title: Leading on the frontlines with passion and persistence: a necessary condition for Breastfeeding Best Practice Guideline uptake.
abstract: OBJECTIVE
  The research question explored was what are the processes and strategies used by frontline leaders to support the uptake of the Breastfeeding Best Practice Guideline by nurses in maternity care practice settings?
  
  
  BACKGROUND
  Best Practice Guidelines have been shown to enhance client care and outcomes. Leadership is known to have a key role in moving Best Practice Guidelines into nursing practice yet how this happens is poorly understood. This insight is needed to consistently and efficiently facilitate Best Practice Guideline uptake into clinical practice.
  
  
  METHODS
  Constructivist grounded theory was used to explore the social processes and strategies involved in facilitating Best Practice Guideline uptake.
  
  
  METHODS
  Purposive, criterion-based, theoretical and negative case sampling were used recruiting 58 health professionals and 54 clients. Triangulation and constant comparison of data sources and types (interviews, documents and field notes) were used for analysis and rigour.
  
  
  RESULTS
  Passionate, persistent, respected frontline leaders using tailored, multifaceted strategies aimed at three groups of nurse adopters effectively support the uptake of the Breastfeeding Best Practice Guideline in nursing practice. Successful uptake strategies used by frontline leaders that are new or underdeveloped in the previous literature are presented.
  
  
  CONCLUSIONS
  The study findings illuminated multidimensional, tailored strategies that frontline leaders use to facilitate the uptake of Best Practice Guidelines. Attention to individual attitudes and beliefs, as well as organisational, interorganisational and interprofessional partnerships are vital to uptake. Organisations that aspire to foster Best Practice Guideline uptake must invest in frontline leaders to 'make it happen' and sustain Best Practice Guideline uptake in practice.
  
  
  CONCLUSIONS
  Understanding how frontline leaders facilitate Best Practice Guideline uptake is essential to selecting, educating and supporting them to foster desired practice changes. Strategies are explicated that frontline leaders can adopt and tailor to their own practice contexts.
authors.affiliation: School of Nursing and Health Sciences Research & Innovation, Mohawk College, Hamilton, ON, Canada. nancy.maich@mohawkcollege.ca
authors.forename: Nancy
authors.initials: N
authors.lastname: Matthew-Maich
authors.forename: Jenny
authors.initials: J
authors.lastname: Ploeg
authors.forename: Susan
authors.initials: S
authors.lastname: Jack
authors.forename: Maureen
authors.initials: M
authors.lastname: Dobbins
mesh_terms: D000328:Adult; D001942:Breast Feeding; D005260:Female; D019983:Guideline Adherence; D017408:Guidelines as Topic; D006801:Humans; D007857:Leadership