From frustration to function: Standardizing tools and education in nursing governance

Abstract

Background: Nursing professional governance (NPG) promotes shared decision-making and is a Magnet® expectation, yet inconsistent tools and fragmented education can decrease council effectiveness.

Purpose: The purpose of this project was to standardize tools and education to improve role clarity, engagement, and council health across a large academic medical center.

Methods: This quality improvement project used iterative Plan-Do-Study-Act cycles from June 2023-July 2024. Interventions included redesigned council charters and agendas, slides created for enhanced communication, a centralized SharePoint site, a formal NPG orientation, an electronic feedback form, and a governance-specific email inbox. Council health was measured using the Hess Council Health Survey (CHS) at baseline and two post-intervention time points.

Results: Baseline CHS results identified gaps in education, role expectations, time-dedication strategies, and pathways for non-member input. Postintervention improvements were observed in: agreement that new members received formal education (40.9% to 57.3%), availability of strategies to dedicate time (50% to 76.1%), clarity of expectations (63.6% to 83.3%), and opportunities for non-member input (46.3% to 61.1%). Although some gains declined at later follow-up, most remained above baseline.

Conclusions: Standardizing governance tools and providing structured education improved engagement and role clarity; ongoing reinforcement is needed to sustain gains.

Keywords: council effectiveness; nurse engagement; nursing professional governance; professional governance; quality improvement; shared governance.