article · BMC Nursing
Implementing evidence-based practice in nursing is vital for improving patient outcomes, but systemic challenges, resource shortages, and leadership hurdles frequently impede adoption. A qualitative study across two acute care settings in the UK examined how nurse managers guide their teams through these difficulties. The findings highlight six central themes: adopting a blend of directive and collaborative leadership styles, overcoming resource barriers such as staff shortages, leveraging learning networks and mentorship, managing the introduction of digital tools and related literacy gaps, adapting clinical evidence to individual patient preferences, and providing emotional support to mitigate staff change fatigue. Sustaining evidence-informed nursing care requires coordinated leadership actions alongside broader systemic support within healthcare organisations.
High-quality patient care relies on successfully translating clinical research into everyday ward practices. Understanding how nurse managers overcome tight resources, staff resistance, and technology barriers provides healthcare administrators and educators with actionable insights to design better leadership training and support systems in hospital settings.
This research could inform the design of healthcare leadership training modules, change management programmes, and workforce development toolkits for hospital administrators and educators. Judged strictly from the abstract, this work presents qualitative findings from two settings, placing it at an early research stage rather than near a commercial or off-the-shelf product.
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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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DOI: 10.1186/s12912-025-02912-5
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