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How Formal and Informal Nurse Leaders Enact Shared Implementation Leadership in a Hospital Setting.

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Τίτλος: How Formal and Informal Nurse Leaders Enact Shared Implementation Leadership in a Hospital Setting.
Συγγραφείς: Castiglione SA; Ingram School of Nursing, McGill University; Research Institute of the McGill University Health Centre, Montréal, Québec, Canada., Lavoie-Tremblay M; Faculté des Sciences Infirmières, Université de Montréal; Centre de Recherche de L'institut Universitaire en Santé Mentale de Montréal, Montréal, Québec, Canada., Kilpatrick K; Susan E. French Chair in Nursing Research and Innovative Practice, Ingram School of Nursing, McGill University; CIUSSS de L'est-de-L'île-de-Montréal-Hôpital Maisonneuve-Rosemont, Montréal, Québec, Canada., Gifford W; Loyer DaSilva Research Chair in Community & Public Health Nursing; Centre for Research on Health and Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada., Semenic SE; Ingram School of Nursing, McGill University; Research Institute of the McGill University Health Centre, Montréal, Québec, Canada.
Πηγή: Journal of advanced nursing [J Adv Nurs] 2026 Aug; Vol. 82 (8), pp. 7987-8005. Date of Electronic Publication: 2025 Nov 11.
Τύπος έκδοσης: Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Blackwell Scientific Publications Country of Publication: England NLM ID: 7609811 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1365-2648 (Electronic) Linking ISSN: 03092402 NLM ISO Abbreviation: J Adv Nurs Subsets: MEDLINE
Imprint Name(s): Publication: Oxford : Blackwell Scientific Publications
Original Publication: Oxford, Blackwell.
Ιατρικοί όροι (MeSH): Nurse Administrators*/psychology , Nurse Administrators*/organization & administration , Nursing Staff, Hospital*/organization & administration , Nursing Staff, Hospital*/psychology , Leadership* , Nurse's Role*, Humans ; Cooperative Behavior
Περίληψη: Aim: To describe how implementation leadership manifests among formal and informal point of care nurse leaders during a successful evidence-based practice implementation.
Design: A collective case study.
Methods: A conceptual framework on shared implementation leadership guided the study. Two units known for strong implementation were selected as instrumental cases from a healthcare network. Data were collected from multiple sources (2022-2023), including document review, site visits, focus group and individual interviews with formal managerial and non-managerial nurse leaders, staff nurses, interdisciplinary clinical staff and departmental leaders. The Framework Method was used to thematically analyse within-case findings, followed by cross-case comparison.
Results: Nurse leaders in formal and informal roles engaged in collaborative processes to collectively enact leadership behaviours throughout the implementation phases. Change-, relation- and task-oriented behaviours aimed to foster staff readiness, ensure supportive presence, structure implementation activities and reinforce the use of evidence-based practices on the units. Collaborative processes fostered leaders' engagement and kept one another informed to align and synchronise their collective actions.
Conclusion: This study extends our understanding of implementation leadership in nursing by highlighting a shared and relational approach among diverse point of care leaders. Strengthening team-level processes is essential to enhance leadership capacity for implementation in nursing.
Implications for the Profession: Given the global push for innovative, high-quality healthcare, strong leadership is needed to create conditions for implementation and practice change. This study makes visible how multiple and diverse leaders collectively support implementation.
Impact: With much focus on nurse manager roles, there is a gap in the research showing how multiple point of care leaders facilitate implementation, which this study addresses. This study can serve as a template to assist nurse leaders in their implementation efforts and to advocate for developing diverse nurse leadership roles.
Reporting Method: The report adheres to the COnsolidated criteria for REporting Quality research (COREQ) guidelines.
Patient or Public Contribution: This study did not include patient or public involvement in the design, conduct or reporting.
Trial Registration: International Registered Report Identifier (IRRID): DERRI-10.2196/54681.
(© 2025 The Author(s). Journal of Advanced Nursing published by John Wiley & Sons Ltd.)
