Nursing unit leaders' influence on the long-term sustainability of evidence-based practice improvements
Open accessAbstract
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.
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Program evaluation has been consistently recognized in the literature as a key ingredient for program sustainment.
“Program evaluation has been consistently recognized in the literature as a key ingredient for program sustainment [18, 21, 56].”
Rather than testing comprehensive frameworks, many studies have examined individual factors or used qualitative research to identify stakeholder perspectives on sustainability.
“Rather than testing comprehensive frameworks, many studies have examined individual factors or have used qualitative research to identify stakeholder perspectives on sustainability (38, 70, 95).”
From The Sustainability of Evidence-Based Interventions and Practices in Public Health and Health Care (2018) · cites this paper as [38]
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The Sustainability of Evidence-Based Interventions and Practices in Public Health and Health Care
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“Program evaluation has been consistently recognized in the literature as a key ingredient for program sustainment [18, 21, 56].”
Background
- Authors
- Fleiszer, A. R., Semenic, S. E., Ritchie, J. A., Richer, M.-C., & Denis, J.-L.
- Affiliations
- McGill University (CA)
- McGill University Health Centre (CA)
- École Nationale d'Administration Publique (CA)
- Corresponding author
- Fleiszer, Andrea R.
- Venue
- Journal of Nursing Management
- Publisher
- Wiley
- Published
- 2015-06-17
- Volume
- 24
- Issue
- 3
- Pages
- 309-318
- ISSN
- 0966-0429 (ISSN-L)
- OpenAlex
- W2112184996
- Cited by
- 77
- References
- 41
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 8 · 2023: 7 · 2022: 12 · 2021: 16 · 2020: 4 · 2019: 2 · 2018: 8 · 2017: 4 · 2016: 5 · 2015: 3
- FWCI
- 12.16
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Nursing Management (publishedVersion)
- PubMed (publishedVersion)
- Funders
- McGill University Health Centre Research Institute
- FERASI Centre
- Fonds de recherche du Québec - santé
- McGill University
- Canadian Nurses Foundation
- Topics
- Health Sciences › Health Professions › General Health Professions › Health Sciences Research and Education
- Health Sciences › Nursing › Research and Theory › Nursing education and management
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Keywords
- evidence-based practice, best practice guidelines, nursing leadership, hospital wards, organizational change, teamwork, accountability
- MeSH terms
- Canada, Humans, Interviews as Topic, Nurse Administrators, Nursing Staff, Hospital, Nursing, Supervisory, Program Evaluation, Nurse's Role, Qualitative Research, Evidence-Based Nursing, Quality Improvement
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