Shared Governance Research Articles

Reduction of CAUTI Events in an ICU During the COVID-19 Pandemic Through Shared Governance and Using Process Improvement Strategies

BackgroundCatheter Associated Urinary Tract Infections (CAUTIs) are associated with an increase in mortality, morbidity, length of stay, and hospital costs. Intensive Care Units (ICUs) have higher rates of CAUTIs than other hospital units. During the Coronavirus (COVID-19) pandemic, Hospital Associated Infections (HAIs) have increased, including a 30% increase in CAUTI events within ICUs nationwide. The aim of this project was to engage the frontline staff in reducing CAUTI rates in the ICU.MethodsThis project occurred on a 40 bed Intensive Care Unit (ICU) in a 350+ bed community hospital. The patient population included patients positive for COVID-19. The Shared Leadership Council (SLC), which comprised of both unit leadership and frontline staff, utilized Plan-Do-Check-Act (PDCA) framework to reduce the incidence of CAUTIs on the unit. Peri-care and catheter care was identified as a gap in recent CAUTI events. The SLC developed a 4-pronged approach to include: hand hygiene cues, peri-care and catheter care training, CAUTI prevention bundle and external device review, and Patient Care Assistants (PtCA) to champion and standardize catheter and peri-care in daily unit workflow.ResultsThe result was a reduction in the number of CAUTI events in the ICU during 2021 from 3 in Quarter 1, to 2 in Quarter 2, to 0 in Quarter 3.ConclusionsThese results support success in engaging front line staff in Process Improvement Projects aimed at reducing HAIs. The SLC identified opportunities to close CAUTI prevention bundle element gaps, developed a set of interventions, and executed the interventions in the ICU.

Sustaining Higher Education Quality by Building an Educational Innovation Ecosystem in China—Policies, Implementations and Effects

This article analyzes how China has worked to develop and build a higher education innovation ecosystem in the past decade. Binding its analysis to three types of data, namely clusters of national policies issued by important Chinese government bodies, dozens of articles in an internal journal of the Ministry of Education, and various Chinese media accounts, the article unravels how resources are mobilized and the direction chartered for unprecedented engagement between different stakeholders for education purposes. The findings reveal that the establishment of a higher education innovation ecosystem derives from the need to improve the overall higher education quality in full swing and has been realized as a strategic consensus among the government, enterprises, higher education, and social forces. The ecosystem is underpinned by the assigning of different roles to different stakeholders based on collaboration and division of labor. At the same time, there is also substantive capital, resource mobility, and the infusion of industrial technological expertise underpinning such an innovation ecosystem that involves six categories of collaboration at macro and micro levels. The impact of the higher education innovation ecosystem thus far includes deepened and extensive participation in higher education quality improvement by multiple types of stakeholders and the same type of stakeholders across different tiers. Instructors’ teaching and students’ learning have experienced changes due to the ecosystem’s impact at a micro level, and many institutions have increased shared governance practices to better cater to the synergy among different sides. At the same time, there is an unevenness in the innovation ecosystem in terms of participating higher education institutions and enterprises.

A Hospital's Roadmap for Improving Nursing Excellence Using AACN's Healthy Work Environment Standards.

A Hospital's Roadmap for Improving Nursing Excellence Using AACN's Healthy Work Environment Standards.

Greening Cities, Shaping Cities: Pinpointing Nature-Based Solutions in Cities between Shared Governance and Citizen Participation

The topic of pinpointing Nature-Based Solutions (NBS) in the urban context has been cultivating interests lately from different scholars, urban planning practitioners and policymakers [...]

