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The need for CQI is determined by multiple entities like accrediting and regulatory agencies and hospital committees (GCU, 2018a) In some cases, all it takes is one individual to take the initiative and promote the need for quality improvement in a certain area inside the health network. Typically nurses are the ones to do this and it does not require s formal position to do so. At my hospital, shared governance is practiced and the opportunity to join a CQI committee is open to all registered nurses with any type of experience. This gives me the opportunity to join a committee and participate in a project. This opportunity is part of a program that is based on Patricia Banner’s theory which delineates 5 levels of expertise in nursing practice based on experiential learning (GCU, 2018). The five levels are novice, advanced, competent, proficient, and expert. The novice levels are typically new graduates or nurses new to a practice. They learn the basic rules and policies and learn how to use them in context on the floor. Incentives start at the advance level to the expert level. Advanced level nurses participate at most unit meetings and are involved in a committee. By the expert level, a nurse has been in the specialty for 4 years, has a BSN, participates at most unit meetings, and participates in a committee. Receiving incentives is based on how many points you earn at your level. Points can be earned by completing literature search, developing a research proposal and submitting it for approval. 
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