How nursing leaders promote evidence‐based practice implementation at point‐of‐care: A four‐country exploratory study

AIMS To describe strategies nursing leaders use to promote evidence-based practice implementation at point-of-care using data from health systems in Australia, Canada, England and Sweden. DESIGN A descriptive, exploratory case-study design based on individual interviews using deductive and inductive thematic analysis and interpretation. METHODS Fifty-five nursing leaders from Australia, Canada, England and Sweden were recruited to participate in the study. Data were collected between September 2015 and April 2016. RESULTS Nursing leaders both in formal managerial roles and enabling roles across four country jurisdictions used similar strategies to promote evidence-based practice implementation. Nursing leaders actively promote evidence-based practice implementation, work to influence evidence-based practice implementation processes and integrate evidence-based practice implementation into everyday policy and practices. CONCLUSION The deliberative, conscious strategies nursing leaders used were consistent across country setting, context and clinical area. These strategies were based on a series of activities and interventions around promoting, influencing and integrating evidence-based practice implementation. We conjecture that these three key strategies may be linked to two overarching ways of demonstrating effective evidence-based practice implementation leadership. The two overarching modes are described as mediating and adapting modes, which reflect complex, dynamic, relationship-focused approaches nursing leaders take towards promoting evidence-based practice implementation. IMPACT This study explored how nursing leaders promote evidence-based practice implementation. Acknowledging and respecting the complex work of nursing leaders in promoting evidence-based practice implementation through mediating and adapting modes of activity is necessary to improve patient outcomes and system effectiveness.