title: A theory-based approach to nursing shared governance.
abstract: The discipline of nursing uses a general definition of shared governance. The discipline's lack of a specified theory with precepts and propositions contributes to persistent barriers in progress toward building evidence-based knowledge through systematic study.
  
  
  
  The purposes of this article were to describe the development and elements of a program theory approach for nursing shared governance implementation and to recommend further testing.
  
  
  
  Five studies using multiple methods are described using a structured framework. The studies led to the use of Lipsey's method of theory development for program implementation to develop a theory for shared governance for nursing.
  
  
  
  Nine competencies were verified to define nursing practice council effectiveness. Other findings reveal that nurse empowerment results from alignment between the competencies of self- directed work teams and the competencies of organizational leaders. Implementation of GEMS theory based nursing shared governance can advance goals at the individual, unit, department, and organization level.
  
  
  
  Advancing professional nursing practice requires that nursing concepts are systematically studied and then formalized for implementation. This article describes the development of a theoretical foundation for the systematic study and implementation of nursing shared governance.
authors.affiliation: College of Nursing, The University of Iowa, Iowa City, IA. Electronic address: maria-joseph@uiowa.edu.
authors.forename: M Lindell
authors.initials: ML
authors.lastname: Joseph
authors.affiliation: College of Nursing, The University of Iowa, Iowa City, IA.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Bogue
mesh_terms: D000328:Adult; D005260:Female; D006075:Governing Board / Q000458:organization & administration*; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D008875:Middle Aged; D017146:Models, Organizational; D009718:Nurse Administrators / Q000458:organization & administration* / Q000523:psychology*; D015401:Nursing Administration Research / Q000458:organization & administration*; D009741:Nursing Staff, Hospital / Q000458:organization & administration* / Q000523:psychology*; D009742:Nursing Theory; D015279:Organizational Culture; D014481:United States; D017132:Workplace / Q000458:organization & administration*
keywords: Alignment; Empowerment; GEMS; Nursing teams; Shared governance; Theory