How Formal and Informal Nurse Leaders Enact Shared Implementation Leadership in a Hospital Setting.

Area of Science:

• Nursing Leadership
• Evidence-Based Practice Implementation
• Healthcare Management

Background:

• Strong leadership is essential for driving innovation and practice change in healthcare.
• Existing research often focuses on formal nurse manager roles, leaving a gap in understanding leadership at the point of care.
• This study addresses the need to explore diverse leadership approaches in implementing evidence-based practices.

Purpose of the Study:

• To describe implementation leadership behaviors among formal and informal point of care nurse leaders.
• To understand how these leaders collaborate during successful evidence-based practice implementation.
• To highlight a shared and relational leadership model in nursing.

Main Methods:

• A collective case study design was employed.
• Data were collected from two healthcare units using document review, site visits, focus groups, and interviews.
• The Framework Method was used for thematic analysis and cross-case comparison.

Main Results:

• Nurse leaders in formal and informal roles engaged in collaborative leadership.
• They exhibited change-, relation-, and task-oriented behaviors to support implementation.
• These collaborative processes fostered engagement and aligned leaders' actions.

Conclusions:

• Implementation leadership in nursing is characterized by a shared and relational approach among diverse point of care leaders.
• Strengthening team-level processes is vital for enhancing nursing leadership capacity.
• The findings offer a template for nurse leaders to facilitate implementation and advocate for diverse leadership roles.