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. 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. 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. 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. 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. 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. Not applicable.
Yu et al. (Sat,) studied this question.