EBP Implementation Leadership of Frontline Nurse Managers: Validation of the Implementation Leadership Scale in Acute Care
Open accessAbstract
Background: Frontline nurse managers influence the implementation of evidence‐based practices (EBP); however, there is a need for valid and reliable instruments to measure their leadership behaviors for EBP implementation in acute care settings. Aim: The aim of this study was to evaluate the validity and reliability of the Implementation Leadership Scale (ILS) in acute care settings using two unique nurse samples. Methods: This study is a secondary analysis of ILS data obtained through two distinct multisite cross‐sectional studies. Sample 1 included 200 registered nurses from one large Californian health system. Sample 2 was 284 registered nurses from seven Midwest and Northeast U.S. hospitals. Two separate studies by different research teams collected responses using written and electronic questionnaires. We analyzed each sample independently. Descriptive statistics described individual item, total, and subscale scores. We analyzed validity using confirmatory factor analysis and within‐unit agreement (awg). We evaluated factorial invariance using multigroup confirmatory factor analyses and evaluating change in chi‐square and comparative fit index values. We evaluated reliability using Cronbach's alpha. Results: Confirmatory factor analyses in both samples provided strong support for first‐ and second‐order factor structure of the ILS. The factor structure did not differ between the two samples. Across both samples, internal consistency reliability was strong (Cronbach's alpha: 0.91–0.98), as was within‐unit agreement (awg: 0.70–0.80). Linking Evidence to Action: Frontline manager implementation leadership is a critical contextual factor influencing EBP implementation. This study provides strong evidence supporting the validity and reliability of the ILS to measure implementation leadership behaviors of nursing frontline managers in acute care. The ILS can help clinicians, researchers, and leaders in nursing contexts assess frontline manager implementation leadership, deliver interventions to target areas needing improvement, and improve implementation of EBP.
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The ILS has been successfully validated in child welfare, substance use treatment, and acute care.
“Subsequent studies have begun this work, including successful validation of the instrument in child welfare [30], substance use treatment [31], and acute care [32];”
From Leading the charge in the education sector: development and validation of the School Implementation Leadership Scale (SILS) (2022) · cites this paper as [32]
All values on the original subscales (proactive, knowledgeable, supportive, perseverant) were consistently higher than the original ILS development sample in outpatient mental health and validations in substance use treatment settings and acute care, but generally comparable to a validation study in child welfare.
“All values on the original subscales (i.e., proactive, knowledgeable, supportive, perseverant) were consistently higher than the original ILS development sample in outpatient mental health [26] and validations in substance use treatment settings [31] and acute care [32], but generally comparable to a validation study in child welfare [30].”
From Leading the charge in the education sector: development and validation of the School Implementation Leadership Scale (SILS) (2022) · cites this paper as [32]
Cites
Advancing a Conceptual Model of Evidence-Based Practice Implementation in Public Service Sectors
Aarons, G. A., Hurlburt, M., & Horwitz, S. M. (2011) · Administration and Policy in Mental Health and Mental Health Services Research · doi:10.1007/s10488-010-0327-7 · Cited by 3,240 · see citing works
Self-citationAarons, G. A., Ehrhart, M. G., & Farahnak, L. R. (2014) · Implementation Science · doi:10.1186/1748-5908-9-45 · Cited by 559 · see citing works
Self-citationAarons, G. A., Ehrhart, M. G., Moullin, J. C., Torres, E. M., & Green, A. E. (2017) · Implementation Science · doi:10.1186/s13012-017-0562-3 · Cited by 159 · see citing works
Self-citationAarons, G. A., Ehrhart, M. G., Torres, E. M., Finn, N. K., & Roesch, S. C. (2016) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2016.05.004 · Cited by 57 · see citing works
Self-citationCross-Validation of the Implementation Leadership Scale (ILS) in Child Welfare Service Organizations
Finn, N. K., Torres, E. M., Ehrhart, M. G., Roesch, S. C., & Aarons, G. A. (2016) · Child Maltreatment · doi:10.1177/1077559516638768 · Cited by 45 · see citing works
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Lyon, A. R., Corbin, C. M., Brown, E. C., Ehrhart, M. G., Locke, J., Davis, C., Picozzi, E., Aarons, G. A., & Cook, C. R. (2022) · Implementation Science · doi:10.1186/s13012-022-01222-7 · Cited by 34 · see citing works
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- Authors
- Shuman, C. J., Ehrhart, M. G., Torres, E. M., Veliz, P., Kath, L. M., VanAntwerp, K., Banaszak‐Holl, J., Titler, M. G., & Aarons, G. A.
- Affiliations
- University of Michigan (US)
- University of Central Florida (US)
- George Mason University (US)
- San Diego State University (US)
- Monash University (AU)
- University of California San Diego (US)
- Corresponding author
- Shuman, Clayton J.
- ORCID
- Venue
- Worldviews on Evidence-Based Nursing
- Publisher
- Wiley
- Published
- 2019-10-22
- Volume
- 17
- Issue
- 1
- Pages
- 82-91
- ISSN
- 1545-102X (ISSN-L)
- 1741-6787
- OpenAlex
- W2981819141
- Cited by
- 46
- References
- 5
- Citations by year
- 2026: 5 · 2025: 3 · 2024: 9 · 2023: 15 · 2022: 5 · 2021: 7 · 2020: 2
- FWCI
- 4.77
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Worldviews on Evidence-Based Nursing (publishedVersion)
- PubMed (publishedVersion)
- Monash University Research Portal (Monash University) (submittedVersion, other-oa)
- Deep Blue (University of Michigan) (submittedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Health Sciences Research and Education
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Health Sciences › Nursing › Research and Theory › Nursing education and management
- Keywords
- implementation leadership, evidence-based practice implementation, nurse managers, scale validation, acute care nursing, factor structure, measurement invariance, reliability statistics
- MeSH terms
- Adult, Cross-Sectional Studies, Female, Hospitals, Humans, Iowa, Leadership, Male, Middle Aged, Minnesota, New Hampshire, Nurse Administrators, Psychometrics, Surveys and Questionnaires, Vermont, Reproducibility of Results, Evidence-Based Practice
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