In 2007, our organization embarked on a journey to establish Shared Governance throughout the nursing division of our hospital. Shared Governance- nursing model that revolves around moving power, decision-making to the level of action. This movement gives healthcare professionals autonomy over their practice extending their voice into decisions previously made by managers.

Proposed change:

All nurses in our organization are encouraged to participate in Shared Governance at unit level through unit coordinating council (UCC). UCC manages unit decision-making through six councils: Practice, Service/Satisfaction, Research, Quality/Safety, Professional Development, Leadership.  Chairs of each unit council serves on their respective council at the organization level facilitating the dissemination of ideas. These councils meet monthly on Wednesday, known as "Working Wednesday". The chair of each council serves on the Nursing Coordinating Council, which functions as a clearinghouse and disseminator of information and decisions to the appropriate council for action.

Implementation, outcomes and evaluation:

Our success is attributed to best practice, desires to see goals accomplished. Leaders are committed to empowering staff nurses to be involved in decision-making by arranging for nurses to have scheduled time to attend meetings, work on projects, even in the midst of tighter budgets. Finally, our success is our excellent outcomes, which motivate staff to continue to be involved and commit to the next initiative to improving our practice. Our outcomes are: Leadership: Self-scheduling, peer interview team; Practice: Developed policies for unit practice changes:  kangaroo care, cue based feeding, care of micropreemie; Professional Development:  Unit skills fair, "Policy of the Month" as continuing education; Service & Satisfaction: NICU Parent Support Group,developed floating expectations for staff; Research: Cue-based feeding research project; Quality and Safety: Catheter associated blood stream infection (CABSI) initiative, results = over 1000+ days with no CABSI's created MRSA action plan, leading to 1 year MRSA free.

Implications for nursing practice:

Our unit's mission: Put patient and family first, set goals for patient care, believe in ourselves to achieve goals we have set. To achieve our mission, we had to change the way we think. This unit belongs to "us." "We" have a voice. Together, with leaders, "we" contol practice and what happens in the practice environment.  Shared Governance has helped us to reach our goals and go far beyond our  wildest dreams! 

Keywords:

Shared Governance, power, decision-making, Nursing Coordinating Council, Unit Coordinating Council, empower.