming a key component of the modern healthcare system, as it is seen to be an important factor in enhancing job satisfaction, patient care, and the retention of healthcare professionals, particularly nurses (Diab et al., 2023). But many health care organizations continue to face challenges with inconsistent implementation and limited nurse involvement in decision-making processes.

2. Thesis Statement

The purpose of this paper is to establish that shared governance is an effective tool for improving nurse engagement, clinical decision-making, and patient care outcomes by providing structure, models, and frameworks for collaboration among bedside nurses, advanced practice nurses, and nurse leaders.

II. Body

First Topic: Overview and Significance of Shared Governance

Point A: Definition and Core Principles

1. Shared governance operates on principles of partnership, accountability, equity, and ownership in decision-making (Diab et al., 2023).

2. It provides an opportunity for all nurses to contribute to standards of clinical practice, policy development, and quality improvement (Regie Buenafe Tumala, 2025).

Point B: Importance in Nursing Practice

1. Shared governance fosters nurse autonomy, satisfaction, and retention, as evidenced.

2. It improves patient safety by leveraging frontline clinical practice knowledge in decision-making (Hughes, 2020).

Second Topic: Barriers and Challenges to Shared Decision Making

Point A: Organizational and Structural Barriers

1. There is a tendency for hierarchical leaders to restrict the role of the nurse in decision-making processes (Hughes, 2020).

2. Poor time management, staffing, and communication systems impact engagement in governance activities (Musheke & Phiri, 2021).

Point B: Cultural and Professional Barriers

1. Leadership or senior staff resistance can hinder the shared governance process.

2. Bedside nurses’ participation may be hindered by variation in nursing empowerment and confidence (Daicampi et al., 2025).

Third Topic: Decision-Making Models and Leadership Frameworks

Point A: Shared Decision-Making and Transformational Leadership Models

1. In the Shared Decision-Making Model, patients, nurses, and health care teams work together in making clinical decisions (Daicampi et al., 2025).

2. Transformational leadership promotes leaders to inspire, motivate, and empower the nurses to join the governance process (Hughes, 2020).

Point B: Application of the Clinical Judgment Model

1. The Tanner’s Clinical Judgement Model underpins decision-making for the bedside nurse to facilitate evidence-based decisions that inform governance discussions (Daicampi et al., 2025).

2. This model enhances critical thinking and helps to ensure that frontline clinical experiences influence policies.

Fourth Topic: Application of Shared Governance Across Nursing Levels

Point A: Bedside Nurses and Staff Nurses

1. Join unit-based councils to give input to the policies and processes of patient care (Diab et al., 2023).

2. Identify clinical issues and offer evidence-based solutions to these issues (Diab et al., 2023).

Point B: Nurse Managers and Leaders

1. Host shared governance councils and include nurse voices in decision-making processes (Hughes, 2020).

2. Facilitate professional learning and provide a setting to promote nurse involvement.

Point C: Advanced Practice Nurses (APNs)

1. Apply clinical skills to impact organization policy and practice guidelines.

2. Implement interdisciplinary working to ensure coordination of governance decisions and clinical outcomes (Kongkar et al., 2025).

III. Conclusion

1. Summary of Main Points

Shared governance is a key model that can increase nurse involvement in decision-making, increase job satisfaction, and improve the quality of patient care. However, it has not been widely adopted due to organizational structure and culture. Various decision-making models offer structured means to facilitate their success at all levels of nursing, including transformational leadership, shared decision-making, and clinical judgment.

2. Final Statement

Shared governance in healthcare organizations promotes collaboration, accountability, and empowerment, enabling nurses at all levels to make a meaningful impact on patient care and safety.

