Barriers and facilitators to the implementation of a complex nursing intervention

Samenvatting

Exploration, Preparation, Implementation, and Sustainment" (EPIS) framework, this longitudinal qualitative study examined barriers and facilitators during implementation of the PREDOCS nursing intervention across twelve Dutch cardiothoracic centers from 2016 to 2019. We conducted 252 structured interviews across eight measurement waves with diverse healthcare professionals. Data were systematically coded for barriers and facilitators using the Capability, Opportunity, Motivation-Behaviour (COM-B) model through a hybrid approach combining Large Language Model (LLM) assisted analysis with rigorous human verification. Hospitals were categorized into three implementation outcome groups: Implementation (n = 4), Delayed Implementation (n = 5), and No-Implementation (n = 3).