Developing a Context-Sensitive Implementation Science Framework for Evidence-Based Nursing Interventions in Resource-Limited Nigerian Hospitals

Background: Implementation science frameworks guiding evidence-based practice adoption are predominantly derived from high-income country healthcare systems and lack contextual validity for resource-limited Nigerian hospital environments. Aim: This study developed a context-sensitive implementation science framework for evidence-based nursing interventions in resource-limited Nigerian hospitals. Methods: A three-phase study design was adopted. Phase one conducted a systematic review of implementation frameworks and their applicability to low-resource settings. Phase two used participatory action research with 55 nurses and 12 nurse managers across six hospitals in North West, South East, and South South Nigeria to co-develop a locally adapted framework. Phase three pilot-tested the framework through implementation of two evidence-based nursing interventions across three hospitals over nine months. Results: The resulting CONTEXT-N Framework comprised six domains: contextual assessment, organisational readiness, nurse-centred co-design, training and capacity building, embedded sustainability planning, and continuous learning cycles. Pilot testing demonstrated improved evidence uptake rates compared with conventional implementation approaches. Conclusion: The CONTEXT-N Framework offers a rigorous, contextually grounded tool for guiding evidence-based nursing implementation in Nigerian hospitals. Its adoption can systematically improve translation of nursing research into practice across resource-varied settings. Keywords: implementation science, evidence-based practice, nursing, resource-limited hospitals, Nigeria.