Clinical nursing leaders’, team members’ and service managers’ experiences of implementing evidence at a local level

Abstract

Managers need to be more attuned to the personal risks local leaders experience, providing support for leaders to experiment and innovate. Managers need to integrate local priorities with broader system wide agendas.

Being a nurse leader in bedside nursing in hospital and community care contexts in Norway and Sweden

“…In addition, especially in hospital organisations, more administrative and human resource tasks have been put on them [8,12] . There are also expectations on nurse leaders to take on a central role in development projects and research activities to ensure that the care is evidencebased [13,14] . Accordingly, both expectations and responsibilities of nurse leaders in the clinical setting have increased [15] .…”

Middle managers’ role in quality improvement project implementation, are we all on the same page? – A review of current literature

“…Only four of the 16 articles distinguished the perspective of middle managers from other levels of leadership. Various stakeholders' perspective of the middle managers' role in QI implementation Although many of the studies (n = 8) included middle managers within their sample, the middle manager's perspective was not separated from the broader healthcare team (physicians, upper management, frontline staff ) in either the data collection and/or analysis [1,[6][7][8][9][11][12][13]. Within a combined stakeholder perspective, healthcare middle managers are perceived to have four roles in implementation [14].…”

“…They have a responsibility in leading the multidisciplinary team, advocating for resources [5,11,12] and strengthening the role of frontline workers in QI implementation [12,15]. As a communicator, middle managers are described as needing to synthesize organizational strategies, translating them into day-to-day activities for the frontline [6,14,16,17] and positioning improvement initiatives in the context of clinical relevance [14,16].…”

“…Middle managers are the primary supporter of frontline staff during the implementation of a QI initiative. This is demonstrated by middle managers appropriately delegating responsibilities [12,17,18], and supplying the necessary tools and resources for effective implementation [6][7][8][9]20]. As such, managers support and empower frontline staff in QI implementation [1,16,17,20].…”

“…This is illustrated in Tables 2, 3, and 4. For example amongst the healthcare team, there is a perception that the middle manager has a role in transcending inter-professional boundaries and providing leadership to improve the knowledge of the multidisciplinary team [9,12,15]. Middle managers do not hold the same perception.…”