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Background <p>IABP monitoring is essential in critical care, yet its accuracy is frequently compromised. A systematic understanding of the barriers and facilitators from frontline nurses’ perspectives is lacking.</p> Aims <p>To comprehensively explore factors influencing IABP monitoring accuracy through the lens of the i-PARIHS framework and to develop ICU nurse personas to inform tailored improvement strategies.</p> Study design <p>A descriptive qualitative study following COREQ guidelines, augmented with quasi-quantitative cluster analysis for persona development. Semi-structured interviews were conducted with 24 ICU nurses from a single tertiary hospital in China between September and October 2025. All interviews were carried out by a trained interviewer in private settings. Data analysis involved directed content analysis guided by the i-PARIHS framework, followed by cluster analysis to develop nurse personas.</p> Results <p>Data saturation was achieved after 24 interviews. Four themes aligned with i-PARIHS were identified: the dual nature of the innovation (value vs. risk), varied recipient competency, contextual barriers (e.g., lack of protocols), and facilitation strategies. Through cluster analysis of participant characteristics, three nurse typologies emerged: (1) The Experience-Guarded Expert (highly skilled but reliant on personal experience), (2) The Guidance-Seeking Practitioner (knows standards but struggles with application), and (3) The System-Advocating Catalyst (focuses on systemic solutions). Each profile exhibited unique needs and barriers. Methodological rigor was ensured through member checking, peer debriefing, and reflexive journaling.</p> Conclusions <p>Improving IABP accuracy requires a move beyond one-size-fits-all approaches. The integration of the i-PARIHS framework with persona development provides a powerful strategy for developing targeted interventions. It is essential to tailor support to the specific characteristics of different nurse profiles, including providing decision aids for Practitioners and engaging Catalysts in quality improvement, to enhance patient safety.</p> Relevance to clinical practice <p>The findings provide nurse managers with a framework for systematically assessing barriers to accurate IABP monitoring. Crucially, the identified personas enable a shift from generic training to precision interventions. By guiding leaders to tailor support to specific needs, this approach enhances monitoring reliability and patient safety. Examples of tailored support include simplified job aids for less confident staff and leadership roles for system-oriented nurses.</p> Clinical trial number <p>Not applicable.</p>

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Factors influencing invasive arterial blood pressure monitoring accuracy: a qualitative study using the i-PARIHS framework and personas

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月18日

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  • Ming Yu,
  • Tingting Shen,
  • Yuling Zhang,
  • Rong Tang,
  • Jing Ji,
  • Lili Jiang,
  • Suping Cai,
  • Ronghui Geng,
  • Lingling Jiang

摘要

Background

IABP monitoring is essential in critical care, yet its accuracy is frequently compromised. A systematic understanding of the barriers and facilitators from frontline nurses’ perspectives is lacking.

Aims

To comprehensively explore factors influencing IABP monitoring accuracy through the lens of the i-PARIHS framework and to develop ICU nurse personas to inform tailored improvement strategies.

Study design

A descriptive qualitative study following COREQ guidelines, augmented with quasi-quantitative cluster analysis for persona development. Semi-structured interviews were conducted with 24 ICU nurses from a single tertiary hospital in China between September and October 2025. All interviews were carried out by a trained interviewer in private settings. Data analysis involved directed content analysis guided by the i-PARIHS framework, followed by cluster analysis to develop nurse personas.

Results

Data saturation was achieved after 24 interviews. Four themes aligned with i-PARIHS were identified: the dual nature of the innovation (value vs. risk), varied recipient competency, contextual barriers (e.g., lack of protocols), and facilitation strategies. Through cluster analysis of participant characteristics, three nurse typologies emerged: (1) The Experience-Guarded Expert (highly skilled but reliant on personal experience), (2) The Guidance-Seeking Practitioner (knows standards but struggles with application), and (3) The System-Advocating Catalyst (focuses on systemic solutions). Each profile exhibited unique needs and barriers. Methodological rigor was ensured through member checking, peer debriefing, and reflexive journaling.

Conclusions

Improving IABP accuracy requires a move beyond one-size-fits-all approaches. The integration of the i-PARIHS framework with persona development provides a powerful strategy for developing targeted interventions. It is essential to tailor support to the specific characteristics of different nurse profiles, including providing decision aids for Practitioners and engaging Catalysts in quality improvement, to enhance patient safety.

Relevance to clinical practice

The findings provide nurse managers with a framework for systematically assessing barriers to accurate IABP monitoring. Crucially, the identified personas enable a shift from generic training to precision interventions. By guiding leaders to tailor support to specific needs, this approach enhances monitoring reliability and patient safety. Examples of tailored support include simplified job aids for less confident staff and leadership roles for system-oriented nurses.

Clinical trial number

Not applicable.