Bridging the Gap: The Crucial Role of Nurses in Implementation Science

As the largest segment of the global healthcare workforce and at the forefront of patient care, nurses have a deep understanding of the daily complexities of healthcare delivery. However, nurses have traditionally had very limited active involvement in the evidence implementation process. In this special issue of the Journal of Advanced Nursing, we challenge the notion that nurses have a limited role in driving the effective implementation of evidence into routine practice. We highlight the nursing profession as an effective change agent, which is an essential partner in closing that 17-year gap between evidence generation and implementation (Rubin 2023). One message stands out: nurses must play an active role in implementation science teams, particularly in the adoption and adaptation of new interventions and practice changes. More than knowledge consumers, nurses must be empowered as knowledge mobilisers, able to tailor and embed interventions that reflect the realities of complex care settings. Implementation science, which focuses on strategies to embed research findings and evidence-based practices into everyday healthcare, represents an important goal for health systems globally (Eccles and Mittman 2006). Implementation science aims to make available evidence-based practices and interventions from what we know have worked in controlled environments to work in real-world settings. This means that implementation science in the healthcare setting relies heavily on a well-informed and sustainable implementation strategy with a clinician-partnered approach. We turn our attention to the invaluable contributions of nurses as implementers and drivers for change who can and should help lead evidence translation. The inclusion of nurses in implementation teams brings a relational and pragmatic lens to implementation planning—nurturing team cohesion, patient engagement and local contextual understanding. Nurses are often the first point of contact for patients, and their proximity and holistic approach place them at the centre of healthcare delivery. Several studies in this special issue highlight the pivotal role of nurses in implementation science. For example, nurse-led trials for early antiretroviral therapy demonstrate how nurses can drive innovative intervention strategies, improving outcomes for vulnerable populations (Zhou et al. 2024). Similarly, the development and implementation of sexual and gender minority curricula for advanced practice nursing illustrate how nurses can champion inclusivity and responsiveness in care (Tsusaki et al. 2024). Studies examining barriers and facilitators to culturally responsive care in general practice nursing, and the implementation of clinical supervision, reinforce the idea that nurses are not just passive recipients of change—they are active agents who shape, adapt and sustain new practices (Oakley et al. 2024; Ryu et al. 2024). Their insights into the realities of care delivery are invaluable for uncovering the context for change efforts; what works, for whom and under what circumstances. Importantly, nurse-led initiatives often reflect a systems-thinking approach—simultaneously addressing clinical, relational and organisational levels of change. Implementation science is not about generating knowledge; it is about making a tangible difference in the lives of patients and communities by ensuring new knowledge reaches them. The special issue includes studies that employ a range of methodologies—to address real-world challenges. For example, qualitative analyses of barriers to preventing hospital-acquired pressure injuries in paediatrics, and systematic reviews on determinants of vascular access device selection, provide actionable insights that can inform practice guidelines and policy (Fernández-Fernández et al. 2024). Nurses, with their deep understanding of patient needs and system constraints, are essential partners in these efforts. Their involvement ensures that interventions are not only evidence-based but also feasible, acceptable and sustainable in everyday practice. The development of competency-measuring tools for health professionals, as featured in this issue, further supports nurses in fostering evidence-based practice and continuous professional development (Wang et al. 2024). Moreover, nurse-led implementation efforts often go beyond clinical efficacy to incorporate patient experience, workforce well-being and health equity—dimensions that are too often overlooked in top-down implementation models. The advancement of implementation science depends on robust frameworks and effective leadership. This issue showcases the use of the i-PARIHS framework to evaluate mentorship programmes, and the Behaviour Change Wheel to redesign sepsis pathways for emergency clinicians (Munroe et al. 2024; Nyholm et al. 2024). These frameworks provide structured approaches to understanding and addressing the complexities of practice change. Nurse managers and leaders play a critical role in guiding teams through the implementation process. The evaluation of implementation leadership training programmes for nurse managers highlights the importance of equipping nurse leaders with the skills and knowledge to drive change (Chen et al. 2024). The cultivation of implementation leadership across all career stages—not just managerial levels—is essential for sustaining a culture of evidence-informed care. Leadership at all levels of nursing is essential for fostering a culture of innovation and continuous improvement. A recurring theme in this special issue is the pursuit of equity in healthcare. Studies on translating proportionate universal healthcare into system designs, and adaptations to psychosocial support in oncology during COVID-19, underscore the need for implementation strategies that address disparities and promote access for all (Fjordkvist et al. 2024). Nurses, who often serve marginalised and underserved populations, are well placed to advocate for and implement equitable care models. Community-driven interventions, such as peer-led mental health cafés and family support initiatives in intensive care units, further demonstrate the power of engaging nurses in co-designing and delivering services that resonate with local needs (Murphy et al. 2025). The Baby-Friendly Community Initiative, for example, exemplifies how nurses can lead the way in promoting maternal and child health through evidence-based, community-centred approaches (Lok et al. 2024). End-of-life and specialised care require sensitivity, expertise and a commitment to patient-centred values. The development and implementation of new approaches to dementia care, and the Practice Programme for Upright Positions in the Second Stage of Labour, highlight the nuanced role of nurses in supporting patients and families during critical moments (Huang et al. 2023). By actively participating in the design and delivery of these interventions, nurses ensure that care is compassionate, respectful and aligned with patient preferences. In doing so, nurses anchor implementation efforts in values of justice, dignity and responsiveness—principles central to both nursing and implementation science. The studies featured in this special issue collectively advance our understanding of implementation science and its potential to transform healthcare. However, the further impact of these innovations is strengthened through the engagement and leadership of nurses. As frontline providers, nurses are not only implementers but also innovators, advocates and champions of change. Their active participation in implementation science is essential for translating evidence into practice, improving outcomes and achieving health equity. To realise this potential, structural and cultural shifts are needed to embed nurses in all stages of implementation—planning, execution, evaluation and scale-up. Investment in education, leadership development and collaborative research will ensure that nurses continue to drive progress in implementation science—turning knowledge into action and action into better health outcomes for all. The authors declare no conflicts of interest.