An Integrative Review of Interventions for Enhancing Leadership in the Implementation of Evidence‐Based Nursing

Abstract

Background: The most common barriers to evidence-based nursing (EBN) are related to nurse leadership and to organizational characteristics. Scientific evidence is needed regarding interventions that support nurse leadership. Aims:The aim was to gather, assess, and synthesize the current empirical evidence regarding interventions for enhancing nursing leadership in EBN implementation. Methods:We conducted an integrative review of interventions that enhance the roles of nurse leaders in EBN implementation using reporting guidance according to the PRISMA statement.Results: The search identified five studies, which described two intervention types: interventions improving nurse leaders' capabilities for EBN implementation and supporting the activities for EBN implementing. The interventions focused on strategic, teamwork, and individual levels. All interventions produced positive outcomes on primary outcomes, however all not statistically significant.Linking Evidence to Action: The studies mainly had descriptive designs and short follow-up times, so it was not possible to propose evidence-based recommendations for effective interventions. The certainty of evidence was very low due to the study designs and the risk of bias. Structured clinical education might promote new innovations in evidence-based leadership in nursing. Conclusions about the impact of the interventions must be drawn with caution. They might be useful for promoting the abilities of nurse leaders to implement EBN, but further studies are needed to provide more reliable recommendations.

Nurse leaders’ perceptions and experiences of leading evidence: A qualitative enquiry

“…Leaders also need the support of committed facilitators or change agents who support the EBP of their units (Hanharan et al, ; Warren et al, ). Evidence‐based interventions to support shared learning and to create infrastructures that promote EBP are also required (Heinen et al, ; Välimäki et al, ; XX et al, 2017). The implementation of EBP in decision‐making that concerns work with patients is a key challenge (Häggman‐Laitila, Mattila, & Melender, ; Heinen et al, ).…”

“…This leadership should also be constantly assessed and developed based on evidence‐based knowledge. Yet there continues to be little research knowledge available that details the leadership practices that best support EBP (Välimäki et al, ); this must be addressed with significant research investment to ensure that leaders are fully supported in their work.…”

“…The use of research evidence has not yet become established in the decision‐making that concerns patients, even though considerable efforts to include EBP competence in nursing education (Melnyk et al, ) have been made. Different training and leadership interventions have been used to promote EBP in many working communities (Häggman‐Laitila, Mattila, & Melender, , ; Välimäki, Partanen, & Häggman‐Laitila, ).…”

Validity and reliability of Evidence‐Based Practice Leadership Scale and Evidence‐Based Work Environment Scale in Turkish

“…13 The goal of EBP is to enable patients to have access to highquality healthcare services, to improve their satisfaction, to reduce healthcare costs, to contribute to the development of nursing studies, to ensure that nursing services are predicated on evidence, and to promote autonomy and high job satisfaction in nursing practices. [14][15][16][17] In health care, disseminating and exchanging research evidence has been the main focus of knowledge management. 16,18,19 Although practitioners are aware of significant contribution of EBP to healthcare system, research shows that nurses do not use EBPs sustainably in practice.…”

“…[14][15][16][17] In health care, disseminating and exchanging research evidence has been the main focus of knowledge management. 16,18,19 Although practitioners are aware of significant contribution of EBP to healthcare system, research shows that nurses do not use EBPs sustainably in practice. 20 Carlson and Plonczynski, 21 in their systematic review of studies, revealed that sustainability of EBPs is related with characteristics of the organization, as well as other nurse-related factors including lack of time to read and research, lack of authority to change patient care procedures, and insufficiency of administrative support.…”