Nurses and ward managers' perceptions of leadership in the evidence-based practice: A qualitative study.

Aim To describe nurses and ward managers' experiences with nursing leadership in the implementation of evidence-based practice. Background The implementation of evidence-based practice requires to identify the most suitable styles of nursing leadership for the successful application. Design A qualitative descriptive study. Methods The study was carried out with 57 nurses (clinical nurses and ward managers) in eight focus groups from five public hospitals. Template analysis, using the Promoting Action on Research Implementation in Health Services framework, was used. The Consolidated Criteria for Reporting Qualitative Research guide was followed in planning and reporting this research. Results Three types of nursing leadership were identified: traditional leadership, medium leadership, and transformational leadership. Traditional leadership was the most frequent, with a predominance of bureaucratic tasks for ward managers, so implementation of evidence-based practice is difficult. Conclusion Nurses do not feel empowered and they perceive the changes as an imposition. In the absence of strong leadership for evidence-based practice, a natural leader emerges. Implications for nursing management Clinical nurses demand more empowerment for decision making and ward managers need clarity of roles. To create an environment favourable to evidence-based practice, it is necessary consider the role of the transformational leader.