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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.)
References: Scand J Caring Sci. 2021 Mar;35(1):178-195. (PMID: 32200550)
Implement Sci Commun. 2020 Oct 06;1:85. (PMID: 33043300)
JMIR Res Protoc. 2024 Feb 19;13:e54681. (PMID: 38373024)
J Clin Nurs. 2021 May;30(9-10):1417-1428. (PMID: 33559236)
J Adv Nurs. 2008 Apr;62(2):228-37. (PMID: 18394035)
BMC Health Serv Res. 2019 Mar 25;19(1):189. (PMID: 30909897)
J Med Internet Res. 2019 Mar 22;21(3):e11413. (PMID: 30901003)
Worldviews Evid Based Nurs. 2016 Feb;13(1):25-31. (PMID: 26788694)
Implement Res Pract. 2023 Jul 27;4:26334895231190855. (PMID: 37790168)
Front Health Serv. 2022 Jul 13;2:896885. (PMID: 36925794)
J Nurs Manag. 2020 Jan;28(1):94-101. (PMID: 31705769)
Implement Sci. 2021 Jun 10;16(1):61. (PMID: 34112191)
Res Nurs Health. 2020 Jan;43(1):90-102. (PMID: 31544967)
SAGE Open Nurs. 2023 Nov 27;9:23779608231216161. (PMID: 38033620)
BMJ Open Qual. 2022 Jun;11(2):. (PMID: 35697358)
Implement Sci. 2019 Jan 5;14(1):1. (PMID: 30611302)
J Nurs Manag. 2016 Apr;24(3):309-18. (PMID: 26081157)
J Healthc Leadersh. 2017 Mar 29;9:15-23. (PMID: 29355212)
Front Health Serv. 2023 Apr 17;3:1112936. (PMID: 37138952)
Implement Sci. 2018 Sep 27;13(1):127. (PMID: 30261927)
Nurs Leadersh (Tor Ont). 2023 Apr;36(1):57-74. (PMID: 37552518)
Med Teach. 2024 May;46(5):603-610. (PMID: 37734451)
J Adv Nurs. 2025 Nov;81(11):7514-7524. (PMID: 39382263)
Int J Qual Health Care. 2007 Dec;19(6):349-57. (PMID: 17872937)
J Subst Use Addict Treat. 2024 Oct;165:209437. (PMID: 38866139)
JMIR Nurs. 2023 Aug 25;6:e44435. (PMID: 37624628)
J Healthc Leadersh. 2024 Feb 29;16:93-104. (PMID: 38440078)
J Adv Nurs. 2026 Aug;82(8):7987-8005. (PMID: 41220187)
Qual Quant. 2018;52(4):1893-1907. (PMID: 29937585)
Pilot Feasibility Stud. 2019 Aug 19;5:103. (PMID: 31452925)
Implement Sci Commun. 2023 Jan 20;4(1):9. (PMID: 36670493)
J Nurs Manag. 2015 Nov;23(8):1126-36. (PMID: 25377902)
BMC Nurs. 2024 May 30;23(1):359. (PMID: 38816867)
Nurs Leadersh (Tor Ont). 2023 Jul;36(2):27-43. (PMID: 37917343)
Front Health Serv. 2022 Oct 17;2:913585. (PMID: 36925772)
Worldviews Evid Based Nurs. 2023 Feb;20(1):6-15. (PMID: 36751881)
Int J Health Policy Manag. 2023;12:6734. (PMID: 37579391)
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: 20260813
Update Code: 20260813
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.)
