Abstract
<title>Abstract</title> <p> <bold>Background</bold> With the accelerating process of population aging and shrinking family size, the traditional family-centered inpatient caregiving model in China is becoming increasingly unsustainable, which has promoted the piloting of an unaccompanied-care model, where professionally trained nursing assistants provide bedside care in collaboration with healthcare teams, thereby reducing reliance on family caregivers. Although this model has shown potential advantages in improving ward management and reducing caregiving burdens, its implementation still faces many obstacles. At present, empirical evidence on how this model can be successfully implemented and normalized in China’ s healthcare environment remains relatively scarce. <bold>Aim</bold> To explore facilitators and barriers to implementing the unaccompanied-care model in China and develop strategies. <bold>Methods</bold> Interviews were conducted with 80 stakeholders in three tertiary hospitals in Jinan, China. Data were mapped to CFIR and NPT constructs. Strategies were developed using the CFIR-ERIC tool. <bold>Results</bold> Nine facilitators and eleven barriers were identified. While recognized for its advantages, implementation faces challenges regarding payment misalignment, legal liability, and adaptation within the context of care culture. Five strategies were developed: Economic & Incentive Support, Risk & Liability Management,Infrastructure & Process Optimization, Training & Capacity Building and Culture & Public Trust Shaping. <bold>Conclusion</bold> By integrating the Consolidated Framework for Implementation Research (CFIR) with Normalization Process Theory (NPT) and applying the CFIR-ERIC matching tool, this study systematically elucidates the implementation mechanisms of the unaccompanied-care model within China’ s healthcare context. The study reveals that the normalization process of this model not only requires addressing the objective challenges of financial investment and staffing, but is, in essence, a profound process of adapting a modern nursing system to local economic realities and traditional caregiving culture. </p>