Abstract
BACKGROUND: Patient-reported outcomes (PROs) are crucial for understanding patient needs and improving patient-centred care. Nurses are key facilitators in PROs implementation, offering valuable insights. However, their perspectives and challenges remain underexplored. This study aims to investigate nurses’ perceptions, barriers, and support needs in implementing PROs. METHODS: A descriptive qualitative study was conducted, using semi-structured interviews with 17 nurses from a tertiary public hospital in China. Data were analysed using thematic analysis, with post-hoc mapping of emergent themes to the Consolidated Framework for Implementation Research (CFIR). The study adhered to the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist for thorough reporting. RESULTS: Three main themes were identified: (1) Reframing the value of patient-centred care through PROs, including enhancing the quality of nurse–patient communication and advancing the professionalisation of nursing practice; (2) Structural barriers to the implementation of PROs, encompassing the cognitive–practical competency gap and the lack of organisational support mechanisms; and (3) Innovation needs and pathways for a digitally enabled, PROs-oriented transformation in nursing, covering institutional pathways for implementation and facilitating integrative innovation through intelligent technologies. CFIR mapping highlighted how individual knowledge and beliefs, organisational culture, and intervention adaptability shaped both facilitators and barriers. CONCLUSIONS: This study demonstrates that while nurses generally have positive attitudes towards the integration of PROs and acknowledge its potential to enhance communication, care quality, and professional practice, significant multi-level barriers remain. Addressing these challenges requires department-wide training, strong leadership, clear policies, and investment in adaptable digital infrastructure. These system-level strategies can empower nurses to use PROs confidently and consistently, thereby supporting the institutionalisation of patient-centred care in China and similar healthcare contexts. CLINICAL TRIAL NUMBER: Not applicable. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12912-025-03847-7.