The impact of shared governance on the adverse mood of parturients with gestational hypertension and perinatal indicators of newborns

This study aimed to investigate the effect of shared governance on the adverse mood of parturients with gestational hypertension and perinatal indicators of newborns. A total of 318 patients with gestational hypertension treated in our hospital were enrolled as study subjects and were divided into a study group (200 cases) and a control group (118 cases) using double-blind, controlled and randomised methods. Before intervention, the systolic blood pressure (SBP), diastolic blood pressure (DBP), Hamilton Anxiety Rating Scale (HAMA), Hamilton Depression Rating Scale (HAMD) and Quality of Life Scale (SF-36) scores did not differ significantly between the two groups (p>.05). After intervention, the study group had lower SBP, DBP, HAMA and HAMD scores and higher SF-36 scores than the control group (p<.05). The neonates in the study group experienced a lower incidence of adverse outcomes than those in the control group (p<.05). Shared governance can regulate blood pressure and improve mood and quality of life in parturients with gestational hypertension. It can also reduce the incidence of adverse events in newborns during the perinatal period. Impact Statement What is already known on this subject? Gestational hypertension is the development of hypertension in pregnant women after 2 or 20 weeks of gestation and is characterised by headache, dizziness, nausea and swelling of the lower legs. Early intervention is key to improving maternal and neonatal prognosis. Shared governance is an emerging model of participatory decision-making in which nurses are empowered to make decisions about clinical practice standards, quality improvement, staff and professional development, and research, aiming to cultivate the patients' sense of responsibility for their health. What do the results of this study add? This study demonstrated that shared governance can regulate maternal blood pressure and improve maternal adverse mood, maternal quality of life and reduce the incidence of perinatal adverse events in the newborn, indicating the potential of shared governance and may promote the clinical application of shared governance. What are the implications of these findings for clinical practice and/or further research? This study starts with adverse mood of parturients and perinatal outcomes of newborns, and demonstrates in detail the impact of shared governance in nursing interventions on parturients with gestational hypertension and neonates. The data are detailed and reliable, providing certain clinical references for follow-up research.

Survey Research: Do All RN Types Have the Same Perceptions Regarding Professional Nursing Governance?

Researchers examined professional nursing governance perception differences by RN type (clinical, manager, and other RNs), and nurse-related outcome associations. Shared governance is associated with improved nurse-related outcomes. Understanding differences in RN types regarding shared governance perceptions is important and not well studied. Mean Index of Professional Nursing Governance (IPNG) scores from 3 hospitals' 502 RNs were used to evaluate associations by RN type and unit-based nurse-related outcomes. Descriptive and inferential statistical methods were used. Shared governance was the predominant finding (overall score and 4 of 6 subscale scores) with no significant differences by RN type. Traditional governance was scored for 1 subscale (control over personnel), which was not significant. There were no significant differences in the IPNG score associations with outcomes data by RN type. Clinical nurses, managers, and other RN types perceived their governance as shared, without significant difference in the nurses' perceptions based on role.

Pandemic Responses: What They Reveal About Crisis Management, Decision-Making, and Shared Governance

Colleges and universities have, by and large, responded well, one might say, very effectively as organizations, to the pandemic. This observation may come as a surprise because some would vehemently disagree. Surprising also because in many academic environments, decision-making around managing crises, let alone implementation of solutions, is slow, politicized, and often driven by personal or constituent agendas. Responding to internal or external challenges, implementing strategic plans or effectuating decisions proactively, particularly at the system or institutional level, is difficult. I believe this less than sanguine view is commonly held, and research on decision making in academic organizations over the past 75 years lends credence to this observation.

Using shared governance to advance completion and transfer

AbstractThis article explores shared governance in advancing access, completion, and transfer. Shared governance is a critical vehicle for consultation and collective decision‐making in higher education. It is the structure and process through which priorities are set and decisions are made in academic institutions. The demographic cliff facing higher education across most of the country for admissions demands coordination and collaboration among stakeholders to ensure the sustainability of institutions. Additionally, to address the completion and transfer challenges, presidents need to engage stakeholders including trustees, students, faculty, and staff to identify and implement related strategic priorities. The article calls for constructive engagement of unions in advancing these priorities through legislative advocacy for funding and collaboration on student enrollment and persistence efforts. The 2020 pandemic highlighted how well college stakeholders can mobilize and respond to a crisis. The demographic threat most institutions are facing calls for the same level of organization and response.

