A Contemporary Shared Governance Structure and Its Role in Managing Nurse Turnover

Practice Problem: Nurse turnover can adversely impact any health system\u27s financial performance and the clinical practice environment, and it is detrimental to patient safety and quality of care. PICOT: The PICOT question that guided this project was for nurses on a Labor and Delivery and Antepartum unit at a 382-bed community hospital in Austell, GA(P), does the utility of a contemporary shared governance structure in everyday practice (I) compared to the current shared governance structure (C) decrease nurse turnover rates (O) within four weeks (T)? Evidence: Shared governance permits the reduction of turnover and the intent to leave for nurses by promoting nursing autonomy and engagement, directly linked to decreasing turnover rates. Intervention: The contemporary shared governance structure facilitated nurse decision-making at the point of care in real-time and interprofessional team collaboration to effect change. Outcome: Nurse turnover rates compared four weeks prior and post-implementation showed a decrease from 68.26% to 63.08%, translating into a 5.11% drop-in turnover rates. Conclusion: The contemporary shared governance structure facilitated the direct care nurse\u27s ability to make changes at the point of care in collaboration with the interprofessional team using a rolling idea-generating process integrated into everyday practice. The project was clinically significant as it transformed the direct care nurse\u27s autonomy in their practice fostering a positive practice environment in four weeks. This project showed how nurse engagement could be improved when on-demand decision-making in the clinical area was facilitated, resulting in reduced turnover to yield better patient outcomes and overall organization performance