References

Daicampi, C., Veronese, M., & Cesaro, E. (2025). Impact of bedside handover on patient perceptions and hospital organizational outcomes: A systematic review. Journal of Nursing Management, 2025(1). https://doi.org/10.1155/jonm/3803491

Diab, A., Sharif, L., Katooa, N. E., Kandil, F. S., Mahsoon, A., & Abdelaziz, N. (2023). Relationship between nurses’ perception of professional shared governance and their career motivation in Egypt: A cross-sectional study. International Journal of Nursing Sciences, 10(4). https://doi.org/10.1016/j.ijnss.2023.09.016

Hughes, R. (2020). Tools and strategies for quality improvement and patient safety. National Library of Medicine; Agency for Healthcare Research and Quality (US). https://www.ncbi.nlm.nih.gov/books/NBK2682/

Kongkar, R., Ruksakulpiwat, S., Phianhasin, L., Benjasirisan, C., Niyomyart, A., Ahmed, B., Puwarawuttipanit, W., Chuenkongkaew, W., & Adams, J. (2025). The impact of interdisciplinary team-based care on the care and outcomes of chronically ill patients: A systematic review. Journal of Multidisciplinary Healthcare, 18(18), 445–457. https://doi.org/10.2147/jmdh.s497846

Musheke, M. M., & Phiri, J. (2021). The effects of effective communication on organizational performance based on the systems theory. Open Journal of Business and Management, 9(2), 659–671. https://doi.org/10.4236/ojbm.2021.92034

Regie Buenafe Tumala. (2025). Clinical nurses’ involvement in decision-making process at the nursing unit-based council level: A cross-sectional study of shared professional governance in the kingdom of Saudi Arabia. Nursing Reports, 15(12), 426–426. https://doi.org/10.3390/nursrep15120426

Decision Making-DAX-DL01 Nora Hernandez-Pupo

Decision Making Process Paper Due

6 pages

Use at least 10 current scholarly references [not older than 5 years] other than your main text. Uses APA 7th edition formatting with DOI

Decision-Making Process Paper 

Instructions

In this assignment, you will be writing a 6–8-page paper identifying [ maximum page limit is 8 pages- do not exceed as it will incur a penalty], comparing and contrasting at least 3 different decision-making approaches of care from a multidisciplinary perspective using a pertinent and significant topic in nursing [The following topics are NOT allowed and will not be approved:  shortage and nurse turnover, nurse staffing ratios, unit closures, and restructuring, use of contract employees (i.e., registry and travel nurse)]. The topic  MUST BE APPROVED  by your nursing instructor before writing the paper. Your topic was approved in week 3- please refer to week 3's approved topic. You are required to use APA 7th edition format, and the page count, appropriate headings, the title page, and the reference page. Reflect on your decision-making practices and the implications this will have regarding differing approaches taken by nursing leaders and staff nurses/clinical practitioners in decision-making regarding issues in practice.  To complete this assignment, do the following:

1. Select and describe an issue in nursing that impacts nurses at all levels from bedside to advanced practice. Make sure to provide an adequate background and its significance to all levels of nursing using a strong review of the literature. Additionally, this should include a thorough literature review that provides a good understanding of what the cause of this problem is; what is suggested to address this problem. Essentially, this review must support your choices of the decision-making models and this needs to include how all levels of nursing practice (the bedside nurse to the APN are impacted by the problem).

2. Identify how you would expect a nurse leader/manager, a bedside/staff nurse and an Advanced practice nurse (CNO or NP) to address your selected issue using at least 2 [3 ideal] different decision-making approaches which are clearly supported by the literature review. This must first include aa detailed analysis/overview of the selected decision making models and how they are used in practice. Then a detailed analysis of how these decision-making approaches/models would address the problem/along with a detailed analysis of how each of the three selected models would be applied to address the selected issue/problem making sure to incorporate this at all levels of practice. One of the decision-making models may be more applicable to the bedside nurse; whereas the other more applicable to the APN; however, all levels of nursing practice need to be addressed with at least one of the chosen 3 decision-making models. However, this does not mean that each decision-making model will apply to all levels of practice only that in this discussion needs to include how each level of nursing practice would utilize the decision-making model to address the problem. For instance, one decision making model may apply to the bedside nurse; the second decision making model may be more applicable at the level of APN (CNO, NP, etc) and the other decision-making model may be best applied to the nurse manager. This section should be detailed; meaning specific, well thought out, realistic solutions of how the nurse (at the level identified; this may include more than one level for the same decision-making model or not) would address the problem using the decision-making model is provided and well supported by the literature. of the benefits and limitations of various decision-making approaches that are applied appropriately to the level of nursing practice to address the selected issue/problem. This is informed from course readings, literature, clinical scenarios and other evidence-based and scholarly sources.

