Implementing evidence-based training for nurses is crucial for improving maternal health, especially in low- and middleincome countries. In Brazil, the Obstetric Nursing Residency Program of Pernambuco (ONRPP) was established to pro mote humanized childbirth care by developing the nursing workforce. This study used the Consolidated Framework for Implementation Research (CFIR) to analyze key factors affecting the program’s implementation. We conducted a qualita tive, multiple-case study at two reference hospitals in Pernambuco. Data were collected through document analysis, semistructured interviews with managers and preceptors, and a focus group with residents. We performed a directed content analysis based on the five domains and 39 constructs of the CFIR. D ata were coded and synthesized using MAXQDA to assess the valence and strength of each construct. Our findings revealed several facilitators, including the strong scientific basis of the training, high resident engagement, and a flexible program structure. However, we also identified significant barriers: lack of infrastructure and funding, weak inter-institutional communication, resistance from some clinical staff, and limited opportunities for feedback. Although residents reported increased autonomy and alignment with evidencebased practices, their role remained ambiguous for some staff. The ONRPP is a promising model for strengthening obstetric nursing and humanized care in Brazil. However, its long-term success requires strategic investment in leadership, communication, and organizational learning. This study contributes to the use of implementation frameworks like CFIR in nursing education and highlights their importance for guiding future scale-up strategies.
Downloa d PDF: https://soalf.eu.org/Oiowqt
