通过结构方程模型探讨护士长在循证实践实施中领导力、组织支持和知识管理的影响。
Exploring the Impact of Leadership, Organizational Support, and Knowledge Management in Evidence-Based Practice Implementation Among Nurse Managers Through SEM.
作者信息
Abou Hashish Ebtsam Aly, Khattab Sabrein Mahmoud Ali Khalifa, Mohammad Heba Farouk, Elliethey Nancy Sabry
机构信息
Faculty of Nursing, Alexandria University, Alexandria, Egypt.
College of Nursing, King Saud bin Abdul-Aziz University for Health Sciences, Jeddah, Saudi Arabia.
出版信息
Worldviews Evid Based Nurs. 2025 Jun;22(3):e70051. doi: 10.1111/wvn.70051.
BACKGROUND
Nurse managers are pivotal to the successful implementation of evidence-based practice (EBP). However, enhancing their skills and competencies remains a critical priority. Assessing the influence of nurse managers' competencies in managing and practicing EBP is essential, as it directly impacts outcomes across all levels of healthcare institutions.
PURPOSE
This study explored how leadership, organizational support, and knowledge management influence EBP implementation among nurse managers.
METHODS
A descriptive correlational study was conducted with a convenience sample of nurse managers in seven Egyptian hospitals. A total of 369 nurse managers completed three validated instruments: EBP Leadership and Organizational Support Scale (EBPLOSS), Knowledge Management Competencies for Nurse Managers (KMQN), and EBP Questionnaire (EBPQ). Descriptive statistics, hierarchical regression, and structural equation modeling (SEM) were applied for data analysis.
RESULTS
Nurse managers reported high levels of perceived EBP leadership (84.7%), organizational support (79.52%), knowledge management (KM) competencies (75.15%), and EBP implementation (74.83%). SEM analysis identified KM competencies as the strongest predictor of EBP implementation, with a direct effect (B = 0.86, p < 0.001) accounting for 86% of the total effect. EBP leadership significantly influenced EBP implementation both directly (β = 0.31, p = 0.02) and indirectly through KM competencies (B = 0.89, p < 0.001). Organizational support showed a minimal direct effect (B = 0.13, p < 0.05) and a slightly negative indirect effect through KM competencies (B = -0.10, p < 0.001).
LINKING EVIDENCE TO ACTION
KM competencies are critical for EBP implementation, mediating the effects of leadership and organizational support. Healthcare organizations should enhance nurse managers' KM skills, foster transformational leadership, and create supportive environments. Future research should address barriers and explore longitudinal relationships in EBP implementation from a managerial perspective.
背景
护士长对于循证实践（EBP）的成功实施至关重要。然而，提升他们的技能和能力仍是一项关键优先事项。评估护士长在管理和践行循证实践方面的能力所产生的影响至关重要，因为这直接影响各级医疗机构的成效。
目的
本研究探讨领导力、组织支持和知识管理如何影响护士长的循证实践实施。
方法
对埃及七家医院的护士长进行便利抽样，开展描述性相关性研究。共有369名护士长完成了三份经过验证的工具：循证实践领导力与组织支持量表（EBPLOSS）、护士长知识管理能力量表（KMQN）和循证实践问卷（EBPQ）。采用描述性统计、层次回归和结构方程模型（SEM）进行数据分析。
结果
护士长报告称，他们感知到的循证实践领导力水平较高（84.7%）、组织支持水平较高（79.52%）、知识管理（KM）能力水平较高（75.15%）以及循证实践实施水平较高（74.83%）。结构方程模型分析确定知识管理能力是循证实践实施的最强预测因素，直接效应（B = 0.86，p < 0.001）占总效应的86%。循证实践领导力对循证实践实施有显著的直接影响（β = 0.31，p = 0.02），并通过知识管理能力产生间接影响（B = 0.89，p < 0.001）。组织支持显示出最小的直接效应（B = 0.13，p < 0.05），并通过知识管理能力产生轻微的负向间接效应（B = -0.10，p < 0.001）。
将证据与行动联系起来
知识管理能力对于循证实践实施至关重要，它介导了领导力和组织支持的作用。医疗机构应提升护士长的知识管理技能，培养变革型领导力，并营造支持性环境。未来的研究应从管理角度探讨循证实践实施中的障碍，并探索纵向关系。
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