Nursing unit leaders' influence on the long-term sustainability of evidence-based practice improvements

作者：Fleiszer Andrea R^*; Semenic Sonia E; Ritchie Judith A; Richer Marie Claire; Denis Jean Louis

来源：Journal of Nursing Management, 2016, 24(3): 309-318.

DOI：10.1111/jonm.12320

• hospital units
• leadership
• management
• practice guidelines
• sustainability

Aim To describe how actions of nursing unit leaders influenced the long-term sustainability of a best practice guidelines (BPG) program on inpatient units.
Background Several factors influence the initial implementation of evidence-based practice improvements in nursing, with leadership recognized as essential. However, there is limited knowledge about enduring change, including how frontline nursing leaders influence the sustainability of practice improvements over the long term.
Methods A qualitative descriptive case study included 39 in-depth interviews, observations, and document reviews. Four embedded nursing unit subcases had differing levels of program sustainability at 7 years (average) following implementation.
Results Higher levels of BPG sustainability occurred on units where formal leadership teams used an integrated set of strategies and activities. Two key strategies were maintaining priorities and reinforcing expectations. The coordinated use of six activities (e.g., discussing, evaluating, integrating) promoted the continuation of BPG practices among staff. These leadership processes, fostering exchange and learning, contributed to sustainability-promoting environments characterized by teamwork and accountability.
Conclusions Unit leaders are required to strategically orchestrate several overlapping and synergistic efforts to achieve long-term sustainability of BPG-based practice improvements.
Implications As part of managing overall unit performance, unit leaders may influence practice improvement sustainability by aligning vision, strategies, and activities.

• 出版日期2016-4
• 单位McGill