Keywords
Innovation theory
Diffusion of Innovations
Clinical decision-making
How to Cite
Abstract
Background: Theories establish conceptual approaches that underpin clinical decision-making and inform nursing practices. Innovation is essential for developing ideas and processes that improve patient outcomes. Nurse leaders are strategically positioned to promote innovation to practice by applying these inventive theoretical models to support the implementation of practice innovation, and, where institutional structures permit, to position innovation adoption.
Aim: Conduct a scoping review of existing literature to identify prevailing theories related to innovation.
Methods: A two-part scoping review was conducted in 2022 using Google Scholar, selected intentionally to capture gray literature and dissertations alongside peer-reviewed publications, complemented by a Semantic Scholar update in 2025. Both databases were searched to identify which existing theories nurse leaders utilize to guide practice innovation.
Results: Nurse leaders used six of 25 identified innovation theories across 68 publications (23 peer-reviewed articles, 43 dissertations): Diffusion of Innovations Theory (N=35), Leader-Member Exchange Model (N=15), Karasek's Job Demands-Control Model (N=10), Cognitive Stress-Coping Theory (N=4), Job Characteristics Model (N=4), and Champion Behavior (N=1). Innovation occurred across evidence-based practice (N=15), clinician roles (N=8), coping (N=7), leadership style (N=7), leader-member relationships (N=6), empowerment (N=6), recruitment and retention (N=5), education (N=4), work environment and organizational culture (N=3), and innovation implementation (N=3)..
Conclusions: Nursing leadership literature favors a select few highly cited theories and may benefit from broader, more inclusive theoretical approaches when developing and evaluating innovative practice. Diversifying theoretical frameworks ensures innovation efforts are contextually appropriate, evidence-based, and sustainable.
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