Barriers to Research and Quality Improvement in Nephrology: Nurses and Allied Health Professionals' Perspectives

BACKGROUND: Nurses and allied health professionals play a critical role in delivering kidney care and improving outcomes for people with kidney disease. However, engagement in research remains limited, and barriers within nephrology are not well understood. OBJECTIVES: To explore perceived barriers and facilitators to research and quality initiatives engagement among nephrology nurses and allied health professionals in Australia and New Zealand. DESIGN, PARTICIPANTS, AND METHODS: A mixed-methods convergent parallel study was conducted using an online survey and facilitated workshop at the Renal Society of Australasia Conference (June 2025). The Capability, Opportunity, Motivation-Behaviour (COM-B) framework guided data collection and analysis. Quantitative data were analysed descriptively, while qualitative data from focus groups were analysed using framework analysis and mapped to COM-B domains. RESULTS: Forty-seven survey responses and 28 workshop participants were included. Barriers related to opportunity (lack of time, resources, and organisational support) and capability (limited knowledge of research processes and low confidence with research methodologies) were identified. Despite these barriers, strong motivational facilitators were identified. Participants valued research as important for improving patient care and clinical practice and expressed a strong desire to be involved in future research and quality initiatives. Findings reinforced the importance of mentorship, networking, leadership support, and protected time as enablers of research engagement. CONCLUSIONS: Research engagement is influenced by interacting capability, opportunity, and motivational factors. Strategies to build research and quality improvement capacity in nephrology should address knowledge gaps, strengthen organisational support, and foster collaborative research cultures to enable sustainable clinician-led research and evidence-based kidney care.