Background: The adoption of Hospital Management Information Systems (HMIS) is critical for improving healthcare quality and patient safety. However, in many Low- and Middle-Income Countries (LMICs), nurses face significant barriers to system use. This study examined the barriers, facilitators, and strategies for improving HMIS utilization among nurses at Federal Medical Centre (FMC), Gusau, Nigeria.

Methods: A quantitative, descriptive cross-sectional survey was conducted among 205 registered nurses selected via stratified random sampling. Data were collected using a structured, validated questionnaire based on the Technology Acceptance Model (TAM) and Diffusion of Innovations (DOI) theory. Descriptive statistics frequencies, means, standard deviations were used for analysis.

Results: The overall HMIS utilization was suboptimal (mean=3.01/5.0). Severe infrastructural barriers included frequent power outages (mean=3.82) and unreliable internet (mean=3.71). Organizational barriers included inadequate training (mean=3.67), with 61.5% of nurses reporting no formal HMIS training. Although nurses perceived HMIS as useful (mean=3.54), essential facilitators like stable connectivity (mean=2.21) and technical support (mean=2.45) were absent. Nurses strongly endorsed improving power/internet (98.0%), regular training (96.6%), and dedicated technical support (93.7%) as key strategies.