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Bartley, L., A. Metz, and W. O. Fleming. 2022. “What Implementation Strategies Are Relational? Using Relational Theory to Explore the ERIC Implementation Strategies.” Frontiers in Health Services 2: 913585. https://doi.org/10.3389/frhs.2022.913585.
Boehm, L. M., M. F. Mart, M. S. Dietrich, et al. 2022. “Effects of Social Influence and Implementation Climate and Leadership on Nurse‐Led Early Mobility Behaviours in Critical Care.” BMJ Open Quality 11, no. 2: e001885. https://doi.org/10.1136/bmjoq‐2022‐001885.
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Contributed Indexing: Keywords: acute care; collective case study; implementation leadership; nursing leader roles; nursing leadership teams; qualitative research; shared leadership
Entry Date(s): Date Created: 20251112 Date Completed: 20260712 Latest Revision: 20260726
Update Code: 20260726
PubMed Central ID: PMC13356293
DOI: 10.1111/jan.70374
PMID: 41220187
Βάση Δεδομένων: MEDLINE
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  Data: How Formal and Informal Nurse Leaders Enact Shared Implementation Leadership in a Hospital Setting.
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  Data: <searchLink fieldCode="AU" term="%22Castiglione+SA%22">Castiglione SA</searchLink>; Ingram School of Nursing, McGill University; Research Institute of the McGill University Health Centre, Montréal, Québec, Canada.<br /><searchLink fieldCode="AU" term="%22Lavoie-Tremblay+M%22">Lavoie-Tremblay M</searchLink>; Faculté des Sciences Infirmières, Université de Montréal; Centre de Recherche de L'institut Universitaire en Santé Mentale de Montréal, Montréal, Québec, Canada.<br /><searchLink fieldCode="AU" term="%22Kilpatrick+K%22">Kilpatrick K</searchLink>; Susan E. French Chair in Nursing Research and Innovative Practice, Ingram School of Nursing, McGill University; CIUSSS de L'est-de-L'île-de-Montréal-Hôpital Maisonneuve-Rosemont, Montréal, Québec, Canada.<br /><searchLink fieldCode="AU" term="%22Gifford+W%22">Gifford W</searchLink>; Loyer DaSilva Research Chair in Community & Public Health Nursing; Centre for Research on Health and Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.<br /><searchLink fieldCode="AU" term="%22Semenic+SE%22">Semenic SE</searchLink>; Ingram School of Nursing, McGill University; Research Institute of the McGill University Health Centre, Montréal, Québec, Canada.
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  Data: <searchLink fieldCode="JN" term="%227609811%22">Journal of advanced nursing</searchLink> [J Adv Nurs] 2026 Aug; Vol. 82 (8), pp. 7987-8005. <i>Date of Electronic Publication: </i>2025 Nov 11.
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  Data: Aim: To describe how implementation leadership manifests among formal and informal point of care nurse leaders during a successful evidence-based practice implementation.<br />Design: A collective case study.<br />Methods: A conceptual framework on shared implementation leadership guided the study. Two units known for strong implementation were selected as instrumental cases from a healthcare network. Data were collected from multiple sources (2022-2023), including document review, site visits, focus group and individual interviews with formal managerial and non-managerial nurse leaders, staff nurses, interdisciplinary clinical staff and departmental leaders. The Framework Method was used to thematically analyse within-case findings, followed by cross-case comparison.<br />Results: Nurse leaders in formal and informal roles engaged in collaborative processes to collectively enact leadership behaviours throughout the implementation phases. Change-, relation- and task-oriented behaviours aimed to foster staff readiness, ensure supportive presence, structure implementation activities and reinforce the use of evidence-based practices on the units. Collaborative processes fostered leaders' engagement and kept one another informed to align and synchronise their collective actions.<br />Conclusion: This study extends our understanding of implementation leadership in nursing by highlighting a shared and relational approach among diverse point of care leaders. Strengthening team-level processes is essential to enhance leadership capacity for implementation in nursing.<br />Implications for the Profession: Given the global push for innovative, high-quality healthcare, strong leadership is needed to create conditions for implementation and practice change. This study makes visible how multiple and diverse leaders collectively support implementation.<br />Impact: With much focus on nurse manager roles, there is a gap in the research showing how multiple point of care leaders facilitate implementation, which this study addresses. This study can serve as a template to assist nurse leaders in their implementation efforts and to advocate for developing diverse nurse leadership roles.<br />Reporting Method: The report adheres to the COnsolidated criteria for REporting Quality research (COREQ) guidelines.<br />Patient or Public Contribution: This study did not include patient or public involvement in the design, conduct or reporting.<br />Trial Registration: International Registered Report Identifier (IRRID): DERRI-10.2196/54681.<br /> (© 2025 The Author(s). Journal of Advanced Nursing published by John Wiley & Sons Ltd.)
