Pioneering leadership competencies for evidence-based nursing in China: a groundbreaking application of effective leadership theory

BACKGROUND: Evidence-based nursing (EBN) is widely recognized as a cornerstone for improving the quality and safety of nursing care. Effective leadership is critical to the successful implementation of EBN; however, there is limited empirical understanding of the leadership competencies required to support EBN in complex healthcare systems, particularly in the Chinese context. This study aimed to identify and conceptualize the core competencies of effective leadership for EBN in China, drawing on leadership theory from the management sciences. METHODS: A qualitative study design was employed using focus group discussions. Eight focus groups were conducted across multiple regions in China, involving nursing leaders, frontline nurses, and academic experts with experience in EBN practice, management, and education. Data were analyzed using thematic analysis, guided by an established leadership behavior framework encompassing task-oriented, relation-oriented, change-oriented, and external-oriented leadership behaviors. RESULTS: The analysis identified a comprehensive set of competencies required for effective EBN leadership across four interrelated dimensions. Task-oriented leadership competencies included defining EBN goals, planning context-sensitive initiatives, monitoring EBN implementation, and solving clinical problems with evidence. Relation-oriented leadership emphasized providing emotional support, fostering professional development, recognizing contributions, and empowering nurses to take ownership of EBN projects. Change-oriented leadership competencies focused on advocating for EBN integration, promoting innovation, and facilitating continuous learning within the team. Finally, external-oriented leadership involved networking with external experts, monitoring emerging evidence, and representing nursing in institutional decision-making. CONCLUSIONS: This study develops a theoretically grounded and context-sensitive framework of effective leadership competencies for evidence-based nursing in China. The findings demonstrate that effective EBN leadership extends beyond individual research knowledge to encompass relational, organizational, and system-level competencies. Although rooted in the Chinese healthcare context, the framework offers transferable insights for other countries facing similar organizational constraints and implementation challenges. The framework provides a practical foundation for nursing leadership development, education, and policy aimed at strengthening the implementation of EBN practice.