Date of Award


Document Type

Scholarly Project

Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Dr. Sheri Jacobson, PhD, RN

Second Advisor

Dr. Lisa P. Teel, DNP, RN, NEA-BC, CCRN-K


Practice Problem: Nurse turnover can adversely impact any health system's financial performance and the clinical practice environment, and it is detrimental to patient safety and quality of care.

PICOT: The PICOT question that guided this project was for nurses on a Labor and Delivery and Antepartum unit at a 382-bed community hospital in Austell, GA(P), does the utility of a contemporary shared governance structure in everyday practice (I) compared to the current shared governance structure (C) decrease nurse turnover rates (O) within four weeks (T)?

Evidence: Shared governance permits the reduction of turnover and the intent to leave for nurses by promoting nursing autonomy and engagement, directly linked to decreasing turnover rates.

Intervention: The contemporary shared governance structure facilitated nurse decision-making at the point of care in real-time and interprofessional team collaboration to effect change.

Outcome: Nurse turnover rates compared four weeks prior and post-implementation showed a decrease from 68.26% to 63.08%, translating into a 5.11% drop-in turnover rates.

Conclusion: The contemporary shared governance structure facilitated the direct care nurse's ability to make changes at the point of care in collaboration with the interprofessional team using a rolling idea-generating process integrated into everyday practice. The project was clinically significant as it transformed the direct care nurse's autonomy in their practice fostering a positive practice environment in four weeks. This project showed how nurse engagement could be improved when on-demand decision-making in the clinical area was facilitated, resulting in reduced turnover to yield better patient outcomes and overall organization performance.


Scholarly project submitted to the University of St. Augustine for Health Sciences in partial fulfillment of the requirements for the degree of Doctor of Nursing Practice.

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