Evidence-based practice (EBP) is a systematic approach to the use of the best research evidence applied to clinical expertise and patient values [1
]. Evidence-based leadership (EBL) covers the best use of evidence to organize, guide, deliver, finance and improve the quality of care and patient safety [3
]. Since the 1990s, there have been many discussions, guidelines and articles published all over the world about the importance of EBP [1
] . The change from experience-based practice to EBP is going on and urgently needed; like the Institute of Medicine (IOM) [6
] has set the goal that health care should be evidence-based in 2020.
According to one American study, 53.6% (n=544) of nurses agreed or strongly agreed that EBP was implemented in their organizations [7
] whilst another American study [8
] found that 43% of the practicing nurses reported that 61 – 100% of their practice was evidence-based. A Norwegian study [9
] showed that the nurses used more experience-based knowledge than research evidence in practice. The Finnish National Programs since 2004 have recommended developing evidence-based health care [4
]. The Finnish Health Care Act says “The provision of health care shall be based on evidence and recognized treatment and operational practices. The health care provided shall be of high quality, safe and appropriately organized.” [10
]. There are no Finnish studies showing what proportion of practice is evidence-based.
Nurse leaders are central to developing evidence-based nursing practice [3
] because they create a culture of evidence-based practice and have the responsibility of designing and supporting nursing environments that promote the high quality of care, based on the best available evidence [7
]. Nurse leaders themselves need to be able to use scientific evidence and embrace continuous learning [3
Leadership is a key element in developing EBP in health care organizations [8
]. Porter-O’Grady and Malloch (2008) [22
] wrote the implementation of EBP is in progress. The nurse leaders need be skillful at evidence-based leadership and practice in order to spearhead the change from experience-based to evidence-based practice. The key skills of leaders trying to advance EBP are innovative thinking, planning and implementation of the change [22
]. Leaders have to be able to change continuously. The application and integration of evidence-based principles into nursing leadership is a complex process, itself part of a complex system. The process needs the passion, respect and knowledge of nursing science [14
]. Support from nurse leaders is vital to the promotion of EBP. Research by Eneh et al. [23
] about the transformational leadership style of Finnish nurse leaders (nurse managers, nursing directors) asked from the nursing staff (n=1497) showed that Finnish nursing directors appeared not to use evidence-based knowledge at all, whilst 50% of nursing staff had no perception if their nurse directors’ used it.
Many nurse leaders perceive EBP as being desirable, but they do not know how they might implement it [16
]. Marshall [24
] highlighted the nurse leaders’ slow pace of application of EBP in their work. There are still many ineffective routines in nursing practice and leadership. There have been many different programs to develop leadership generally, or from specific views, such as empowerment of nurse leaders [19
], effects of education on evidence-based practice courses [20
], development and evaluation of a joint academic-service nursing journal club [3
] and an advanced educational program promoting evidence-based practice [21
]. This study introduces one Finnish evidence-based nursing leadership training program.
Nurse leaders who carry out evidence-based practice appreciate the expertise of other evidence-based professionals. For example, the collaboration between nurse leaders and librarians is an important way of promoting the EBP process. Innovative nurse leaders understand this and so collaborate with the librarians, using their expertise of searching for useful research papers and articles [19
]. Many studies underline the use of mentors implementing EBP [7
Johansson et al. [20
] found that head nurses who had additional education in scientific methodology utilized more research findings than those who lacked that additional education. About half of them (n=99) searched, read and discussed research results with their colleagues. They encouraged their staff to read research findings, but their staff did not have enough time to find relevant research and read the results [20
The Finnish Health Care Act expanded the choice of public institution where someone could receive treatment [10
]. The choice increases demands on organizations because people would expect to receive care based on the best available evidence. Therefore, it is most important to educate nurse leaders about EBP and EBL. Apart from the training, the willingness of nurse leaders to adopt EBP has been seen to be important in the change process [19