Abstract
AIM: To understand barriers and facilitators to the implementation of a novel paediatric critical care nurse preceptor programme in Malawi. DESIGN: Qualitative content analysis. METHODS: Using the Consolidated Framework for Implementation Research (CFIR), 20 individual interviews via Zoom were conducted. A predetermined codebook was used to code transcripts using the five CFIR domains. Barriers and facilitators were identified per domain and coded using the CFIR constructs, and themes were generated per domain. RESULTS: Participants reported the preceptor programme was comprehensive, well designed and delivered effectively (innovation). Partnerships are essential to the programme's initiation and likely are important to the programme's sustainability (outer setting). Participants voiced challenges with the lack of physical and human resources, leading to prioritisation of patient needs over programme attendance at times (inner setting). Yet, preceptors were motivated by this programme and appreciated the advantage of this programme over previous programmes and gained confidence and competence in their ability to precept students (individuals). In terms of the process, participants felt they needed additional time to devote to this programme and fully engage (process). CONCLUSION: This paediatric critical care nurse preceptor programme had significant strengths across all five CFIR domains, yet participants also discussed areas to improve upon. Participants voiced enthusiasm for the programme to be sustained and to expand within and beyond Malawi. IMPLICATIONS FOR PRACTICE: Understanding the barriers and facilitators to a programme is critical before scaling up or scaling out. Improving challenges and building upon facilitators will strengthen the programme in future iterations. IMPACT: Providing bedside nurses with knowledge and skills to precept students may decrease the shortage of quality paediatric critical care nurses through two avenues: (1) empowering them with confidence and competence and (2) improving the pipeline of well-trained students. Ultimately, improving clinician quality can impact patient outcomes. REPORTING METHODS: This study complied with the standards for reporting qualitative research (SRQR). PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.