The role of clinical directorate managers in facilitating evidence-based practice: a report of an exploratory study

This paper presents an exploration of the role of clinical directorate managers in facilitating evidence-based practice. It reports on a small qualitative study which explored the perceptions held by directorate managers regarding their role in facilitating evidence-based practice for their nursing teams. Insights were sought into the nature of the overt and covert behaviours which the managers used in encouraging nurses to base their practices on research evidence. The sample consisted of 10 directorate managers from two teaching hospitals in one Trust, whose characteristics were not atypical from other directorate managers. Data were collected using semi-structured, tape-recorded interviews. Interviews focused on manager's backgrounds, professional responsibilities and practices, personal research agendas and socio-political influences. Findings revealed some constraining influences on the development of evidence-based practice, such as the Clinical Managers' budget allocations, and the policies and goals of the Trust. However, in respect of the managers' own practices, whilst some facilitative behaviours were identified, the data suggested that clinical managers were behaving in a manner which actually inhibited the development of evidence-based nursing practice. It would appear that in the post-reform National Health Service (NHS) clinical managers find themselves in a difficult position which gives rise to a practical failure to use their position and organizational authority to influence the utilization of research in practice. The implications of these findings for an evidence-based health service are discussed.