{"title":"Implementation Leadership in Evidence-Based Practice in Healthcare: A Systematic Review and Meta-Analysis.","authors":"Suvi Kuha, Jouko Miettunen, Outi Kanste","doi":"10.1111/wvn.70163","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Evidence-based practice (EBP) is essential in contemporary high-pressure healthcare environments, yet its implementation remains challenging. Despite the pivotal role of leadership, the lack of pooled quantitative evidence limits understanding of implementation leadership levels and the identification of development needs.</p><p><strong>Aim: </strong>To investigate the pooled mean levels of implementation leadership in EBP among healthcare professionals and managers.</p><p><strong>Design: </strong>Systematic review and meta-analysis.</p><p><strong>Methods: </strong>This systematic review followed the Joanna Briggs Institute methodology and utilized the PRISMA statement. Findings were synthesized using random-effects meta-analyses of mean levels. Heterogeneity was assessed using the I<sup>2</sup> statistic. A systematic search was conducted in November 2025 in MEDLINE (Ovid), CINAHL, Scopus, Web of Science, ProQuest, and Medic with no date or geographical limits. Studies in English, Finnish, and Swedish were included.</p><p><strong>Results: </strong>A total of 22 studies published between 2014 and 2025 across nine countries, involving 9970 participants, were included. The overall pooled mean level of implementation leadership in EBP, measured using the Implementation Leadership Scale (range 0-4), was 2.66 (95% CI: 2.49-2.83). Subscale pooled means were highest for supportive leadership (3.00, 95% CI: 2.83-3.16), followed by knowledgeable (2.78, 95% CI: 2.57-3.00), perseverant (2.77, 95% CI: 2.58-2.96), and proactive leadership (2.43, 95% CI: 2.25-2.61). Subgroup analyses showed pooled means of 2.47 (95% CI: 1.98-2.97) for managers and 2.70 (95% CI: 2.52-2.88) for professionals. Considerable heterogeneity was observed across studies.</p><p><strong>Linking evidence to action: </strong>Strengthening implementation leadership to support EBP is needed across healthcare. Organizations should invest in structured, targeted leadership development initiatives that cultivate supportive, knowledgeable, perseverant, and especially proactive leadership behaviors, while ensuring programmes are context-sensitive and adaptable to variability across healthcare settings. In addition, role-based differences highlight the need for tailored support for managers that reflect the complexity and accountability of their leadership responsibilities.</p><p><strong>Trial registration: </strong>PROSPERO ID: [CRD420251241584].</p>","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":"23 4","pages":"e70163"},"PeriodicalIF":5.3000,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13458221/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Worldviews on Evidence-Based Nursing","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/wvn.70163","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NURSING","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Evidence-based practice (EBP) is essential in contemporary high-pressure healthcare environments, yet its implementation remains challenging. Despite the pivotal role of leadership, the lack of pooled quantitative evidence limits understanding of implementation leadership levels and the identification of development needs.
Aim: To investigate the pooled mean levels of implementation leadership in EBP among healthcare professionals and managers.
Design: Systematic review and meta-analysis.
Methods: This systematic review followed the Joanna Briggs Institute methodology and utilized the PRISMA statement. Findings were synthesized using random-effects meta-analyses of mean levels. Heterogeneity was assessed using the I2 statistic. A systematic search was conducted in November 2025 in MEDLINE (Ovid), CINAHL, Scopus, Web of Science, ProQuest, and Medic with no date or geographical limits. Studies in English, Finnish, and Swedish were included.
Results: A total of 22 studies published between 2014 and 2025 across nine countries, involving 9970 participants, were included. The overall pooled mean level of implementation leadership in EBP, measured using the Implementation Leadership Scale (range 0-4), was 2.66 (95% CI: 2.49-2.83). Subscale pooled means were highest for supportive leadership (3.00, 95% CI: 2.83-3.16), followed by knowledgeable (2.78, 95% CI: 2.57-3.00), perseverant (2.77, 95% CI: 2.58-2.96), and proactive leadership (2.43, 95% CI: 2.25-2.61). Subgroup analyses showed pooled means of 2.47 (95% CI: 1.98-2.97) for managers and 2.70 (95% CI: 2.52-2.88) for professionals. Considerable heterogeneity was observed across studies.
Linking evidence to action: Strengthening implementation leadership to support EBP is needed across healthcare. Organizations should invest in structured, targeted leadership development initiatives that cultivate supportive, knowledgeable, perseverant, and especially proactive leadership behaviors, while ensuring programmes are context-sensitive and adaptable to variability across healthcare settings. In addition, role-based differences highlight the need for tailored support for managers that reflect the complexity and accountability of their leadership responsibilities.
期刊介绍：
The leading nursing society that has brought you the Journal of Nursing Scholarship is pleased to bring you Worldviews on Evidence-Based Nursing. Now publishing 6 issues per year, this peer-reviewed journal and top information resource from The Honor Society of Nursing, Sigma Theta Tau International, uniquely bridges knowledge and application, taking a global approach in its presentation of research, policy and practice, education and management, and its link to action in real world settings.
Worldviews on Evidence-Based Nursing is written especially for:
Clinicians
Researchers
Nurse leaders
Managers
Administrators
Educators
Policymakers
Worldviews on Evidence-Based Nursing is a primary source of information for using evidence-based nursing practice to improve patient care by featuring:
Knowledge synthesis articles with best practice applications and recommendations for linking evidence to action in real world practice, administra-tive, education and policy settings
Original articles and features that present large-scale studies, which challenge and develop the knowledge base about evidence-based practice in nursing and healthcare
Special features and columns with information geared to readers’ diverse roles: clinical practice, education, research, policy and administration/leadership
Commentaries about current evidence-based practice issues and developments
A forum that encourages readers to engage in an ongoing dialogue on critical issues and questions in evidence-based nursing
Reviews of the latest publications and resources on evidence-based nursing and healthcare
News about professional organizations, conferences and other activities around the world related to evidence-based nursing
Links to other global evidence-based nursing resources and organizations.
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