# Understanding Implementation of the Family and Community Nurse Role Using Consolidated Framework for Implementation Research: A Case Study

## TL;DR

This study examines how to successfully implement community nurses in Italy, highlighting the need for policy alignment, organizational flexibility, and professional training.

## Contribution

The study provides insights into the contextual and organizational factors influencing the implementation of Family and Community Nurses in a specific health authority.

## Key findings

- Alignment with national policy and population needs supported adoption of the FCN role.
- Organizational flexibility enabled role adaptation, but fragmented coordination limited integration.
- FCNs showed motivation but lacked confidence in community-based and educational activities.

## Abstract

To explore the factors influencing the Family and Community Nurse (FCN) role implementation within the local health authority (LHA) of Biella, Italy.

Qualitative single embedded case study.

Twenty‐two participants (18 FCNs and 4 managers) were interviewed using in‐depth semistructured interviews and timeline elicitation. Observational data were recorded in field notes. Data were analyzed using the Framework Analysis approach and organized through the Consolidated Framework for Implementation Research.

At the outer setting level, alignment with national policy and population needs supported adoption, although public awareness of the role was initially low. Within the inner setting, organizational flexibility enabled role adaptation, especially regarding project participation and time allocation. However, fragmented coordination with existing services and the persistence of task‐based workflows limited integration. At the individual level, FCNs expressed strong motivation and professional identification, but also reduced confidence linked to limited preparation for community‐based and educational activities. The process was supported by reflective leadership and the progressive tailoring of strategies to local needs and staff competencies.

Implementing the FCN role is a dynamic process shaped by structural conditions, professional boundaries, and stakeholder engagement. Sustainability requires system‐level support, cross‐sector collaboration, and a clearly defined scope of practice.

This study highlights key organizational and contextual conditions required to support the sustainable integration of FCNs. These insights may guide health service managers and policymakers in strengthening community‐based care models, improving interprofessional coordination, and investing in role‐specific education to meet the needs of aging populations.

The study adhered to the Standards for Reporting Qualitative Research.

None.