Hindering and Facilitating Factors While Implementing the Family and Community Nursing Model in Italy: Findings from a Qualitative Study

Abstract

Background/Objectives: Several Italian regions have started to introduce the Family and Community Nurse model. The aim of this study was to describe the facilitating and hindering factors that have influenced the implementation of the model by analyzing regional policies from the perspective of nurses appointed as Family and Community Nurses. Methods: A qualitative study from 2023 to 2024 following the Standards for Reporting Qualitative Research. Nurses attending a training course were eligible (N = 68) and multi-method data collection was used. Mandatory written project works were requested at the end of the course, and interviews conducted after six months with 14 purposively selected nurses were used. The data were subjected to content analysis. The factors identified were categorized by level (nurse, microsystem, mesosystem, exosystem, and macrosystem) and by the domains of the Consolidated Framework for Implementation Research. Results: A total of 23 facilitating factors and 20 hindering factors were identified across all levels and four domains of the Consolidated Framework for Implementation Research. Implementation required nurses to shift from a task-oriented to a user-oriented approach to care that emphasizes accountability and citizen needs. Facilitating factors were the availability of advanced competencies, digital skills, familiarity with communities, and effective teamwork supported by leaders. Challenges arose from fragmented systems and unmet community expectations. Strengthening cross-sector collaboration, fostering trust, and engaging third sector resources were critical factors hindering holistic, patient-centred care. Conclusions: The Family and Community Nurses model promotes integrated, patient-centred care through proactive approaches that require advanced competence and interprofessional collaboration. Training, leadership support, and the removal of systemic barriers are critical. Future research should focus on integrating the identified factors into strategies to optimize the implementation of the Family and Community Nurses model.

Keywords: consolidated framework for implementation research; experiences; facilitating; family and community nurse; hindering; models of care delivery.

Figure 1

Facilitating and hindering factors according to the Consolidated Framework for Implementation Research [21,22].