Barriers and facilitators of the implementation of a leadership training program based on the Developing and Sustaining Nursing Leadership Best Practice Guideline: A qualitative study

Objectives: This study aimed to identify barriers and facilitators influencing the implementation of a leadership training program based on the Developing and Sustaining Nursing Leadership Best Practice Guideline for nurse managers. Methods: The descriptive qualitative study was conducted through semi-structured individual interviews at a tertiary hospital in Beijing, China. We selected 16 nurse managers who had participated in a leadership training program using a purposive sampling method with a maximum variation strategy from March to August 2024. The collected data were analyzed using thematic analysis. Results: This study identified 7 barriers and 17 facilitators guided by the Consolidated Framework for Implementation Research (CFIR). Barriers were identified as: intervention characteristics (complexity of content, excessive content, challenging assignments after training, gap between theory and practice, and time-consuming), and inner setting (unclear training goals, mentor incompetence). Key facilitators emerged from: intervention characteristics (internally developed content, Best Practice Guideline with high level of evidence, focusing on leadership competency for manager, logically connected design), outer setting (meeting participants' needs, networking with leadership authority, peer pressure), inner setting (effective communication, supported teamwork, tension for change, fitting the participants' value), characteristics of individuals (intrinsic motivation, self-efficacy, beginning or mid-stage of change), and process (planning developed in advance, full motivation, feedback and team debriefing) domains. Conclusions: This study identified drivers of implementation for a leadership training program in the Chinese context. These findings support the successful delivery of this program and can inform future leadership training and support improvements in nurse managers' leadership.