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Objective To explore nurse managers' perceptions of the frequency and importance of professional activities performed in their daily work in public hospitals in Hunan, China. Background Nurse managers are responsible for the management of almost all nursing activities in Chinese hospitals. Understanding how nurse managers operationalize their role and their perceptions of the importance of each activity is essential for clarification of their role and the competencies required to perform it. Methods A cross-sectional questionnaire survey. Results A total of 1,371 nurse managers in Hunan Province completed the survey. Nursing quality/safety management and patient management were performed most frequently and perceived as most important. Nurse managers performed nursing information management frequently while perceiving it as less important. They seldom performed nursing research management and placed low value on it. Conclusions Patient-centred care remains central to nursing management. Nursing managers can create a leadership culture in their hospital settings that includes the effective management of information and facilitation of research knowledge to benefit nurse managers, staff and patients. Implications for nursing management The results provide evidence for standardization of roles and job descriptions of nurse managers and for developing their knowledge and skills to ensure quality patient care.

Aim To translate the Implementation Leadership Scale (ILS) into Chinese and evaluate how Chinese nursing staff and leaders understood and responded to the Chinese ILS. Background Leadership is a critical factor for implementing evidence-based practice. The ILS is a valid and reliable instrument to understand leadership for evidence-based practice; however, this scale or the other similar instrument does not exist in Chinese. Methods We followed the translation and cross-cultural validation guideline developed by Sousa and Rojjanasrirat. Translation included two forward and blind backward translations, and their comparisons. Two rounds of cognitive interview were used to evaluate the linguistic validity. Results The translation process took 12 months. In the forward and backward translations, 24 translation issues were identified, of which semantic equivalence issues were most frequent. Ten nurses participated in each round of cognitive interviews and 33 linguistic issues were found. The final Chinese ILS had seven significant adaptations to the original instrument. Conclusion This study provided a deep understanding of using the ILS in the local context and laid the foundation for future psychometric statistical testing. Implications for nursing management Implementation leadership scale could support organisational leadership development programmes and strategies to facilitate and support EBP implementation and sustainability.

Background Understanding the types of barriers that exist when implementing change can assist healthcare managers to tailor implementation strategies for optimal patient outcomes. Aim The aim of this paper is to present an organising framework, the Barriers Assessment Taxonomy, for understanding barriers to nurses' use of clinical practice guideline recommendations. Barriers to recommendations are illustrated using the Barriers Assessment Taxonomy and insights discussed. Method As part of a pilot implementation study, semi-structured interviews (n = 26) were conducted to understand barriers to nurses' use of nine guideline recommendations for diabetic foot ulcers. Content analysis of verbatim transcripts included thematic coding and categorising barriers using the Barriers Assessment Taxonomy. Results Nineteen barriers were associated with nine recommendations, crossing five levels of the health care delivery system. The Barriers Assessment Taxonomy revealed that all recommendations had individual and organisational level barriers, with one recommendation having barriers at all levels. Individual level barriers were most frequent and lack of knowledge and skills was the only barrier that crossed all recommendations. Implications for nursing management The Barriers Assessment Taxonomy provides a framework for nursing managers to understand the complexity of barriers that exist, and can assist in choosing intervention strategies to support improved quality care and patient outcomes.

gifford w., davies b., tourangeau a. & lefebre n. (2011) Journal of Nursing Management 19, 121–132 Developing team leadership to facilitate guideline utilization: planning and evaluating a 3-month intervention strategy Background Research describes leadership as important to guideline use. Yet interventions to develop current and future leaders for this purpose are not well understood. Aim To describe the planning and evaluation of a leadership intervention to facilitate nurses’ use of guideline recommendations for diabetic foot ulcers in home health care. Method Planning the intervention involved a synthesis of theory and research (qualitative interviews and chart audits). One workshop and three follow-up teleconferences were delivered at two sites to nurse managers and clinical leaders (n = 15) responsible for 180 staff nurses. Evaluation involved workshop surveys and interviews. Results Highest rated intervention components (four-point scale) were: identification of target indicators (mean 3.7), and development of a team leadership action plan (mean 3.5). Pre-workshop barriers assessment rated lowest (mean 2.9). Three months later participants indicated their leadership performance had changed as a result of the intervention, being more engaged with staff and clear about implementation goals. Conclusions and implications for nursing management Creating a team leadership action plan to operationalize leadership behaviours can help in delivery of evidence-informed care. Access to clinical data and understanding team leadership knowledge and skills prior to formal training will assist nursing management in tailoring intervention strategies to identify needs and gaps.

Research describes leadership as important to guideline use. Yet interventions to develop current and future leaders for this purpose are not well understood.To describe the planning and evaluation of a leadership intervention to facilitate nurses' use of guideline recommendations for diabetic foot ulcers in home health care.Planning the intervention involved a synthesis of theory and research (qualitative interviews and chart audits). One workshop and three follow-up teleconferences were delivered at two sites to nurse managers and clinical leaders (n=15) responsible for 180 staff nurses. Evaluation involved workshop surveys and interviews.Highest rated intervention components (four-point scale) were: identification of target indicators (mean 3.7), and development of a team leadership action plan (mean 3.5). Pre-workshop barriers assessment rated lowest (mean 2.9). Three months later participants indicated their leadership performance had changed as a result of the intervention, being more engaged with staff and clear about implementation goals.Creating a team leadership action plan to operationalize leadership behaviours can help in delivery of evidence-informed care. Access to clinical data and understanding team leadership knowledge and skills prior to formal training will assist nursing management in tailoring intervention strategies to identify needs and gaps.