Nurse Managers' Perspectives on Digital Transformation and Informatics Competencies in E-Leadership: A Qualitative Study.

To explore nurse managers' perspectives on the competencies required for effective e-leadership in the context of healthcare digital transformation. As healthcare systems adopt digital technologies, nurse managers must acquire informatics and leadership competencies to navigate evolving responsibilities, improve team performance, and enhance care quality. A qualitative descriptive design was used at a major Saudi hospital. Semistructured interviews were conducted with a purposive sample of 42 nurse managers between 2023 and 2024. Data were analyzed thematically using Braun and Clarke's six-step approach. Participants were predominantly female (90.5%) and Saudi nationals (52.4%), with most aged 40-50 years. While all held at least a bachelor's degree, 61.9% had a master's qualification. Most had 5-10 years of managerial experience, though 61.9% reported lacking digital leadership training. Thematic analysis identified six key themes: digital transformation, e-leadership, e-leadership competencies (knowledge, skills, and attitudes), self-efficacy evaluation, barriers, and recommendations. Participants recognized the transformative role of digital tools but cited challenges such as limited training, infrastructure constraints, and hierarchical resistance. Nurse managers acknowledged the need for enhanced digital literacy, technical proficiency, and a positive attitude toward change. Strengthening these competencies is essential for leading digital innovation and supporting healthcare reform initiatives such as Saudi Arabia's Vision 2030. Healthcare organizations should invest in structured leadership development, mentorship, and academic-practice partnerships to equip nurse managers with the skills and confidence to lead digital transformation effectively.