Abstract:

Objective To explore the barriers and facilitators encountered by intensive care unit（ICU） nurses in the prevention and management of mucous membrane pressure injuries（MMPI）. Methods A descriptive qualitative study design was employed. Semi-structured interviews were conducted with ICU nurses from a tertiary Grade A hospital in Nanjing. Thematic analysis was used to organize，code，and analyze the data. The identified themes were then mapped onto the Theoretical Domains Framework（TDF） to systematically identify barriers and facilitators influencing MMPI prevention and management. Results Interviews were conducted with 12 ICU nurses. The coded interview data mapped to 14 theoretical domains，yielding 8 main themes and 23 sub-themes. The promoting factors for the implementation of MMPI included three themes，including physician-nurse cooperation and manager support，knowing the significance of MMPI management，management supervision and personal characteristics. The theme of barriers included four themes，including insufficient cognition and skills of MMPI，decision-making dilemma caused by multiple consequences beliefs，lack of confidence in the effect of prevention management，and negligibility of MMPI. The theme of human resources and prevention materials was not only a barrier factor but also a promoting factor. Conclusion The factors influencing nurses’ prevention and management of MMPI are complex. The findings of this study can inform clinical practice by leveraging facilitators while mitigating barriers，ultimately aiming to reduce the incidence of MMPI in critically ill patients.

Key words: Mucous Membrane Pressure Injury, Barriers, Facilitators, Qualitative Research, Intensive Care