An analysis of a governance model in nursing service

Linda R. Stumpf

This dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 9614235; ProQuest document ID: 304217882. The author still retains copyright.

Abstract

The purpose of this study was to investigate the influence of governance type on culture, nurse work satisfaction, nurse retention, and patient satisfaction with care in acute care hospitals. A theoretically derived path model was proposed to guide the study. The original intent was to analyze the path model of governance type for nursing service, however, due to high intercorrelation among the independent variables this was not possible. Therefore, in order to approximate the analysis regarding the influence of governance type on the variables, a secondary contingency analysis was used in which statistically significant differences (p = $<$.05) between the two governance types and the variables of interest were examined. The study was conducted among 396 registered nurses working in five acute care hospitals in Southwestern Pennsylvania that had both a shared governance and a traditional governance unit within the organization. The convenience sample (n = 396) of nurses meeting the inclusion criteria was surveyed, of which 59% or two hundred thirty-four registered (234) nurses responded. In addition, one hundred twenty-one (121) patients were surveyed in the same sites for their opinion of nursing care. Results of the study suggested that governance did influence culture, work satisfaction, nurse retention, and patient satisfaction. Using the Chi-square to compare categorical sociodemographic information, no statistically significant differences were found between the two groups of registered nurses in the two governance types. The instruments used to measure the variables were the Organizational Culture Inventory with an average Cronbach alpha of.84, the Work Satisfaction Scale with a total scale alpha of.87, and the Patient's Opinion of Nursing Care that had a Cronbach's alpha of.88. All of the tools had established construct and content validity. The independent two-tailed t-test was used to analyze the scores from the instruments. Statistically significant differences resulted between the scores of the nurses on the variables of nursing service and between the scores of the patients receiving care on the two governance type units. It was found that the shared governance group had a constructive culture, a higher work satisfaction and patient satisfaction than the traditional governance group that had a passive-aggressive culture type.