Shared Governance

The Shared Governance Council structure consists of an executive council, four system councils (practice, education, quality and management), four system sub-councils (forms and documentation; policy and procedure; research: recruitment and retention), and seven divisional practice councils, representing unit-based practice councils.

Unit-based practice councils are the foundation of the Shared Governance structure. These councils exist to give registered nurses a voice in the practice of nursing at the point of delivery. Nurses use research and best-practice evidence to develop standards of practice, identify educational needs and professional development opportunities and collaborate with peers and nursing leaders to make optimal use of nursing resources.

Divisional practice councils facilitate collaboration by unit-based practice councils with similar patient populations and/or services, allowing them to resolve common problems and share local successes.

The systems councils and executive council provide oversight, a decision structure, and resource support to the work of the unit-based practice councils, the divisional practice councils and the systems sub-Councils.

Nursing Grand Rounds

Nursing Grand Rounds is a collaborative effort of the Education Council and the Research Council.

Evidence-based Practice

Evidence-based practice is the conscientious use of current best evidence in making decisions about patient care. It incorporates clinical research and best practice information, clinical expertise, and the preferences and values of the patient. (Melnyk & Fineout-Overholt, 2005).

Why Do Evidence-Based Practice?

  • Nursing practice has been based on tradition and not always evaluated for usefulness and effectiveness.
  • Knowledge is evolving rapidly, so practice must be evaluated frequently to be sure it is consistent with current knowledge.
  • Systematic review of evidence establishes a method to evaluate practice and provide guidance for clinical decision making.

Five Steps of Evidence-Based Practice: 

  1. Ask the clinical question in a way that will yield the most relevant and best evidence.  
  2. Collect the best evidence available, searching for systematic reviews, meta-analyses, and best practice guidelines first. Next search information from case studies, text books, or other sources.  
  3. Critically appraise the evidence for validity, significance, and relevance to the situation at hand.  
  4. Integrate the evidence with the practitioners’ clinical expertise and the needs and preferences of the patient.  
  5. Evaluate the effectiveness of practice decisions based on the evidence.  

Quality Improvement vs. Research in Building Evidence-Based Practice: 

Quality improvement (i.e., practice guidelines, nurse-sensitive outcome indicators, national standards, etc.) represents sources of known evidence or the current state. These data are evaluated to see if it answers the clinical question at hand. If the evidence is insufficient, research is conducted to develop new knowledge or evidence.

For Saint Francis Nurses