M Health Fairview: An aligned academic health system

BackgroundThe aim of this article is to familiarize the reader with one system’s approach to creating an aligned academic health system that facilitates delivery of academic health care in community hospitals. MethodsA wide variety of approaches to this challenge include viewing the community facilities as strictly feeders to the academic centers with no shared governance, to viewing them as branding opportunities with aligned governance, to a more integrated model such as ours, and to creating exclusive centers of excellence in the community facilities by consolidating services initially dispersed across competing hospitals into one center. ResultsWe leveraged service lines and domains to standardize care across all hospital settings which facilitated delivery of complex tertiary care in community hospitals, thus increasing capacity in the Academic Medical Center for complex quarternary care. ConclusionThrough creating a more completely integrated, patient centric health system that leverages the community partners we minimized the need for people to travel from their community hospitals to the Academic Medical Center while still ensuring they received the expertise of a leading academic institution.

Legitimising shared governance in China's higher education sector through university statutes

AbstractThis article reports on a study in which the legitimisation of shared governance in the Chinese higher education sector was investigated. Norman Fairclough's three‐level discourse analysis was used for analysing documents and interviews. The research materials consist of thirteen Chinese university statutes and qualitative semi‐structured interviews with 22 university administrators, faculty members, students and social representatives. The research focused on how university statute texts articulate shared governance, and how shared governance is practically implemented. Study findings demonstrate that Chinese university statute discourses officially legitimise shared governance in various manifestations, by replacing the term management with the term governance in statute texts, explicitly using democracy‐related phrases, especially establishing a joint meeting mechanism at both institutional and departmental levels, and by using the wording multiple‐stakeholder participation in university affairs. In practice, shared governance is a recognised ideal of governance structures to embrace among all different stakeholders. Chinese universities have, more than ever before, taken up shared governance practices. Yet, the degree of participation, or sharing, in policy implementation in general, remains to be further improved compared with the ideal state stipulated in discourses. Findings identify tokenism as a feature of policy implementation. Insufficient administrative professionalism is identified as a catalyst for such tokenism—a reason for why shared governance efforts remain incomplete thus far.

The Role of Participation in and Effectiveness of Shared Governance Councils in the Nurses' Perception of a Professional Practice Work Environment.

The aims of this study were to identify the differences in nurses' perceptions of their professional practice work environment (PPWE) related to their participation in shared governance (SG) councils and to examine the perception of effectiveness of SG councils among nurses who participate in them. Research suggests that adopting SG in nursing can lead to significant, positive outcomes, such as patient and nurse satisfaction and enhanced nurse empowerment, engagement, and a PPWE. The study used a cross-sectional design in a Magnet®-designated urban Jordanian cancer care hospital. A convenience sample of 580 direct care nurses was used. The data were collected using self-administered questionnaires, the Council Health (CH) instrument, and the Professional Practice Work Environment Inventory (PPWEI). Results demonstrated a significant difference in the total score of PPWE between the SG council members (4.85) and nonmembers (4.68) (t = 2.906, P = 0.004). The results also indicated small to strong correlations of the total overall council health mean and all domain means of council effectiveness with total overall PPWEI mean and all domain means of PPWE (P < 0.05) among nurses who participated in SG councils. Findings support involving more staff in SG councils and that enhancing the SG councils' effectiveness positively affects the PPWE.

Management of Conflict in Non-Profit Organization with Shared Governance

In social and non-profit organisations with partnership governance, conflicts are more numerous and more difficult to mitigate. Ostrom’s organisational principles guarantee the stabilisation of such organisations, but we lack studies about ways to restore their stability after a conflict crisis. Based on Rahim’s works on conflict handling styles’ influence over long-lasting collaborations, we hypothesize a linkage between Ostrom’s organisational principles and effective conflict handling styles. Our article explores this topic from action research based on the comparison of three non-profit organizations: an associative school, a Non-Governmental-Organization, a Think Tank, Each organisation is characterized respectively by three conflict handling styles that can each lead to their collapse. The rules of collegial governance exemplify well, in the three cases studied, as variables that directly affect the modes of conflict resolution of its members. This analysis opens up new avenues of action for conflict management, whereby stabilization is achieved, by changing its collective rules to move towards more collegiality in decision-making.

