Role of Magnet®-recognized hospital nurse managers in implementing evidence-based practice: A mixed method study
Healthcare systems recognize evidence-based practice (EBP) as the prestigious standard for providing safe and high-quality care. Implementation of EBP is essential for Magnet®-recognition and is a hallmark in nursing excellence. Despite the well-documented benefits, implementation of EBP at the point of care is inconsistent and remains elusive in the United States and throughout the world. Although research is available to inform nursing practice, many patients still fail to receive evidence-based care. Implementation of EBP is a complex and challenging process. The literature review revealed a huge gap between nursing science and practice but provided evidence that nurse managers (NMs) had a pivotal leadership role in implementing EBP at the bedside. This mixed-method study was based on Goodall’s (2016) Theory of Expert Leadership to examine the roles of Magnet®-recognized hospital nurse managers (MRHNMs) in implementing EBP. A sequential explanatory method with a quantitative-driven design based on a national correlational survey augmented a qualitative descriptive component using semi-structured interviews. The study targeted critical care and acute care NMs of all Magnet®-recognized hospitals in the United States. The data was collected with the Implementation Leadership Scale (ILS) and the interview guide. Correlations, multiple regression, and Creswell’s content analysis answered the research questions. The results reported a moderate level of leadership roles (54.6%) of MRHNMs in implementing EBP, and produced numerous themes indicated that, in fact, NMs did implement EBP with struggle. The prominent themes discovered in the qualitative data analysis upheld and enhanced the findings from the survey. MRHNMs viewed EBP as a healthcare priority and the leadership of NMs is necessary to promote the implementation of EBP. However, lack of knowledge, difficulties with the EBP process, time constraints, and staffing issues negatively impacted EBP. Factors that enhanced the implementation of EBP included post-graduate NMs, formal EBP education, working in critical care units, collaboration with doctorally prepared nurses, and Magnet organizational culture. The leadership of MRHNMs is necessary to shape evidence-based care at the bedside and at an organizational level to sustain Magnet®-recognition.