Objectives: To gain insight into the current implementation of national guidelines on training, examination and registration of proficiencies for the safe use of medical devices and to explore the barriers and facilitators faced during the implementation of these national guidelines. Methods: A questionnaire was sent to all Dutch hospitals and interviews were held with staff at six hospitals. Results: There are differences between hospitals in the implementation stage, but also within hospitals. The questionnaire showed differences between training and examination for devices used by nurses and those used by medical specialists. The interviews showed that most barriers and facilitators for implementation of the national guidelines can be found in organizational factors. Conclusions: According to the hospitals, implementation of national guidelines for the safe use of medical devices is a complex process that involves all departments. Furthermore, the staff do not always feel a sense of urgency to improve the safe use of medical devices. To facilitate implementation, more national guidance could be helpful.