Leadership without evidence: A national study of evidence-based practice competence among acute care nurse leaders

Nurses across the United States lack the skills to translate research into practice, impacting care quality. Acute care nursing leaders' (ANLs') evidence-based practice (EBP) competence is essential for ensuring evidence-aligned care and is expected by national leadership organizations.

To evaluate EBP competence among acute care ANLs in the United States and identify factors associated with higher competence.

A quantitative correlational study was conducted across five U.S. health systems. Participants completed an objective, validated test of EBP knowledge and skills. Multivariate regression was used to identify predictors of competence.

Across 21 hospitals, only 20.8% of 168 ANLs passed the test, scoring below new graduate nurses from a prior study. Doctor of Nursing Practice preparation was associated with higher scores, approaching the passing threshold, whereas BSN- and MSN-prepared ANL scores did not differ.

Nurse leaders may lack adequate preparation to lead EBP. These findings warrant closer examination of nursing graduate curricula, organizational performance expectations for nurse leaders, and hospital-based continuing education and residency programs.