Barriers to implementing clinical practice guidelines for managing patients with pressure injuries in China: a qualitative study using the theoretical domains framework

Pressure injuries (PIs) are a common challenge faced by healthcare institutions worldwide. Evidence-based practice is crucial for improving the quality of patient care, but its implementation often faces many difficulties. This study aims to explore the barriers to implementing clinical practice guidelines (CPGs) to manage patients with PIs in Chinese tertiary hospitals. A qualitative study was conducted using the theoretical domains framework to identify barriers to implementing CPGs. Semi-structured interviews were conducted with 22 healthcare professionals, including nurses and doctors with experience in managing patients with PIs, across multiple departments in tertiary hospitals. Data were analyzed using content analysis, supported by NVivo 11.0 software, to identify key themes. This study identified several barriers to implementing high-quality CPGs for the PIs in China, including insufficient knowledge and skills among healthcare workers. Additionally, challenges such as a lack of multidisciplinary collaboration and information technology support, absence of incentive systems, resource limitations, unfavorable reimbursement policies, and insufficient leadership support were highlighted. Addressing these complex issues requires a multi-faceted system intervention strategy. These findings will provide important references for promoting evidence-based practices in the management of patients with PIs in developing countries. The findings of this study highlight the ongoing challenges in translating evidence-based CPGs into clinical practice for managing patients with PIs in China. This study systematically identifies key barriers related to healthcare providers' ability, opportunity, and motivation, emphasizing the complexity of factors that hinder effective CPGs implementation. The insights gained lay the groundwork for developing targeted intervention strategies to foster the adoption of best practices in wound care and evidence-based practices to manage PIs in the future. Not applicable.