Unit Leadership and Climates for Evidenceâ Based Practice Implementation in Acute Care: A Crossâ Sectional Descriptive Study
Shuman, Clayton J.; Powers, Katherine; Banaszak‐holl, Jane; Titler, Marita G.
2019-01
Citation
Shuman, Clayton J.; Powers, Katherine; Banaszak‐holl, Jane ; Titler, Marita G. (2019). "Unit Leadership and Climates for Evidenceâ Based Practice Implementation in Acute Care: A Crossâ Sectional Descriptive Study." Journal of Nursing Scholarship 51(1): 114-124.
Abstract
PurposeThe purposes of this study were to (a) describe nurse manager (NM) leadership behaviors for evidenceâ based practice, NM evidenceâ based practice competencies, and unit climates for evidenceâ based practice implementation in acute care, and (b) test for differences in NMsâ and staff nursesâ (RNsâ ) perceptions.DesignA multisite crossâ sectional design was used to collect data from a sample of 24 NMs and 553 RNs from 24 adult medicalâ surgical units in seven U.S. community hospitals.MethodsResponses were collected using electronic questionnaires, inclusive of the Nurse Manager Evidenceâ Based Practice Competency Scale (NM only), Implementation Leadership Scale, and Implementation Climate Scale. Eâ mail reminders and gift card lottery drawings encouraged response. Descriptive statistics described total and subscale scores by role. Differences in perceptions were evaluated using independent tâ tests with Bonferroni correction (α = .05).Findings23 NMs and 287 RNs responded (95.8% and 51.9% response rates, respectively). NMs reported they were â somewhat competentâ in evidenceâ based practice (M = 1.62 [SD = 0.5]; 0â 3 scale). NMs and RNs perceived leadership behaviors (NM: M = 2.73 [SD = 0.46]; RN: M = 2.88 [SD = 0.78]; 0â 4 scale) and unit climates for evidenceâ based practice implementation (NM: M = 2.16 [SD = 0.67]; RN: M = 2.24 [SD = 0.74]; 0â 4 scale) as evident to a â moderate extent.â RN and NM perceptions differed significantly on the Proactive (p = .01) and Knowledgeable (p < .001) leadership subscales.ConclusionsEvidenceâ based practice competencies and leadership behaviors of NMs, and unit climates for evidenceâ based practice were modest at best and interventions are needed. To close the research to practice gap, future studies should investigate the interplay between social dynamic context factors and implementation strategies to promote uptake of evidenceâ based practices.Clinical RelevanceCritical attention is needed to build organizational capacity for evidenceâ based practices through development of unit leadership and climate for evidenceâ based practice to accelerate routine use of evidenceâ based practices for improving care delivery and patient outcomes. The three instruments described herein provide a foundation for nurse leaders to assess these dynamic context factors and design interventions or programs where there is opportunity for improvement.Publisher
Author Wiley Periodicals, Inc.
ISSN
1527-6546 1547-5069
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