Exploring the Impact of Leadership, Organizational Support, and Knowledge Management in Evidence‐Based Practice Implementation Among Nurse Managers Through SEM

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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.

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