CONCLUSIONS
What this study adds to the literature is a detailed exploration
of the roles of NMs in EBPI and the contextual
factors that go some way to explaining why NMs are not
more fully engaged in it. Despite such findings, there are
still calls for NMs to offer clear leadership for EBPI (Davies
et al. 2010). In line with this, this study has identified
scope for NMs to become more supportive through actions
such as a greater presence in clinical areas, more explicit
communication about EBP and more specific delegation
of EBPI responsibilities. There is also scope for NMs to
become more aware of organizational strategies for EBPI
and to act as a direct link between various initiatives. A
potential role for NMs as mediators between nursing and
medical staff on EBPI issues was identified and this could
ameliorate a factor that continues to hinder EBPI progress
in nursing.
What then does this study imply for those seeking to
shape or research the role of NMs in EBPI in the future?
At one extreme, it is possible to argue that there are good
reasons why NMs continue to play a marginal role in EBPI,
and we may need to adjust our expectations about the role
that they can play. The emphasis would then need to shift
to other actors in healthcare organizations, particularly
the roles played by senior managers, charge nurses and
those with specialist remits, such as practice development
nurses and clinical nurse specialists. At the other extreme,
the marginal role played by NMs can still be viewed as
an impediment to EBPI which needs to be addressed. In
this scenario, the emphasis is likely to be on the linking,
facilitative and supportive roles that could be played by
NMs. The argument would remain that their middle management
position means that they are well placed to fulfill
such roles. As role overload seems to be a key impediment
to pursuing this course of action, this issue would be a
need to be addressed head on.