Sustainable Mobility and Resilient Urban Spaces in the United Kingdom. Practices and Proposals

The development of integrated and multi-scalar regeneration strategies focused on public space and involving innovated mobility, environmental and historic networks is a key issue of international references and an actual challenge of pandemic and social distancing measures. The innovation of urban planning and design toward multi-scalar and integrated methodological and operational references is the topic of a research and didactic path carried out at Sapienza University, focused on the regeneration of infrastructure and public space networks. In this framework, United Kingdom represents an interesting field of study for the conditions that have recently led to an efficient cooperation model among local authorities, aimed at achieving sustainable common goals. A shared territorial governance that promotes the integrated management of soil, water and biological resources from an eco-systemic perspective. A collaborative planning approach based on a responsible, inclusive and sustainable strategy for the construction and networking of new resilient urban spaces, green infrastructures and new forms of sustainable mobility. The networking of green spaces, waterfronts and cycle paths represent a resilient response to cities’ regeneration for the contribution provided by ecosystem services in increasing health and well-being and a greater adaptability to climate change. The paper aims to illustrate the main methodological and operational references, case studies and results of the research and didactic path focused on multiscalarity and integration of planning and projects through the design of public space along blue and green networks in the United Kingdom. Key concepts that link together the phases of contextualization of the national planning background, the analysis of ongoing regeneration practices on waterfronts and the experimentation related to a regeneration proposal for King’s Lynn, in Norfolk County (England). Research and practices that integrate green, blue and grey infrastructures addressing the UN Agenda 2030 and the National Planning Policy Framework of England.

Tripartite Evolutionary Game Analysis of Shared Manufacturing by Manufacturing Companies under Government Regulation Mechanism

In order to study the decision‐making behavior of the participating groups in shared manufacturing, this paper constructs a tripartite evolutionary game model of shared manufacturing by manufacturing companies under government regulation mechanism. Using evolutionary game theory, it is to analyze the evolutionary stable strategy (ESS) of the model. The utilization efficiency of government regulatory input and the influence of government nonregulation in the proportion of regulatory income are discussed. MATLAB numerical simulation is used to analyze the influence of different parameter changes on the evolution result. It is concluded that the initial sharing probability of manufacturing companies, the level of trust in the company, the government’s penalties for nonsharing parties, the utilization efficiency of government inputs and the rewards given to the government by the state all play a positive role in promoting shared manufacturing and government regulation of manufacturing companies. The lower the ratio of government nonregulation to the income of regulation is, the more active government regulation is. In addition, the shared income should be distributed reasonably. Therefore, in the shared manufacturing process, all the above factors should be considered.

Leveraging Shared Governance to Build a Healthier Work Environment in a NICU.

A unit-shared governance model was established in the NICU at Tampa General Hospital to enhance nursing autonomy and improve job satisfaction, teamwork, and patient outcomes. Shared governance models have been introduced within health systems to shape healthy work environments. The NICU experienced an extended hiring freeze that led to a significant nursing shortage and staff dissatisfaction. A unit-shared governance model was established to address key areas of concern. This led to the development of the new employee orientation committee. Their goal was to make significant changes in the onboarding and precepting process, including: (1) revising the Registered Nurse Competency-Based Orientation tool to align with a 3-phased orientation process, (2) incorporating a systems approach throughout the orientation period, (3) embedding references to best practices and policies, (4) creating a reference list of recommended reading materials, and (5) developing a skills checklist to guide in selection of patient assignments. The final step was developing a NICU preceptor course to increase consistency between preceptors and standardize orientation. Recent engagement survey results revealed significant improvements in employee satisfaction, validating key improvements made in the onboarding process.

