Managers' Experiences in Implementing Internet Plus Nursing Service in China: A Qualitative Study

To describe the experiences of managers directly involved in O2O-style Internet Plus Nursing Service (IPNS) in China.

A descriptive qualitative study design was used. Semistructured interviews were conducted with 24 participants, including 18 hospital-based nurse managers and 6 platform managers, using maximum variation purposive sampling.

Four main themes were identified: (1) extending care and professional value beyond hospital walls (optimizing the delivery of continuity of care and elevating nurses' professional fulfillment and growth drive); (2) mobilizing nursing resources amid workforce constraints (underutilization of service potential, divergent views on nurse turnover, and difficulty in utilizing community nursing resources); (3) managing service delivery across organizational boundaries (difficulty in launching the service, lack of support and assurance, and weak and challenging service regulation); and (4) building conditions for sustainable development (refining rules and division of labor, increasing publicity, and developing sustainable market-oriented mechanisms).

The study highlights both the benefits and challenges experienced by managers involved in O2O-style IPNS. Sustainable development of this model requires clearer regulatory boundaries, stronger institutional support, improved platform-hospital coordination, and greater recognition of nurses' professional roles beyond hospital settings.

Nursing managers should strengthen workforce planning through flexible staffing, targeted training, and appropriate incentive mechanisms. Health authorities, hospitals, and service platforms should jointly clarify responsibilities, standardize quality monitoring and documentation procedures, and provide regulatory guidance to support the safe and scalable development of O2O-style IPNS.