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To identify barriers and facilitators to implementing an electronic shared decision-making tool for managing anticoagulant-related drug-drug interactions that affect bleeding risk in routine clinical care.
Preimplementation qualitative study using semistructured interviews.
Three academic medical centres in the southeastern and western USA. Interviews were conducted between 27 March and 25 September 2024.
36 participants, including 19 clinicians involved in prescribing or managing anticoagulants and seventeen patients prescribed anticoagulants, were recruited using purposive and convenience sampling.
Participants identified multiple barriers and facilitators to tool implementation. Common barriers included limited visit time, challenges integrating the tool into existing workflows, role and scope-of-practice constraints, and variation in patient digital literacy. Facilitators included clear visualisation of bleeding risk, access to supporting evidence, familiar interface design and perceived potential to support patient engagement and shared decision-making. Several determinants functioned as both barriers and facilitators, depending on clinical context and user role.
This preimplementation qualitative study identified context-specific determinants that influence the adoption of an electronic shared decision-making tool for anticoagulant-related drug–drug interactions. Findings highlight the importance of early attention to workflow integration, role alignment and usability to support uptake in routine care. Addressing these factors during design and implementation may inform strategies to support adoption and future evaluation in real-world clinical settings.
The dynamic landscape of contemporary healthcare organisations presents substantial challenges and competition, underscoring the imperative to improve the quality of work life for staff nurses.
Investigating the mediating role of authentic followership between job crafting and nurses' quality of work life.
A correlational analytical research design was utilised following STROBE guidelines, and data were collected from 264 nurses. Instruments included a Job Crafting Questionnaire, Quality of Work Life scale and Authentic Followership Profile. Data were collected from the beginning of January to the end of February 2024.
The study shows a significant correlation between job crafting, authentic followership and quality of work life. Specifically, authentic followership and job crafting are positively related to quality of work life. Additionally, various job crafting dimensions are positively related to the quality of work life dimensions. The linear regression analysis indicates that Authentic Followership and Job Crafting together explain 39% of the quality of work life variance (R 2 = 0.390). Path analysis suggests that authentic followership is a significant mediator between job crafting and quality of work life.
Path analysis reveals authentic followership as a vital mediator between job crafting and nurses' quality of work life, suggesting its crucial role in transmitting the positive effects of job crafting.
Practical implications include encouraging job crafting, fostering authentic followership qualities and establishing mentorship programmes. Nursing and health policy must invest in leadership development, mentorship and job-crafting opportunities for nurses, motivating us to take action. This will foster a supportive environment and lead to an effective healthcare system.
No patient or public contribution.
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