Assessing Evidence‐Based Practice Competence in Nurse Leadership Roles in Spain

OBJECTIVE: This study evaluated the competency of nursing leaders and managers in Spain regarding evidence-based practice (EBP) and identified factors that affect its implementation in clinical environments. BACKGROUND: EBP is essential for enhancing healthcare quality; however, there are still gaps between theoretical knowledge and its practical application. Nursing leaders are crucial in promoting EBP, yet their competence levels and obstacles have not been thoroughly examined in Spain. MATERIAL AND METHODS: A cross-sectional study surveyed 159 nurse managers across 16 autonomous communities in Spain, utilizing the validated EBP-COQ Prof tool. The questionnaire assessed four competency domains-attitude, knowledge, skills, and utilization-using a 1 to 5 Likert scale. Predictors of EBP competency, including training, mentorship, and organizational affiliation, were analyzed using multivariate linear regression. RESULTS: Participants demonstrated a strong overall EBP competence, with an average total score of 143.77 out of 175. The highest scores were in the attitude domain (36.26/40) and knowledge (43.09/55), whereas utilization scores were relatively lower (37.57/50). This indicates that applying EBP in practice still lags behind positive attitudes and knowledge. Key factors predicting higher EBP competence included EBP training, consistent reading of scientific literature, mentoring nursing students, and working in a BPSO center. These results also imply that organizational constraints may continue to impede the integration of EBP competence into routine managerial practice. CONCLUSIONS: Spanish nurse managers possess strong EBP knowledge but continue to encounter difficulties in applying it clinically. The study highlights four adjustable factors of EBP competency that could guide focused interventions. IMPLICATIONS FOR NURSING MANAGEMENT: Healthcare institutions should implement (1) training programs for addressing knowledge-to-practice gaps, especially for nonspecialist managers; (2) mentorship systems pairing EBP-competent leaders with novices; (3) protected time for EBP activities; and (4) expanded BPSO accreditation to institutionalize evidence-based care. Future initiatives should include EBP metrics in performance evaluations, and research should explore factors such as leadership styles and the impact of resource allocation on patient outcomes through longitudinal designs.