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  1. Speroni, Karen Gabel PhD, MHSA, BSN, RN
  2. Wisner, Kirsten PhD, RNC-OB, CNS, C-EFM
  3. Stafford, Amy DNP, RN, CIC, CMSRN
  4. Haines, Fiona MCur RN, RM, Adv Mid Adv NeonSc, CPHQ
  5. AL-Ruzzieh, Majeda A. PhD, RN
  6. Walters, Cynthia DNP, RN, NE-BC
  7. Budhathoki, Chakra PhD


Objective: Researchers examined associations between Index for Professional Nursing Governance (IPNG) scores and outcomes, by US and international hospitals.


Background: Nursing governance and effects on nurse-related outcomes are not well studied.


Methods: Associations were evaluated using average IPNG scores from 2170 RNs and nurse-sensitive indicators (NSIs) and patient and RN satisfaction outcomes (n = 205 study units, 20 hospitals, 4 countries).


Results: International units had better IPNG shared governance scores (113.5; US = 100.6; P < 0.001), and outcomes outperforming unit benchmarks (6 of 15, 40.0%; US = 2 of 15, 13.3%). Shared governance significantly outperformed traditional governance for 5 of 20 (25.0%) US outcomes (patient satisfaction = 1, RN satisfaction = 4) and for 3 of 11 (27.3%) international (patient satisfaction = 1, RN satisfaction = 2). Internationally, self-governance significantly outperformed traditional governance and shared governance for 5 of 12 (41.7%) outcomes (NSI = 2, patient satisfaction = 3).


Conclusions: Shared governance is a strategy that can be considered by nurse leaders for improving select outcomes.