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

Background: 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. Purpose: To develop and test an interactionist model of project novelty in nursing. Methods: A cross-sectional design with a multisource approach to data collection. Findings: 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. Discussion: 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.