Exploring barriers and facilitators to the implementation of non-pharmacological preventive nursing interventions for postoperative delirium in elderly adults with hip fracture based on the consolidated framework for implementation research: A qualitative study.

INTRODUCTION: Non-pharmacological prevention of postoperative delirium in elderly hip fracture patients shortens hospital stay and improves rehabilitation quality, but its implementation faces multiple challenges. OBJECTIVE: This study aimed to identify barriers and facilitators to implementing non-pharmacological preventive measures in Chinese healthcare settings, providing a basis for culturally appropriate nursing strategies. METHODS: A descriptive qualitative study was conducted with 21 healthcare professionals from a tertiary Grade A hospital in Shanghai. Semi-structured interviews were performed using an interview guide developed based on the updated Consolidated Framework for Implementation Research, which was also used for deductive analysis of interview data. RESULTS: Four primary themes and sixteen secondary themes of the Consolidated Framework for Implementation Research were identified, including intervention characteristics, outer setting, inner setting, and individual characteristics. A total of 11 barriers and 8 facilitators. CONCLUSION: Key barriers include the complexity of interventions, a lack of awareness of delirium amongst family members, structural constraints within orthopaedic care workflows, and knowledge gaps amongst healthcare providers. To address these challenges, nursing-led optimization strategies are required, including the integration of delirium risk assessment into existing electronic health records, the use of a consultation-liaison model to access specialist support, and the provision of training to enhance nurses' clinical judgement. These context-specific adaptations are designed to improve the feasibility and accuracy of non-pharmacological preventive measures and to enhance cognitive function in older patients.