Research Article| Volume 67, ISSUE 4, P404-418, July 2019

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Nursing innovation: The joint effects of championship behaviors, project types, and initiation levels

Published:February 08, 2019DOI:


      • Champions led four different project types; the most common was quality improvement.
      • Frontline nurse champions led both top-down and bottom-up projects.
      • Project type, initiation level, and personal championship solely do not matter.
      • Bottom-up service and administrative projects require championship behaviors.
      • For human resource and top-down projects, championship behaviors do not matter.



      Frontline nurse champions are key innovation-implementation agents. Despite the growing interest in nurse champions’ innovation, whether project novelty is a product of championship behavior (e.g., expressing confidence in the innovation's success and network building), the project's contextual characteristics (project type and initiation level), or their joint effects, remains unsolved.


      To develop and test an interactionist model of project novelty in nursing.


      A cross-sectional design with a multisource approach to data collection.


      Results demonstrated a direct effect of project type, a two-way interaction effect of level of initiation and project type, a two-way interaction effect of championship and project type, and a three-way interaction effect of project type, initiation level, and championship on project's novelty.


      Bottom-up service and administrative projects require champions’ championship behaviors to foster novelty, whereas for bottom-up quality-improvement projects, such behaviors can harm project novelty. For human-resource projects and for top-down projects, championship behaviors do not matter.


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