Ominyi Jude N, Agom David A, Ekuma Chidiebere Valentine
Researcher, Faculty of Health and Society, University of Northampton, UK.
Associate Lecturer, Faculty of Health and Society, University of Northampton, UK.
J Res Nurs. 2019 Dec;24(8):635-646. doi: 10.1177/1744987119883670. Epub 2019 Dec 4.
Evidence-based practice (EBP) is widely recognised as an essential aspect of contemporary healthcare delivery. However, the rise in cost containment and quest for profitability in healthcare management is found to be compromising implementation of evidence-based initiatives aimed at improving care quality.
The aim of this work was to examine perspectives of nurses regarding the impact of bureaucratic managerialism on EBP implementation in the Nigerian acute care setting.
A qualitative case study methodology was utilised to gather data from two large acute care settings. Drawing on semi-structured interviews, 12 staff nurses, 21 ward managers and 2 nurse managers were interviewed. Data were inductively analysed and themes generated.
The managerial practice in this context is founded on bureaucratic managerialism, which in turn generated hierarchical constraints that denied nurses the opportunity to self-govern. Implementation of evidence-based initiatives was consequently opposed by the managerial desire to maximise throughput.
There is need for nurse managers to have greater managerial influence, which would allow opportunities for implementing EBPs to be created. Managerial autonomy for nurse managers would allow them to create enabling environments capable of facilitating successful implementation.
循证实践（EBP）被广泛认为是当代医疗服务的一个重要方面。然而，人们发现，医疗保健管理中成本控制的增加和对盈利能力的追求正在损害旨在提高护理质量的循证举措的实施。
这项工作的目的是研究护士对官僚管理主义对尼日利亚急性护理环境中循证实践实施的影响的看法。
采用定性案例研究方法，从两个大型急性护理机构收集数据。通过半结构化访谈，对12名护士、21名病房经理和2名护士长进行了访谈。对数据进行归纳分析并生成主题。
在这种情况下的管理实践基于官僚管理主义，这反过来又产生了等级制度的限制，使护士没有自我管理的机会。因此，循证举措的实施遭到了管理层追求最大产出的愿望的反对。
护士长需要有更大的管理影响力，这将为实施循证实践创造机会。护士长的管理自主权将使他们能够创造有利于成功实施的环境。