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  Data: Scand J Caring Sci. 2021 Mar;35(1):178-195. (PMID: <searchLink fieldCode="PM" term="%2232200550%22">32200550)</searchLink><br />Implement Sci Commun. 2020 Oct 06;1:85. (PMID: <searchLink fieldCode="PM" term="%2233043300%22">33043300)</searchLink><br />JMIR Res Protoc. 2024 Feb 19;13:e54681. (PMID: <searchLink fieldCode="PM" term="%2238373024%22">38373024)</searchLink><br />J Clin Nurs. 2021 May;30(9-10):1417-1428. (PMID: <searchLink fieldCode="PM" term="%2233559236%22">33559236)</searchLink><br />J Adv Nurs. 2008 Apr;62(2):228-37. (PMID: <searchLink fieldCode="PM" term="%2218394035%22">18394035)</searchLink><br />BMC Health Serv Res. 2019 Mar 25;19(1):189. (PMID: <searchLink fieldCode="PM" term="%2230909897%22">30909897)</searchLink><br />J Med Internet Res. 2019 Mar 22;21(3):e11413. (PMID: <searchLink fieldCode="PM" term="%2230901003%22">30901003)</searchLink><br />Worldviews Evid Based Nurs. 2016 Feb;13(1):25-31. (PMID: <searchLink fieldCode="PM" term="%2226788694%22">26788694)</searchLink><br />Implement Res Pract. 2023 Jul 27;4:26334895231190855. (PMID: <searchLink fieldCode="PM" term="%2237790168%22">37790168)</searchLink><br />Front Health Serv. 2022 Jul 13;2:896885. (PMID: <searchLink fieldCode="PM" term="%2236925794%22">36925794)</searchLink><br />J Nurs Manag. 2020 Jan;28(1):94-101. (PMID: <searchLink fieldCode="PM" term="%2231705769%22">31705769)</searchLink><br />Implement Sci. 2021 Jun 10;16(1):61. (PMID: <searchLink fieldCode="PM" term="%2234112191%22">34112191)</searchLink><br />Res Nurs Health. 2020 Jan;43(1):90-102. (PMID: <searchLink fieldCode="PM" term="%2231544967%22">31544967)</searchLink><br />SAGE Open Nurs. 2023 Nov 27;9:23779608231216161. (PMID: <searchLink fieldCode="PM" term="%2238033620%22">38033620)</searchLink><br />BMJ Open Qual. 2022 Jun;11(2):. (PMID: <searchLink fieldCode="PM" term="%2235697358%22">35697358)</searchLink><br />Implement Sci. 2019 Jan 5;14(1):1. (PMID: <searchLink fieldCode="PM" term="%2230611302%22">30611302)</searchLink><br />J Nurs Manag. 2016 Apr;24(3):309-18. (PMID: <searchLink fieldCode="PM" term="%2226081157%22">26081157)</searchLink><br />J Healthc Leadersh. 2017 Mar 29;9:15-23. (PMID: <searchLink fieldCode="PM" term="%2229355212%22">29355212)</searchLink><br />Front Health Serv. 2023 Apr 17;3:1112936. (PMID: <searchLink fieldCode="PM" term="%2237138952%22">37138952)</searchLink><br />Implement Sci. 2018 Sep 27;13(1):127. (PMID: <searchLink fieldCode="PM" term="%2230261927%22">30261927)</searchLink><br />Nurs Leadersh (Tor Ont). 2023 Apr;36(1):57-74. (PMID: <searchLink fieldCode="PM" term="%2237552518%22">37552518)</searchLink><br />Med Teach. 2024 May;46(5):603-610. (PMID: <searchLink fieldCode="PM" term="%2237734451%22">37734451)</searchLink><br />J Adv Nurs. 2025 Nov;81(11):7514-7524. (PMID: <searchLink fieldCode="PM" term="%2239382263%22">39382263)</searchLink><br />Int J Qual Health Care. 2007 Dec;19(6):349-57. (PMID: <searchLink fieldCode="PM" term="%2217872937%22">17872937)</searchLink><br />J Subst Use Addict Treat. 2024 Oct;165:209437. (PMID: <searchLink fieldCode="PM" term="%2238866139%22">38866139)</searchLink><br />JMIR Nurs. 2023 Aug 25;6:e44435. (PMID: <searchLink fieldCode="PM" term="%2237624628%22">37624628)</searchLink><br />J Healthc Leadersh. 2024 Feb 29;16:93-104. (PMID: <searchLink fieldCode="PM" term="%2238440078%22">38440078)</searchLink><br />J Adv Nurs. 2026 Aug;82(8):7987-8005. (PMID: <searchLink fieldCode="PM" term="%2241220187%22">41220187)</searchLink><br />Qual Quant. 2018;52(4):1893-1907. (PMID: <searchLink fieldCode="PM" term="%2229937585%22">29937585)</searchLink><br />Pilot Feasibility Stud. 2019 Aug 19;5:103. (PMID: <searchLink fieldCode="PM" term="%2231452925%22">31452925)</searchLink><br />Implement Sci Commun. 2023 Jan 20;4(1):9. (PMID: <searchLink fieldCode="PM" term="%2236670493%22">36670493)</searchLink><br />J Nurs Manag. 2015 Nov;23(8):1126-36. (PMID: <searchLink fieldCode="PM" term="%2225377902%22">25377902)</searchLink><br />BMC Nurs. 2024 May 30;23(1):359. (PMID: <searchLink fieldCode="PM" term="%2238816867%22">38816867)</searchLink><br />Nurs Leadersh (Tor Ont). 2023 Jul;36(2):27-43. (PMID: <searchLink fieldCode="PM" term="%2237917343%22">37917343)</searchLink><br />Front Health Serv. 2022 Oct 17;2:913585. (PMID: <searchLink fieldCode="PM" term="%2236925772%22">36925772)</searchLink><br />Worldviews Evid Based Nurs. 2023 Feb;20(1):6-15. (PMID: <searchLink fieldCode="PM" term="%2236751881%22">36751881)</searchLink><br />Int J Health Policy Manag. 2023;12:6734. (PMID: <searchLink fieldCode="PM" term="%2237579391%22">37579391)</searchLink>
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