Healthcare professionals’ perspectives on barriers and facilitators to implementing a digital delirium prediction tool in adult ICUs: a qualitative study

To explore intensive care unit (ICU) healthcare professionals’ perceived barriers, facilitators, and implementation needs regarding a proposed digital delirium risk prediction clinical decision support (CDS) tool, to inform its development and implementation before clinical deployment. A descriptive qualitative study was conducted using semi-structured, in-depth interviews with physicians, nurses, and managers of adult ICUs following an introduction to the tool concept. Interviews were transcribed verbatim and analyzed using directed content analysis with the Consolidated Framework for Implementation Research (CFIR 2.0)-guided coding and interpretation. Eighteen participants were interviewed. Key facilitators included earlier risk identification enabling proactive prevention, presentation of patient-level risk factors, integration into existing workflows, a shared interdisciplinary risk language, and active leadership engagement. Major identified barriers included heavy manual data entry, alarm fatigue, ambiguous role definitions, discordance between predictions and clinical experience, and technical instability. By investigating healthcare professionals’ perspectives, this study suggests that successful implementation of digital delirium prediction tools may depend on predictive performance, workflow embedding, trust building through explainable outputs, continuous multi-level monitoring and early leadership engagement. Not applicable.