Background: Evidence-based practice is key to delivering the highest quality of healthcare and ensuring the best patient outcomes and decreasing healthcare costs. Therefore, there is currently an increased emphasis in clinical settings on promoting evidence-based practice.
Essential concepts for developing an environment that fosters a culture of evidence-based practice and key strategies for successful implementation of evidence-based practice in clinical settings include vision, engagement, integration, and evaluation. Evidence could be external evidence (e.g. RCTs or cohort studies) generated by researchers. Furthermore, evidence could be internal evidence which is typically generated through practice initiatives, such as outcomes management or quality improvement projects. Leaders have a key role in fostering a culture for evidence-based practice. The role of nurse managers in clinical settings is absolute.
Design: A cross-sectional study.
Methods: The data were collected by an electronic questionnaire in three Finnish acute care hospitals in 2017. Nurse managers were given an open-ended question asking how they implement evidence-based practices in their units. The data were analysed using content analysis. In total, 104 nurse managers participated in the study.
Results: Total 61 (59%) nurse managers responded to the questionnaire. Their average age was 51. On average, the nurse managers were in charge of two units and an average of 37 nurses worked under each nurse manager.
Nurse managers described their role in evidence-based practise implementation to be the one to inform about new practices, to justify the changes, to develop nursing care, to enable nurses in education and training, and to set her-/himself an example. Also, to implement a modern leadership model based on evidence.
Nurse managers described evidence-based practice as involving nursing recommendations, scientific evidence, research information, coherent evidence-based care practices, medical research information, and patients’ experiences and feedback.
Nurse managers discussed evidence-based practices in unit meetings and on development days with their staff. They agreed together on common methods appropriate for their own unit, how to apply them and how to follow up. In addition, research club activity was planned for the future in one unit. Nurse managers shared new information in meetings, by written instructions and e-mail. However, also charge nurses were responsible for sharing information and implementation of evidence-based practices. Nurse managers named training as a means of evidence-based practice implementation. In order to obtain up-to-date information on evidence-based practices, they cooperated with various professional groups and physicians and university hospitals.
Conclusions: In this study most nurse managers recognized their role in promoting evidence-based practice. Nurse managers justified the changes by evidence-based practices. They discussed evidence-based practices in meetings with their staff, shared information with written instructions and enabled training. More research is needed on what is evidence in nurse managers’ view and what kind of strategies are used by nurse managers in clinical settings to implement evidence-based practices.