From Shared Governance to Shared Leadership: Our COVID Response to Faculty Evaluation, Support, and Advancement

As a state comprehensive university in a small, midwestern metropolitan area, “Students First” is more than a slogan. The preamble to our Faculty Constitution and our University’s mission statement both specify that students and their flourishing are the justification for our institution’s existence. We have learned, however, that a precondition to robust attention to students’ well-being is parallel attention to the well-being and development of our faculty. This article chronicles the principles and practices by which our shared leadership team responded to unique challenges presented by the COVID crisis and its ripple effects. A closing theme acknowledges that COVID revealed latent, pre-existing gaps in our care for faculty and students as well as introducing new and temporary challenges, and that some of our resulting solutions may require institutionalization as permanent fixtures.

Interview With Launette Woolforde, EdD, DNP, RN, NEA-BC, NPD-BC, FAAN

Interview With Launette Woolforde, EdD, DNP, RN, NEA-BC, NPD-BC, FAAN

The Structure of Organization and Management of the Research at Universities in the USA

The study aimed to identify the features of the structure of organization and management of the research at universities in the USA so that those features are used as variables in further research. The study used the method of content analysis of qualitative type to identify patterns of the structure of organization and management of the research in universities in the USA. It was found that the structure of organization research management at universities in the USA relies on four domains such as scientific, organisational (institutional), financial and legislative. The university research activity in the USA is regulated by federal law. The research office is involved in proposal development, negotiation, and management of the award, ensuring regulatory compliance regarding intellectual property protection and technology transfer, communication of policies and processes, dissemination of funding opportunities, and the sufficient level of committed effort dedicated to a project and certification. The office draws the emphasis on compliance with the below-outlined areas such as fiscal – cost transfers and sharing, direct charging, effort, financial and income monitoring and reporting, and research – animal subject (IACUC) and human subject (IRB) protections, conflicts of interest, environmental health and safety, export controls, invention disclosure, and reporting, scientific overlap and misconduct. The structure of organization and management of the research is based on the above collaborative work which is called shared governance with the bottom-up management approach. Further research is needed in the bottom-up management application prerequisites to be used in Ukraine.

THE IMPACT OF DIVIDEND POLICY, FINANCIAL DISTRESS RISK AND CORPORATE GOVERNANCE TOWARD STOCK PRICE

Stock investment is emerging in this era. The market on stock investment will be predicted to grow every year. Stock price is defined by offer and bid price. With this term use in Indonesia Stock Exchange, it makes people hard to guess on what will be the opening price tomorrow as asking price and bidding price need to reach an agreement. This research will investigate the impact of Dividend Policy, Financial Distress Risk, and Corporate Governance as the independent variables toward Stock Price. This research is conducted by using quantitative research method using secondary data that were taken from the LQ45 companies which are listed in Indonesian Stock Exchange with the population of 61 companies. The samples are obtained using purposive sampling method. The total sample is 42 companies from the year 2017-2019. The data analysis is using multiple linear regression analysis. Based on the results of research and analysis by using SPSS 25 indicate that: Dividend per share (dividend policy) and corporate governance have significant impact toward stock price while dividend payout ratio (dividend policy) and distress risk does not have significant impact toward stock price. It is concluded that the impact of dividend policy, financial distress risk and corporate governance is only 29.2% as the rest is impacted by other variables.&#x0D;

Use of the Council Health Survey to Assess Shared Governance in a Pediatric Hospital During the COVID-19 Pandemic

This project used the Council Health Survey to evaluate the effectiveness of shared governance councils in a children’s hospital during the COVID-19 pandemic. A SWOT analysis was performed to assess the organization’s strengths, weaknesses, opportunities, and threats regarding council health and to inform strategies to sustain the shared governance environment. The well-established shared governance infrastructure allowed the organization to rapidly pivot council operations to sustain nurse engagement while balancing the unprecedented staffing and resource challenges of the pandemic. Organizations must remain flexible and innovative to maintain an environment supportive of nurse empowerment and shared governance during public health emergencies.