Transformative agency and tensions in knowledge management-A qualitative interview study for nurse leaders.

AIM: To describe Finnish nurse leaders' perceptions of and experiences with knowledge management. BACKGROUND: Health science research has traditionally focused on knowledge transfer and research evidence instead of knowledge management, culture and organisational learning. Systematic reviews indicate a lack of awareness about nurse leaders' activities in knowledge management. DESIGN: Qualitative interview study according to the consolidated criteria for reporting qualitative research (see Supporting Information Table S1). METHODS: Data were collected at a Finnish public, social and healthcare organisation from 33 persons in 2015 and 2017 through 35 individual interviews and seven focus groups. Data were analysed by thematic analysis. RESULTS: Nurse leaders' daily knowledge management activities included assurance of smooth work functions and decisions about sudden changes. When managing knowledge promotion, nurse leaders focused on the near future and served information providers, coaches and developers of operating culture. Anticipatory management of knowledge requirements emphasised nurse leaders' roles as assessors and visionaries. Tensions while managing knowledge were related to the following: changes in clients' service needs, insufficient structures and tools to support the assessment and joint development of competence, time and information management, the operating culture, and nurse leader support. Participants reported only few attempts to solve tensions and therefore little to no transformative agency. CONCLUSION: Nurse leaders prioritised daily knowledge management over management of knowledge promotion and anticipatory management of knowledge requirements. Knowledge management in nursing is a complex task requiring a command of different kinds of agency and related leadership styles. The structures, processes and tools supporting knowledge management should be developed to ensure that activities are systematic. RELEVANCE TO CLINICAL PRACTICE: A description of nurse leaders' perceptions of and experiences with knowledge management could improve recognition of nurse leaders' agencies for knowledge management, identification of related tensions and application of lessons learned from tensions. This description could also promote nurses' professional competence and supplement nurse leaders' training.

Nurse leaders' perceptions and experiences of leading evidence: A qualitative enquiry.

AIM: The aim of this study was to describe nurse leaders' perceptions and experiences of leading evidence-based practices (EBP). BACKGROUND: Leaders can promote EBP in nursing with their own personal example and by striving to renew structures, processes and working cultures. However, previous studies have shown that nurse leaders have tended to be passive with regard to EBP. METHODS: An interview study using general qualitative methods. In total, 33 individual interviews and seven focus groups of leaders were conducted in 2015 and 2017. Data were analysed thematically. RESULTS: The respondents were unfamiliar with EBP as activities that lead to effective patient care. EBP were described as indistinguishable from other practices, lost and random. Overall, they lacked competence with EBP. The activities of nurse leaders do indicate a tentative commitment to EBP, but their main goals seem to be maintaining the status quo. CONCLUSION: Unfamiliarity with EBP reflects adversely on the operations of an entire organisation. The nurse leaders have an opportunity to enhance their understanding with EBP, which will lead to the renewal and improvement of the operating culture and the quality of strategic leadership. IMPLICATIONS FOR NURSING MANAGEMENT: Leaders should take clear responsibility for EBP on the strategic, operational and educational level.

A systematic review of factors influencing knowledge management and the nurse leaders' role.

AIM: To describe factors facilitating or inhibiting the development of registered nurses' competency and nurse leader's role in knowledge management. BACKGROUND: Nurses' competency directly influences patient safety and the quality and effectiveness of patient care. Challenges of nurse leaders in knowledge management include acquiring, assessing and utilising current knowledge and assessing and enhancing competency. EVALUATION: A systematic search was conducted in PubMed, CINAHL, SCOPUS and ERIC databases in April 2015. The search identified 18 relevant research articles published between 2009 and 2015. The quality of the studies was appraised in accordance with study designs. KEY ISSUE: Knowledge management is facilitated by an organisation culture that supports learning, sharing of information and learning together. Leader commitment and competency were factors related to leadership facilitating knowledge management. CONCLUSION: Nurse leaders need evidence-based interventions to support shared learning and to create infrastructures that facilitate competence development. Future research is especially needed to evaluate connections between knowledge management and patient outcomes. IMPLICATIONS FOR NURSING MANAGEMENT AND LEADERSHIP: The results of this review can be utilised in enhancing factors to facilitate knowledge management in clinical practice and identifying nurse leaders' role in strengthening nurses' competency.

Nursing students' expectations of the process of writing a bachelor's thesis in Sweden: A qualitative study.

While performing various academic work, such as writing a bachelor's thesis, are known to be challenging for university students, less is known about students' expectations in this regard. AIM: The aim was to describe students' expectations of the upcoming process of writing a bachelor's thesis. DESIGN: The study employed an explorative, qualitative approach with a single, written open-ended question design. METHODS: The data were collected consecutively 2013-2016 in class. A total of 93 final-year students volunteered and provided hand-written accounts which were analyzed using qualitative content analysis. RESULTS: The students' accounts revealed three generic categories of expectations: Gaining professional knowledge and competency, Planning and organizing the work, and Taking stock of personal resources. Writing a bachelor's thesis was a new challenge for most of the students and the answers testify to mixed feelings about the upcoming work and its supervision. CONCLUSIONS: The nursing students' expectations included present and future competencies, skills and abilities. In promoting development of transferable skills and knowledge, educators of future health-care professionals would be well advised to invite students to reflect on and discuss, their expectations prior to writing a bachelor's thesis and similar academic student papers. This study adds to the research on students' studying and learning in nursing education by bringing to the fore students' expectations of academic learning tasks as an important aspect to consider in higher education contexts, both nationally and internationally.

Comparison of meaningful learning characteristics in simulated nursing practice after traditional versus computer-based simulation method: a qualitative videography study.

BACKGROUND: Nursing educators must ensure that nursing students acquire the necessary competencies; finding the most purposeful teaching methods and encouraging learning through meaningful learning opportunities is necessary to meet this goal. We investigated student learning in a simulated nursing practice using videography. OBJECTIVES: The purpose of this paper is to examine how two different teaching methods presented students' meaningful learning in a simulated nursing experience. DESIGN: The 6-hour study was divided into three parts: part I, general information; part II, training; and part III, simulated nursing practice. Part II was delivered by two different methods: a computer-based simulation and a lecture. SETTINGS: The study was carried out in the simulated nursing practice in two universities of applied sciences, in Northern Finland. PARTICIPANTS: The participants in parts II and I were 40 first year nursing students; 12 student volunteers continued to part III. METHODS: Qualitative analysis method was used. The data were collected using video recordings and analyzed by videography. RESULTS: The students who used a computer-based simulation program were more likely to report meaningful learning themes than those who were first exposed to lecture method. CONCLUSION: Educators should be encouraged to use computer-based simulation teaching in conjunction with other teaching methods to ensure that nursing students are able to receive the greatest educational benefits.