Creating room for evidence‐based practice: Leader behavior in hospital wards

Abstract

The integration (routinizing and sustaining) of evidence‐based practice (EBP) into hospital management is a key element for improving patient safety and ensuring better patient outcomes. Hospital managers and clinical leaders play crucial roles in this integration. Interactions between leaders and integration context influence the improvement's quality, but leader‐based actions that are effective for improving nursing practice remain unclear. The relationship between leaders could also either hinder or enable this implementation process. The aim of this study was to generate a theory about patterns of leader behavior that leaders are engaged in when attempting to integrate EBP in a clinical setting. We used a classic grounded theory methodology to generate a substantive EBP theory. In this study, through participant observation, we observed 63 nurses (15 specialist, 39 registered, and 9 assistant nurses). From these, five ward leaders (two head nurses, one assistant head nurse, and two teaching nurses) participated in individual interviews, and 18 clinical nurses participated in four focus groups. “Creating room for EBP” emerged as a theory for explaining the way in which the leaders attempted to resolve their main concern: How to achieve EBP treatment and care with tight resources and without overextending the nurses. Creating room for EBP encompasses a process of interactions, including positioning for, executing, and interpreting responses to EBP.

The barriers to evidence‐based nursing implementation in mainland China: A qualitative content analysis

“…Third, leadership plays a significant role in evidence implementation. This is consistent with previous studies (Bianchi et al, 2018; Renolen, Hjalmhult, Hoye, Danbolt, & Kirkevold, 2020). The higher the level of leadership, the greater is the impact on the implementation of evidence.…”

Associations between nurse managers’ leadership styles, team culture and competence planning in Norwegian municipal in‐patient acute care services: A cross‐sectional study

“…Moreover, we found that having a position for a professional development nurse was associated with both team culture and competence planning. Professional development nurses play an important role as contributors to competence enhancement and change processes related to nursing practices in the workplace [ 37 , 38 ]. Hence, we argue that the association found between first‐line managers’ team culture focus and competence planning and having a professional development nurse position may reflect a partnership between the professional development nurse and nurse manager, and, thus, that the two complement each other.…”

“…These were: MipACs organised as intermunicipal services or not, number of RNs per bed; number of admissions; percentage of nurses; and physician contracted to be present (hours per week) and position for professional development nurse (yes/no). The variable concerning professional development nurse was added as these nurses typically act as supervisors and educators in clinical settings and are commonly regarded as leadership partners in relation to the achievement of organisational goals [ 37 , 38 ]. We differentiated between managers of MipAC units located in short‐term care units (intermediate units in nursing homes, out‐of‐hours medical services and local medical centres) and units located in long‐term nursing homes.…”

Barriers to research utilization influencing patient safety climate: A cross‐sectional study

“…When considering the organization, the integration of EBP in hospital management is inherent to the role of managers and leaders and is a prerequisite to ensure patient safety (Renolen et al, 2019). Managers need to support the implementation of this approach in nursing care, intervening on organizational and educational factors (Rudman et al, 2020).…”