– Name: Ref
  Label: References
  Group: RefInfo
  Data: Aarons, G. A., M. Sklar, M. G. Ehrhart, S. Roesch, J. C. Moullin, and K. Carandang. 2024. “Randomized Trial of the Leadership and Organizational Change for Implementation (LOCI) Strategy in Substance Use Treatment Clinics.” Journal of Substance Use and Addiction Treatment 165: 209437. https://doi.org/10.1016/j.josat.2024.209437.<br />Arsenault Knudsen, É. N., B. J. King, and L. M. Steege. 2021. “The Realities of Practice Change: Nurses' Perceptions.” Journal of Clinical Nursing 30, no. 9–10: 1417–1428. https://doi.org/10.1111/jocn.15693.<br />Bartley, L., A. Metz, and W. O. Fleming. 2022. “What Implementation Strategies Are Relational? Using Relational Theory to Explore the ERIC Implementation Strategies.” Frontiers in Health Services 2: 913585. https://doi.org/10.3389/frhs.2022.913585.<br />Boehm, L. M., M. F. Mart, M. S. Dietrich, et al. 2022. “Effects of Social Influence and Implementation Climate and Leadership on Nurse‐Led Early Mobility Behaviours in Critical Care.” BMJ Open Quality 11, no. 2: e001885. https://doi.org/10.1136/bmjoq‐2022‐001885.<br />Brunt, B. A., and B. A. Bogdan. 2024. “Nursing Professional Development Leadership.” In StatPearls. StatPearls Publishing.<br />Cadeddu, S. B. M., L. O. Dare, and J. L. Denis. 2023. “Employee‐Driven Innovation in Health Organizations: Insights From a Scoping Review.” International Journal of Health Policy and Management 12: 6734. https://doi.org/10.34172/ijhpm.2023.6734.<br />Castiglione, S. A. 2020. “Implementation Leadership: A Concept Analysis.” Journal of Nursing Management 28, no. 1: 94–101. https://doi.org/10.1111/jonm.12899.<br />Castiglione, S. A., J. Frechette, and V. R. Agnihotram. 2023. “Implementation Leadership in the Point of Care Nursing Context: A Systematic Review Comparing Two Measurement Tools.” SAGE Open Nursing 9: 23779608231216161. https://doi.org/10.1177/23779608231216161.<br />Castiglione, S. A., M. Lavoie‐Tremblay, K. Kilpatrick, W. Gifford, and S. E. Semenic. 2024. “Exploring Shared Implementation Leadership of Point of Care Nursing Leadership Teams on Inpatient Hospital Units: Protocol for a Collective Case Study [Protocol].” JMIR Research Protocols 13: e54681. https://doi.org/10.2196/54681.<br />Cave, J., N. Rohatinsky, and L. Berry. 2023. “Organizational Supports for Nurse Managers in a North American Context: A Scoping Review.” Nursing Leadership 36, no. 2: 27–43.<br />Chen, W., I. D. Graham, J. Hu, K. B. Lewis, J. Zhao, and W. 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