Exploring the Implementation of a New Nursing Role Using the CFIR-ERIC Approach: A Qualitative Study

This study aimed to retrospectively describe the implementation barriers and facilitators when introducing a new nursing role (RPN) using the Consolidated Framework for Implementation Research (CFIR) and to map implementation strategies onto the Expert Recommendations for Implementing Change (ERIC) factors to identify relevant strategies supporting new role implementation in the acute care setting.

A qualitative descriptive study embedded in a multiphase implementation evaluation study.

Semistructured interviews with organizational leaders, implementation leaders, and nurses, combined with document analysis, were analyzed using the CFIR deductively to identify barriers and enablers mapped to the ERIC tool for strategies guiding implementation.

Participants (N = 25) represented organizational leaders (n = 3), implementation leaders (n = 11), RNs (n = 4), and RPNs (n = 7) from October 2024 to January 2025. Seventeen CFIR constructs across five domains were identified. Common themes of enablers include factors in the inner setting, such as a tension for change, mission alignment, and innovation compatibility. Many enablers were also found in the implementation process, which involved teaming, assessing context and needs, engaging, tailoring strategies, and reflecting and evaluating. Barriers to implementation were found in the inner setting, including culture and limited access to knowledge and information about the role. Eleven implementation strategies were identified to address or amplify the barriers or enablers, including involving and preparing staff for the introduction, developing education material, and identifying champions.

The introduction of the RPN role in acute care was shaped by organizational readiness, leadership support, and workforce needs, while challenges related to role clarity and team integration remained. Implementation science approaches may help guide strategies to support the successful integration of new nursing roles within hospital care delivery models.

This study adhered to COREQ guidelines.

No patient or public contribution.