Leading evidence-based practice: nurse managers’ strategies for knowledge utilisation in acute care settings

Abstract Background The implementation of evidence-based practice (EBP) in nursing is essential for improving patient care outcomes, yet systemic barriers, leadership challenges, and resource limitations continue to hinder its integration into clinical practice. Nurse managers (NMs) play a crucial r...

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Main Authors: Jude Ominyi, Aaron Nwedu, David Agom, Ukpai Eze
Format: Article
Language:English
Published: BMC 2025-03-01
Series:BMC Nursing
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Online Access:https://doi.org/10.1186/s12912-025-02912-5
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author Jude Ominyi
Aaron Nwedu
David Agom
Ukpai Eze
author_facet Jude Ominyi
Aaron Nwedu
David Agom
Ukpai Eze
author_sort Jude Ominyi
collection DOAJ
description Abstract Background The implementation of evidence-based practice (EBP) in nursing is essential for improving patient care outcomes, yet systemic barriers, leadership challenges, and resource limitations continue to hinder its integration into clinical practice. Nurse managers (NMs) play a crucial role in bridging the gap between policy directives and frontline implementation, yet the dynamic interplay between leadership strategies, knowledge utilisation, and organisational barriers remains underexplored, particularly in resource-constrained settings. This study examines how NMs navigate these challenges to sustain EBP adoption in acute care environments. Methods This collective case study employed a longitudinal qualitative design across two acute care settings in the UK. Data were collected over eight months through semi-structured interviews with NMs, nonparticipant observations, and document analysis of clinical guidelines and internal reports. A thematic analysis approach was used to synthesise findings and provide a nuanced understanding of leadership strategies and systemic factors influencing EBP adoption. Findings Six interconnected themes emerged: (1) Adaptive leadership strategies, where NMs employ a hybrid of directive and collaborative leadership approaches to drive EBP; (2) Overcoming organisational and resource barriers, including staff shortages, financial constraints, and competing priorities; (3) Knowledge utilisation and learning networks, highlighting the role of informal mentorship, structured CPD, and peer learning in sustaining EBP; (4) Digital transformation and EBP, examining the benefits and challenges of integrating digital tools and addressing IT literacy gaps; (5) Patient-centred adaptations, exploring how NMs balance evidence-based interventions with patient preferences and cultural considerations; and (6) Emotional and psychological support, underscoring the importance of managing staff resistance and mitigating change fatigue. Conclusion Findings of this study emphasise the pivotal role of NMs in driving EBP implementation through adaptive leadership, strategic resource management, and fostering learning networks. Addressing organisational barriers requires multi-level interventions that integrate leadership actions with systemic enablers to promote sustainable, evidence-informed nursing practice. Findings provide critical insights for healthcare policymakers, hospital administrators, and educators in enhancing EBP uptake within resource-limited settings.
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spelling doaj-art-8eebbdafb7984980a804ba9cf0ec5af02025-08-20T03:06:01ZengBMCBMC Nursing1472-69552025-03-0124112010.1186/s12912-025-02912-5Leading evidence-based practice: nurse managers’ strategies for knowledge utilisation in acute care settingsJude Ominyi0Aaron Nwedu1David Agom2Ukpai Eze3School of Nursing, Midwifery & Public Health, University of SuffolkSenior Lecturer, Federal University of Health SciencesSenior Lecturer, School of Nursing, Midwifery & Health Education, University of BedfordshireSenior Lecturer, Chester Medical School, Faculty of Health, Medicine and Society, University of ChesterAbstract Background The implementation of evidence-based practice (EBP) in nursing is essential for improving patient care outcomes, yet systemic barriers, leadership challenges, and resource limitations continue to hinder its integration into clinical practice. Nurse managers (NMs) play a crucial role in bridging the gap between policy directives and frontline implementation, yet the dynamic interplay between leadership strategies, knowledge utilisation, and organisational barriers remains underexplored, particularly in resource-constrained settings. This study examines how NMs navigate these challenges to sustain EBP adoption in acute care environments. Methods This collective case study employed a longitudinal qualitative design across two acute care settings in the UK. Data were collected over eight months through semi-structured interviews with NMs, nonparticipant observations, and document analysis of clinical guidelines and internal reports. A thematic analysis approach was used to synthesise findings and provide a nuanced understanding of leadership strategies and systemic factors influencing EBP adoption. Findings Six interconnected themes emerged: (1) Adaptive leadership strategies, where NMs employ a hybrid of directive and collaborative leadership approaches to drive EBP; (2) Overcoming organisational and resource barriers, including staff shortages, financial constraints, and competing priorities; (3) Knowledge utilisation and learning networks, highlighting the role of informal mentorship, structured CPD, and peer learning in sustaining EBP; (4) Digital transformation and EBP, examining the benefits and challenges of integrating digital tools and addressing IT literacy gaps; (5) Patient-centred adaptations, exploring how NMs balance evidence-based interventions with patient preferences and cultural considerations; and (6) Emotional and psychological support, underscoring the importance of managing staff resistance and mitigating change fatigue. Conclusion Findings of this study emphasise the pivotal role of NMs in driving EBP implementation through adaptive leadership, strategic resource management, and fostering learning networks. Addressing organisational barriers requires multi-level interventions that integrate leadership actions with systemic enablers to promote sustainable, evidence-informed nursing practice. Findings provide critical insights for healthcare policymakers, hospital administrators, and educators in enhancing EBP uptake within resource-limited settings.https://doi.org/10.1186/s12912-025-02912-5Evidence-based practiceNurse managersLeadershipKnowledge utilisationOrganisational barriersResource management
spellingShingle Jude Ominyi
Aaron Nwedu
David Agom
Ukpai Eze
Leading evidence-based practice: nurse managers’ strategies for knowledge utilisation in acute care settings
BMC Nursing
Evidence-based practice
Nurse managers
Leadership
Knowledge utilisation
Organisational barriers
Resource management
title Leading evidence-based practice: nurse managers’ strategies for knowledge utilisation in acute care settings
title_full Leading evidence-based practice: nurse managers’ strategies for knowledge utilisation in acute care settings
title_fullStr Leading evidence-based practice: nurse managers’ strategies for knowledge utilisation in acute care settings
title_full_unstemmed Leading evidence-based practice: nurse managers’ strategies for knowledge utilisation in acute care settings
title_short Leading evidence-based practice: nurse managers’ strategies for knowledge utilisation in acute care settings
title_sort leading evidence based practice nurse managers strategies for knowledge utilisation in acute care settings
topic Evidence-based practice
Nurse managers
Leadership
Knowledge utilisation
Organisational barriers
Resource management
url https://doi.org/10.1186/s12912-025-02912-5
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