Translating a Nurse-Led Coping-Sleep-Adherence Bundle Into Routine Cardiovascular Care: A Theory-Informed...

Adults with cardiovascular disease frequently experience anxiety, sleep disturbance, and challenges with long-term treatment adherence. These factors are associated with poorer quality of life, reduced engagement in guideline-directed therapy, and increased healthcare utilization. Although nurses are well-positioned to address these needs, nurse-led behavioral interventions often encounter barriers to sustained adoption in routine clinical practice.

In this study, we aimed to describe a theory-informed implementation blueprint for integrating a nurse-led coping-sleep-adherence bundle into routine cardiovascular care.

This paper integrates established implementation science frameworks, including the Consolidated Framework for Implementation Research, Expert Recommendations for Implementing Change, the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework, and the Practical, Robust Implementation and Sustainability Model, to guide the development of a structured implementation blueprint aligned with nursing workflows and organizational context.

The proposed blueprint demonstrates how implementation strategies can be systematically aligned with intervention components, clinical workflows, and contextual factors. The integration of frameworks supports feasibility, promotes fidelity, and facilitates evaluation across multiple implementation outcomes, including reach, adoption, and sustainability.

This implementation blueprint provides a practical roadmap for embedding psychosocial and behavioral care into routine cardiovascular nursing practice. By operationalizing implementation science frameworks, it supports the integration and long-term maintenance of nurse-led interventions and strengthens nursing leadership in advancing evidence-based, whole-person cardiovascular care.