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Editorial
Bridging the evidence–practice gap: advancing nursing through implementation science
Youn-Jung Sonorcid

DOI: https://doi.org/10.4040/jkan.26099
Published online: August 10, 2026

Red Cross College of Nursing, Chung-Ang University, Seoul, South Korea

Corresponding author: Youn-Jung Son Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul 06974, South Korea E-mail: yjson@cau.ac.kr
• Received: July 5, 2026   • Revised: July 13, 2026   • Accepted: July 16, 2026

© 2026 Korean Society of Nursing Science

This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License (http://creativecommons.org/licenses/by-nd/4.0) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.

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Over the past 2 decades, evidence-based practice (EBP) has attracted substantial interest among health professionals and has contributed to the development of numerous clinical guidelines and evidence-based interventions in nursing [1]. Since 2020, the Journal of the Korean Academy of Nursing (JKAN) has published approximately 20 EBP-related studies each year. However, the availability of evidence does not ensure its use in healthcare settings, and a substantial proportion of evidence still does not reach the bedside [2,3].
As Skolarus and Williams [4] have noted, this persistent evidence–practice gap—often termed the “know–do gap”—is one of the central challenges in contemporary healthcare. Addressing this gap therefore requires more than the production of additional evidence; it also requires a clear understanding of implementation science and the ability to apply its principles in real-world settings [5]. To ensure that advances in nursing science lead to tangible benefits for patients, nurses must be actively engaged in translating scientific discoveries into practical, patient- and family-centered care. This engagement is pivotal to the effective implementation of EBP in daily nursing care [1,6]. In practice, nurses can serve as clinical champions by adapting protocols to local workflows and monitoring the fidelity of EBP delivery [1,6]. This editorial provides a concise overview of implementation science as an approach to improving the adoption of EBP in nursing.
Implementation science is the study of methods that promote the systematic adoption of EBP into routine care [2]. Its goal is to improve the quality, effectiveness, safety, equity, and sustainability of care [2]. Unlike quality improvement, which typically addresses specific problems within single settings, implementation science seeks to generate transferable knowledge about how EBP is adopted, sustained, and scaled across diverse healthcare contexts [4]. Whereas traditional research asks whether an intervention works, implementation science examines how a proven intervention is adopted, applied, and sustained in routine clinical practice, with attention to the strategies and contextual factors that shape its use [2,5]. More specifically, implementation research is the empirical component of implementation science. It identifies multilevel barriers and facilitators, tests context-sensitive strategies, and evaluates implementation outcomes [2,4].
Implementation strategies are specific methods used to encourage the adoption, delivery, and sustained use of interventions [6]. These methods include audit and feedback, education, clinical championing, reminders, facilitation, and workflow redesign [5]. Implementation is shaped by contextual determinants at multiple levels, including individual knowledge and motivation, professional roles, organizational culture, leadership support, available resources, and compatibility with existing workflows [5,7]. Accordingly, implementation strategies are most likely to be effective when they address context-specific barriers and facilitators [7]. In a systematic review and meta-analysis, Fontaine et al. [8] found that strategies such as education, audit and feedback, champions, and reminders improved nursing practice, although their effects on patient outcomes were generally modest. No single strategy was consistently superior across settings, underscoring the need to select and tailor strategies according to contextual determinants. Education directed at practicing nurses may support implementation, but it is unlikely to be sufficient when nurses’ uptake is shaped by perceived burden, professional identity, and fit with existing workflows [2,7]. A systematic assessment of these contextual factors is therefore required to support successful implementation.
As the field has matured, theories, models, and frameworks (TMFs) have proliferated [9]. Determinant frameworks, such as the Consolidated Framework for Implementation Research, identify factors that shape implementation success or failure. Evaluation frameworks include the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework [5,9]. In addition to clinical outcomes, key implementation outcomes should be measured, including acceptability, adoption, appropriateness, feasibility, fidelity, implementation cost, penetration, and sustainability [5]. Measuring these outcomes is essential for distinguishing an ineffective intervention that was adequately delivered from an effective intervention that was poorly implemented. Beyond categorizing determinants and outcomes, TMFs can guide the selection of strategies for a given context and provide a common structure for transparent reporting of determinants, strategies, adaptations, and outcomes [7]. To generate transferable knowledge, studies should link identified determinants to selected strategies and prespecified implementation outcomes [5,7,8].
Given the interdependence of effectiveness and implementation, hybrid effectiveness–implementation designs evaluate clinical and implementation outcomes within a single study, thereby shortening the path from discovery to routine use [10]. Mixed methods are particularly well suited to this work [5], and rigorous designs should address team and knowledge-user engagement, equity, selection and application of TMFs, fidelity and adaptation monitoring, and sustainability and scalability from the outset [7]. Implementation may also require de-implementing low-value routines, such as routine nighttime vital-sign checks in stable patients, when these practices compromise clinical efficiency [9].
For example, a mobile health-based self-care management program for patients after myocardial infarction could be evaluated using a hybrid effectiveness–implementation design that assesses its clinical effects and real-world implementation simultaneously. A mixed-methods design embedded within this approach could clarify not only whether the program is effective but also which contextual factors facilitate or hinder its uptake across diverse healthcare settings. Nevertheless, hybrid designs require substantial resources and expertise. Therefore, bridging the evidence–practice gap cannot be achieved through a single trial; instead, implementation knowledge depends on replication across settings and synthesis through systematic reviews.
Implementation science is essential for bridging the gap between evidence and routine nursing care. Future research should examine how contextual determinants, including staffing, shift work, and workflow, shape the adoption, delivery, fidelity, scope, and sustainability of EBP, as well as the de-implementation of low-value practices. In implementation research, appropriate TMFs should be applied from the design stage to frame both the analysis of determinants and the evaluation of implementation outcomes. By engaging nurses, clinicians, managers, patients, caregivers, and policymakers to address local barriers and evaluate implementation and patient outcomes together, implementation science can strengthen the uptake and sustained use of evidence in nursing practice. Researchers are encouraged to submit work that contributes to narrowing the gap between nursing research and practice. We hope that JKAN will serve as an important platform for advancing implementation science in nursing.

Conflicts of Interest

Youn-Jung Son serves as Editor-in-Chief of the Journal of Korean Academy of Nursing but has no role in the decision to publish this article. Except for that, no potential conflict of interest relevant to this article was reported.

Acknowledgements

None.

Funding

None.

Data Sharing Statement

Data sharing is not applicable to this article as no new data were created or analyzed in this study.

Disclosure and declaration of AI use

None.

Author Contributions

Conceptualization, Final approval of the manuscript, Investigation, Methodology, Writing–original draft, and Writing–review & editing: YJS.

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