title: The Impact of Shared Governance Over Time in a Small Community Hospital.
abstract: OBJECTIVE
  This study examined the impact of shared governance (SG) on the professional nursing practice environment of a small community hospital over time.
  
  
  BACKGROUND
  Shared governance has been shown to empower nurses in direct patient care to make decisions about their practice and improve job satisfaction. No research has been found that examined the progression of SG over time in a small community hospital.
  
  
  METHODS
  Questionnaires pertaining to the professional practice environment, perception of nursing leadership, nurse empowerment, nurse satisfaction, risk of practice errors, and comfort with evidence-based practice were administered to all nurses employed at a 149-bed community hospital in central North Carolina for 5 consecutive years.
  
  
  RESULTS
  Results showed that nursing leadership and SG explained 90% of the variance in the nursing professional practice environment. This relationship held true for 5 years. All variables showed continued improvement for 4 years, until year 5 when the organization experienced disruptive change. Even during this year, the results did not return to baseline.
  
  
  CONCLUSIONS
  In order to improve the professional practice environment of nurses, hospitals should focus on strong nursing leadership and a sound SG infrastructure.
authors.affiliation: Author Affiliations: Nurse Manager of Geriatric Behavioral Health (Mrs Allen-Gilliam), Surgical Services Staff Nurse (Ms Graham), Women Services Staff Nurse (Mrs Freeman), Nurse Manager of Critical Care and Medical-Surgical (Ms Swain), Geriatric Behavioral Health Staff Nurse (Ms Faircloth), and Geriatric Behavioral Health Staff Nurse (Mr Jenkinson), Novant Health Thomasville Medical Center; and Director of Clinical Education (Dr Kring), Novant Health Forsyth Medical Center, Winston-Salem, North Carolina.
authors.forename: Jerri
authors.initials: J
authors.lastname: Allen-Gilliam
authors.forename: Daria
authors.initials: D
authors.lastname: Kring
authors.forename: Rachel
authors.initials: R
authors.lastname: Graham
authors.forename: Krystal
authors.initials: K
authors.lastname: Freeman
authors.forename: Sandy
authors.initials: S
authors.lastname: Swain
authors.forename: Grace
authors.initials: G
authors.lastname: Faircloth
authors.forename: Brian
authors.initials: B
authors.lastname: Jenkinson
mesh_terms: D003657:Decision Making; D055318:Evidence-Based Nursing / Q000592:standards*; D006764:Hospitals, Community / Q000458:organization & administration*; D006801:Humans; D007588:Job Satisfaction; D007857:Leadership; D016014:Linear Models; D008137:Longitudinal Studies; D016294:Models, Nursing; D017146:Models, Organizational; D009657:North Carolina; D015401:Nursing Administration Research; D009741:Nursing Staff, Hospital / Q000458:organization & administration* / Q000523:psychology; D015279:Organizational Culture; D061214:Patient Safety; D017009:Professional Autonomy; D011795:Surveys and Questionnaires