Abstract: Objective: To explore barriers to the implementation of a nursing clinical decision support system in a tertiary general hospital in Shanghai from the perspectives of nursing staff. Methods: Theoretically guided by the Human, Organization and Technology-Fit (HOT-fit) framework, an interview outline was formulated. Totally 18 nurses from the pilot wards participated in the in-depth interviews, of which the data were analyzed by means of thematic analysis. Results: Barriers to the system implementation can be attributed to four aspects: human, technology, organization, and net benefit. The human aspect includes nurses' difficulty adapting to the system and their negative attitude towards the system. Lack of user-friendly interface design, poor information linkage and ineffective technical support usually lead to technological barriers. The organization aspect refers to inadequate user training and inconsistency in system implementation. Nurses' increased workload and not benefiting from the decision support system further intensify the net benefit barriers. Conclusion: The promotion of a nursing clinical decision support system calls for joint efforts from end users, technical staff and organizers, including regarding the new system in a rational way, improving system usability, fostering inter-disciplinary collaboration and offering administration support.

Key words: clinical decision support system; nursing information system; barrier; nursing process; qualitative study