Barriers and facilitators for the implementation of co-created nursing innovations in a Dutch university hospital

Abstract

Introduction: Escalating global nursing shortages require solutions for efficient care, fewer injuries and lost workdays. When commercial solutions are lacking, innovations developed through co-creation can be a viable alternative. However, many co-created nursing innovations are ineffectively implemented. Understanding the barriers and facilitators for the successful implementation of co-created nursing innovations is crucial. Objective: This study explored nurses’ perceived determinants influencing the implementation of co-created nursing innovations. Methods: We conducted a qualitative study using semi-structured interviews with nurses at a Dutch university hospital who were working with co-created nursing innovations. The Theoretical Domains Framework (TDF) was employed to identify the barriers and facilitators. Data analysis followed a deductive theoretical thematic analysis approach based on the 14 TDF domains. Determinants were labeled as a barrier, facilitator, or both. Results: Of the 14 TDF domains, 9 appeared relevant, including Intention, Professional Role and Identity, and Knowledge. The absence of a “superuser,” lack of storage space, and negative experiences during use were perceived as barriers to the implementation of nursing innovations. The importance of time-saving features, user-friendliness, reminders to use the innovation, and team enthusiasm were perceived as facilitators. Conclusions: Participants confirmed that the Social Influences domain, combined with Behavioral Regulation and Knowledge, were barriers to implementation, while Intentions and Reinforcements and Rewards were seen as facilitators.