Implementing Evidence-Based Nursing: Leadership and Organizational Change for Implementation (LOCI-FIN-P)

This study aims to find out whether a leadership and organizational development program called the LOCI (Leadership and Organizational Change for Implementation) strategy can help nurses and their managers use the best available research in everyday care. Using evidence-based practice.

Previous work in the region showed that nurses and their managers want to use evidence-based practices but face challenges, such as unclear processes, limited support, and differences in skills. The LOCI strategy has helped leaders in other countries improve how new practices are introduced and supported. This study will test a version of LOCI adapted for Finnish healthcare settings.

Nurse managers and staff from selected hospital and elder care units will:

Take part in leadership and training sessions. Receive individual and group mentoring. Work with their teams on plans that support introducing new, research-based ways of working.

Two evidence-based practices will be introduced:

In psychiatric units: A safety planning method to help prevent suicide among people receiving mental health care.

In elder care units: Better ways to identify and treat malnutrition among older adults.

The study involves:

Nurse managers Nursing staff Senior nurse leaders Specialist nurses who support the training

The study will run for one year. The LOCI program lasts nine months, followed by a three-month follow-up period.

Assessment:

How well the adapted LOCI strategy works in practice (for example, whether participants find it useful).

Whether leadership skills and workplace support for evidence-based practices improve.

Whether the new care practices (suicide safety planning and malnutrition prevention) are used more often and more effectively.

Participants will complete questionnaires, take part in interviews or group discussions, and researchers will review documentation and care records to understand how the changes progress.

The study may help improve leadership skills, strengthen support for evidence-based practice, and improve care for patients in both mental health and elder care settings. The results may also help other healthcare organizations adopt similar approaches.

The study follows strict ethical and data protection rules. Survey participation is voluntary, and all personal information will be handled securely and confidentially. The care practices being introduced are already recommended in Finland and are part of normal care.

Study Overview

• Status: Recruiting
• Conditions: Leadership; Malnutrition Elderly; Self-Harm
• Intervention / Treatment: Behavioral: Leadership and organizational change for implementation

• Study Type: Interventional
• Enrollment (Estimated): 300
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Jaakko Varpula, PhD; Phone Number: +358442784794; Email: jaheva@utu.fi
• Study Contact Backup: Name: Riitta Askola, PhD; Phone Number: +358505715760; Email: raasko@utu.fi

Study Locations

• Finland
  • Turku, Finland
    • Recruiting
    • The Wellbeing Services Country of Southwest Finland
    • Contact: Tarja Heino-Tolonen, PhD; Phone Number: +358505725257; Email: tarja.heino-tolonen@varha.fi

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Nurse manager
• Registered nurse
• Practical nurse
• Nurse director

Exclusion Criteria:

• Other healtcare professionals

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: Leadership and Organizational Change for Implementation (LOCI); LOCI (Leadership and Organizational Change for Implementation) is a structured leadership and organizational development strategy designed to help managers strengthen their skills in implementing evidence-based practices. It combines leadership training, individualized mentoring, and organizational support to create a workplace climate that makes it easier to adopt and sustain new, research-based ways of working.

Behavioral: Leadership and organizational change for implementation; LOCI (Leadership and Organizational Change for Implementation) is a structured leadership and organizational development strategy designed to help managers strengthen their skills in implementing evidence-based practices. It combines leadership training, individualized mentoring, and organizational support to create a workplace climate that makes it easier to adopt and sustain new, research-based ways of working.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Acceptability	Acceptability of Intervention Measure (AIM), 4-item, 5-point Likert Scale (1-5), Min score 5, Max score 20. Higher scores indicate greater acceptability.	3months after start of intervention, 9 months (end of intervention)
Appropriateness	Intervention Appropriateness Measure (IAM), 4-item, 5-point Likert scale (1-5), Min score 5, Max score 20. Higher scores indicate greater appropriateness.	3months after start of intervention, 9 months (end of intervention)
Feasibility of intervention	Feasibility of Intervention Measure (FIM), 4-item, 5-point Likert scale (1-5), Min score 5, Xax score 20. Higher scores indicate greater feasibility.	3months after start of intervention, 9 months (end of intervention)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Effectiveness to implementation leadership	Implementation leadership scale (ILS), 21-item, 5-point Likert scale (0-4). Min 0 and Max score 84. Higher scores indicate better implementation-supportive leadership.	Baseline, 3month, 8months, 3 month follow-up
Effectiveness to transformational leadership	Global Transformational Leadership Scale (GTL), 7-item, 5-point Likert Scale (1-5), Min 7, Max score 35, higher score indicate better outcome, more transformational leadership behaviours.	Baseline, 3month, 8months, 3 month follow-up
Effectiveness to implementation climate	Implementation Climate Scale (ICS), 27-item, 5-point Likert scale (0-4), Min 0, Max score 108, higher scores indicate better outcomes - stronger organizational climate supporting evidence-based practice implementation.	Baseline, 3month, 8months, 3 month follow-up
Effectiveness to evidence-based practice attitudes	The Evidence-based Practice Attitude Scale (EBPAS), 15-item, 5-point Likert Scale (0-4). Min 0, Max score 60, higher scores indicate better outcome, more positive atittudes towards evidence-based practice.	Baseline, 3month, 8months, 3 month follow-up

Collaborators and Investigators

• Sponsor: Jaakko Varpula
• Investigators: Study Director: Anna Axelin, Professor, University of Turku, Department of Nursing Science

Study record dates

Study Major Dates

• Study Start (Actual): January 15, 2026
• Primary Completion (Estimated): January 1, 2027
• Study Completion (Estimated): January 1, 2027

Study Registration Dates

• First Submitted: January 14, 2026
• First Submitted That Met QC Criteria: January 22, 2026
• First Posted (Actual): January 30, 2026

Study Record Updates

• Last Update Posted (Actual): February 5, 2026
• Last Update Submitted That Met QC Criteria: February 2, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Keywords: Implementation; Nursing; Evidence-based practice; Leadership
• Additional Relevant MeSH Terms: Behavioral Symptoms; Behavior; Self-Injurious Behavior; Organization and Administration; Health Services Administration; Personnel Management; Leadership; Organizational Innovation
• Other Study ID Numbers: TY/1603/2025

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: De-identified instrument-level data derived from questionnaires (ILS, GTL, ICS, EBPAS, AIM, IAM, FIM) completed by staff participants will be shared. These datasets will include item-level responses but will exclude any direct identifiers or variables that could reasonably enable re-identification.
• IPD Sharing Time Frame: Instrument-level IPD will be made available upon publication of the main study findings.
• IPD Sharing Access Criteria: Researchers may request access by contacting the principal investigators. Data will be shared through a secure repository after approval of a brief data-use proposal and signing a data-use agreement.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No