3. Prioritize the best decision-making approach/model to address the selected problem that is grounded in best practice. This should provide a well-supported rationale for this choice that includes a good comparison and contrasting of the 3 chosen decision-making models that clearly illustrates why the choice was made, that is consistent with the decision making model and how it would address the chosen topic or problem.

4. Identify a possible funding source that would addresses your approach to solving the problem. For instance, if the best approach to solving the nurse-to-patient ratio problem is through the use of SDM and shared governance, perhaps you may seek a local funding source to provide you with funding to implement a small EBP or research project that would be funded by a local nursing organization such as Sigma Theta Tau or perhaps if it was geared more towards assessing the value of this model towards NP in practice than seeking a local organization that supports funding for projects being implemented by practicing NP? If seeking money for research this would need to be overseen by a nurse with a DNP or a PhD or someone with the credentials to do so that are part of their scope of practice. Consider looking at federal, state, or local organizations. For example: There are many grants available through the CDC,HRSA, etc. Again, this need to be specifically applied with sufficient details

5. Use at least 10 current scholarly references [not older than 5 years] other than your main text. Uses APA 7th edition formatting. 

Please see sample APA 7 paper- DO NOT use an Abstract.

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APA 7 professional-annotated-compressed.pdf

Please submit the Decision Making Process Paper in Word [PDF] Format APA 7 formatted (see instructions in the Assignments Tab of Blackboard along with the grading rubric). 

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Topic: Professional Practice, Safety, and Workforce Issues – Shared Governance and Nurse Participation in Decision Making

Shared Governance and Nurse Participation in Decision Making

Natalia Gomez

Florida National University

Decision Making-DAX-DL01

Dr. Nora Hernandez-Pupo

May 21, 2026

Shared Governance and Nurse Participation in Decision Making

I. Introduction

1. Background

Shared governance is a nursing practice that encourages collaborative decision-making among bedside nurses, nurse leaders, and organizational administration. It encourages nurses to be actively involved in decisions that affect patient care, work policies, and professional practice standards. Shared governance is becoming a key component of the modern healthcare system, as it is seen to be an important factor in enhancing job satisfaction, patient care, and the retention of healthcare professionals, particularly nurses (Diab et al., 2023). But many health care organizations continue to face challenges with inconsistent implementation and limited nurse involvement in decision-making processes.

2. Thesis Statement

The purpose of this paper is to establish that shared governance is an effective tool for improving nurse engagement, clinical decision-making, and patient care outcomes by providing structure, models, and frameworks for collaboration among bedside nurses, advanced practice nurses, and nurse leaders.

II. Body

First Topic: Overview and Significance of Shared Governance

Point A: Definition and Core Principles

1. Shared governance operates on principles of partnership, accountability, equity, and ownership in decision-making (Diab et al., 2023).

2. It provides an opportunity for all nurses to contribute to standards of clinical practice, policy development, and quality improvement (Regie Buenafe Tumala, 2025).

Point B: Importance in Nursing Practice

1. Shared governance fosters nurse autonomy, satisfaction, and retention, as evidenced.

2. It improves patient safety by leveraging frontline clinical practice knowledge in decision-making (Hughes, 2020).

Second Topic: Barriers and Challenges to Shared Decision Making

Point A: Organizational and Structural Barriers

1. There is a tendency for hierarchical leaders to restrict the role of the nurse in decision-making processes (Hughes, 2020).

2. Poor time management, staffing, and communication systems impact engagement in governance activities (Musheke & Phiri, 2021).

