is a complex procedure and numerous factors are likely
to influence the process. The literature seems to represent
a fragmented picture with research mainly focusing on a
few factors of possible importance among which, leadership
appears to be one of the more important. Therefore,
this study aimed to systematically review the literature regarding
nursing leadership and its possible influence on
the process of implementing EBP.
Leadership versus EBP Implementation
The presence and the characteristics of nurse leaders
and their influence on EBP implementation has recently
attracted a great deal of attention. As early as 1992,
Pettigrew et al. suggested that successful change is more
likely to take place in contexts with leaders who inspire
and act within a supportive organisation. Their suggestion
has more recently been supported by others investigating
facilitators of and barriers to EBP implementation as well
as nurses’ use of research findings in practice (Parahoo
& McCaughan 2001; Moser et al. 2004; Hutchinson &
Johnston 2006). Moser et al. (2004) found that two of the
most prominent factors impacting the implementation of
EBP were strong leadership and mastery of practice-related
skills, whereas Parahoo and McCaughan (2001) as well as
Hutchinson and Johnston’s (2006) findings indicated that
resistant leadership and lack of support from leaders could
have a negative impact on EBP implementation. One plausible
as well as controversial suggestion as to why leaders
can act as a barrier in the EBP implementation process is
that many nurse leaders lack advanced academic degrees.
As a result, they might be less able to foster professional
development amongst staff or assume a clear leadership
role (Udod & Care 2004). This will most likely result in
a culture where nursing is primarily seen as a ritualistic
and practical activity and where the pursuit of EBP implementation
is likely to fail (Udod & Care 2004). However,
none of the above studies defined the concept of leadership,
making it difficult to identify what might characterise
a leadership role that facilitates successful EBP implementation.
Additionally, some studies seem to use the terms
leader and manager interchangeably.