Understanding, Using, and Facilitating Evidence-Based Practice: A Scoping Review of Influencing Factors Among Nurse Managers in Acute Care

Abstract

Background: Evidence-based practice (EBP) is essential for quality healthcare. Nurse managers (NMs) play a key role in promoting EBP adoption among nurses, given their position as clinical leaders for nurses seeking to change practice. Therefore, it is crucial to understand the factors influencing their understanding and facilitation of EBP in care delivery.

Aim: To synthesize literature on the enablers and barriers faced by NMs in understanding, using, and facilitating EBP within acute care settings.

Methods: A scoping review which followed the Joanna Briggs Institute framework for scoping reviews and reported in accordance with PRISMA extension for scoping reviews. Multiple electronic databases, including MEDLINE, CINAHL, Cochrane Library, Scopus, JBI EBP database, Embase, Emcare, HMIC, and PsycINFO regardless of publication to be comprehensive. Two independent reviewers screened studies and extracted data. Methodological quality of included studies was appraised and considered high.

Results: The search yielded 1338 results of which 24 studies met inclusion criteria and included in the review. Key findings are the central role of strong personal factors-such as positive attitudes, beliefs, and good EBP competencies-in driving understanding and use of EBP. Supportive leadership behaviors can create a positive organizational environment for EBP, while access to resources and infrastructure are essential for EBP implementation. Conversely, barriers such as poor EBP knowledge, skills and competency, heavy workloads, insufficient resources, and lack of effective leadership support impede EBP implementation within acute care settings.

Conclusions: NMs play a crucial role in EBP implementation within their organizations, emphasizing the interconnectedness of personal and organizational factors.

Implications for Nursing management: Developing key personal factors and specific EBP-supportive behaviors of NMs can create a powerful catalyst for overcoming barriers, leading to improved patient care outcomes.