Point B: Cultural and Professional Barriers

1. Leadership or senior staff resistance can hinder the shared governance process.

2. Bedside nurses’ participation may be hindered by variation in nursing empowerment and confidence (Daicampi et al., 2025).

Third Topic: Decision-Making Models and Leadership Frameworks

Point A: Shared Decision-Making and Transformational Leadership Models

1. In the Shared Decision-Making Model, patients, nurses, and health care teams work together in making clinical decisions (Daicampi et al., 2025).

2. Transformational leadership promotes leaders to inspire, motivate, and empower the nurses to join the governance process (Hughes, 2020).

Point B: Application of the Clinical Judgment Model

1. The Tanner’s Clinical Judgement Model underpins decision-making for the bedside nurse to facilitate evidence-based decisions that inform governance discussions (Daicampi et al., 2025).

2. This model enhances critical thinking and helps to ensure that frontline clinical experiences influence policies.

Fourth Topic: Application of Shared Governance Across Nursing Levels

Point A: Bedside Nurses and Staff Nurses

1. Join unit-based councils to give input to the policies and processes of patient care (Diab et al., 2023).

2. Identify clinical issues and offer evidence-based solutions to these issues (Diab et al., 2023).

Point B: Nurse Managers and Leaders

1. Host shared governance councils and include nurse voices in decision-making processes (Hughes, 2020).

2. Facilitate professional learning and provide a setting to promote nurse involvement.

Point C: Advanced Practice Nurses (APNs)

1. Apply clinical skills to impact organization policy and practice guidelines.

2. Implement interdisciplinary working to ensure coordination of governance decisions and clinical outcomes (Kongkar et al., 2025).

III. Conclusion

1. Summary of Main Points

Shared governance is a key model that can increase nurse involvement in decision-making, increase job satisfaction, and improve the quality of patient care. However, it has not been widely adopted due to organizational structure and culture. Various decision-making models offer structured means to facilitate their success at all levels of nursing, including transformational leadership, shared decision-making, and clinical judgment.

2. Final Statement

Shared governance in healthcare organizations promotes collaboration, accountability, and empowerment, enabling nurses at all levels to make a meaningful impact on patient care and safety.

References

Daicampi, C., Veronese, M., & Cesaro, E. (2025). Impact of bedside handover on patient perceptions and hospital organizational outcomes: A systematic review. Journal of Nursing Management, 2025(1). https://doi.org/10.1155/jonm/3803491

Diab, A., Sharif, L., Katooa, N. E., Kandil, F. S., Mahsoon, A., & Abdelaziz, N. (2023). Relationship between nurses’ perception of professional shared governance and their career motivation in Egypt: A cross-sectional study. International Journal of Nursing Sciences, 10(4). https://doi.org/10.1016/j.ijnss.2023.09.016

Hughes, R. (2020). Tools and strategies for quality improvement and patient safety. National Library of Medicine; Agency for Healthcare Research and Quality (US). https://www.ncbi.nlm.nih.gov/books/NBK2682/

Kongkar, R., Ruksakulpiwat, S., Phianhasin, L., Benjasirisan, C., Niyomyart, A., Ahmed, B., Puwarawuttipanit, W., Chuenkongkaew, W., & Adams, J. (2025). The impact of interdisciplinary team-based care on the care and outcomes of chronically ill patients: A systematic review. Journal of Multidisciplinary Healthcare, 18(18), 445–457. https://doi.org/10.2147/jmdh.s497846

Musheke, M. M., & Phiri, J. (2021). The effects of effective communication on organizational performance based on the systems theory. Open Journal of Business and Management, 9(2), 659–671. https://doi.org/10.4236/ojbm.2021.92034

Regie Buenafe Tumala. (2025). Clinical nurses’ involvement in decision-making process at the nursing unit-based council level: A cross-sectional study of shared professional governance in the kingdom of Saudi Arabia. Nursing Reports, 15(12), 426–426. https://doi.org/10.3390/nursrep15120426