To explore the factors influencing clinical nurses' participation in case writing and the corresponding rectification strategies.

A questionnaire survey was conducted via WeChat mini-program in June 2025, targeting 1 461 clinical nurses nationwide. Data on their participation in case writing was collected, and logistic regression analysis was employed to assess the influencing factors of case writing participation frequency.

The frequency of case writing among the included clinical nurses was positively correlated with their cognitive level, training needs, and attitude scores (P<0.05). Logistic regression analysis revealed that working in a public hospital, having a higher cognitive level, and a higher training needs score were facilitating factors for clinical nurses to participate in case writing frequently; whereas being a charge nurse and working in an emergency department or pediatric department were hindering factors (P<0.05).

The nature of the work unit, cognitive level of case writing, training needs, professional title, and department are independent influencing factors for clinical nurses' participation in case writing. The study proposes to construct a three-in-one intervention pathway of "structured training system-organizational support mechanism-job adaptability optimization" to systematically enhance the participation and quality of clinical nurses' case writing.