The results of this review can be utilised in enhancing factors to facilitate knowledge management in clinical practice and identifying nurse leaders' role in strengthening nurses' competency.

Although research on evidence-based practice (EBP) has been available for several decades, EBP has not been implemented successfully by nursing management. Evidence-based practice is a key area of knowledge management (KM), and EBP and KM are subject to similar challenges. However, there has only been limited research on KM and EBP within the context of nursing. The aim of this study was to describe and explain nurses’ perceptions of their own readiness for EBP, and their perceptions of the managerial and organizational support for enhancing competency and EBP. The study design was a cross-sectional survey carried out in accordance with STROBE. Data were collected from 125 nurses using two international instruments and one instrument developed for this study. The data were then analyzed using descriptive and multivariate statistics. Less than half of the nurses reported that their practices were often evidence-based, and only a third had often searched for evidence. The nurses perceived the weakest areas of management leadership to be arranging resources, solving problems and encouraging discussion in the context of EBP, and anticipation of nurses’ competency needs, ensuring competency and intervening when competency was inadequate in the context of KM. The results emphasize the need to develop nurse training, management leadership and an operational environment conducive to KM and EBP. Managers should take a more visible role in mentoring nurses for EBP and in identifying the developmental needs of nurses’ competencies.

Aim To describe Finnish nurse leaders’ perceptions of and experiences with knowledge management. Background Health science research has traditionally focused on knowledge transfer and research evidence instead of knowledge management, culture and organisational learning. Systematic reviews indicate a lack of awareness about nurse leaders’ activities in knowledge management. Design Qualitative interview study according to the consolidated criteria for reporting qualitative research (see Supporting Information Table S1). Methods Data were collected at a Finnish public, social and healthcare organisation from 33 persons in 2015 and 2017 through 35 individual interviews and seven focus groups. Data were analysed by thematic analysis. Results Nurse leaders’ daily knowledge management activities included assurance of smooth work functions and decisions about sudden changes. When managing knowledge promotion, nurse leaders focused on the near future and served information providers, coaches and developers of operating culture. Anticipatory management of knowledge requirements emphasised nurse leaders’ roles as assessors and visionaries. Tensions while managing knowledge were related to the following: changes in clients’ service needs, insufficient structures and tools to support the assessment and joint development of competence, time and information management, the operating culture, and nurse leader support. Participants reported only few attempts to solve tensions and therefore little to no transformative agency. Conclusion Nurse leaders prioritised daily knowledge management over management of knowledge promotion and anticipatory management of knowledge requirements. Knowledge management in nursing is a complex task requiring a command of different kinds of agency and related leadership styles. The structures, processes and tools supporting knowledge management should be developed to ensure that activities are systematic. Relevance to clinical practice A description of nurse leaders’ perceptions of and experiences with knowledge management could improve recognition of nurse leaders’ agencies for knowledge management, identification of related tensions and application of lessons learned from tensions. This description could also promote nurses’ professional competence and supplement nurse leaders’ training.

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Aim The aim of this study was to describe nurse leaders' perceptions and experiences of leading evidence‐based practices (EBP). Background Leaders can promote EBP in nursing with their own personal example and by striving to renew structures, processes and working cultures. However, previous studies have shown that nurse leaders have tended to be passive with regard to EBP. Methods An interview study using general qualitative methods. In total, 33 individual interviews and seven focus groups of leaders were conducted in 2015 and 2017. Data were analysed thematically. Results The respondents were unfamiliar with EBP as activities that lead to effective patient care. EBP were described as indistinguishable from other practices, lost and random. Overall, they lacked competence with EBP. The activities of nurse leaders do indicate a tentative commitment to EBP, but their main goals seem to be maintaining the status quo. Conclusion Unfamiliarity with EBP reflects adversely on the operations of an entire organisation. The nurse leaders have an opportunity to enhance their understanding with EBP, which will lead to the renewal and improvement of the operating culture and the quality of strategic leadership. Implications for nursing management Leaders should take clear responsibility for EBP on the strategic, operational and educational level.

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