Post-implementation experiences of the breastfeeding promotion entrustable professional activities project in undergraduate nursing education: A qualitative descriptive study.

AIM: To explore nursing instructors' and clinical nurses' experiences following the implementation of the Breastfeeding Promotion Entrustable Professional Activities (BFP-EPAs) programme and to understand the contextual factors influencing its implementation and sustainability within academic-clinical partnerships. BACKGROUND: Entrustable Professional Activities (EPAs) are increasingly adopted to bridge competency-based education and clinical practice. However, evidence regarding their implementation in undergraduate nursing education, particularly in breastfeeding education, remains limited. DESIGN: Qualitative descriptive study. METHODS: Purposive sampling was used to recruit 20 participants from 14 academic-clinical partnership sites implementing the BFP-EPAs programme in Thailand. Data were collected through semi-structured interviews and analysed using thematic analysis. The Consolidated Framework for Implementation Research guided data interpretation. RESULTS: Six themes were identified: (1) reframing breastfeeding education towards entrustable practice; (2) programme characteristics; (3) outer setting influences; (4) organisational readiness and collaboration; (5) individual attitudes and professional identity; and (6) implementation processes. Participants perceived that the BFP-EPAs programme enhanced educational structure, clarified performance expectations and strengthened students' clinical confidence. However, implementation was influenced by contextual constraints, including workload, staffing limitations and policy-practice misalignment. Feedback mechanisms and strong academic-clinical collaboration were central to competency development and sustained implementation. CONCLUSION: The implementation of the BFP-EPAs programme represents a system-level transition that requires alignment across educational and clinical settings. While early outcomes are promising, sustainability depends on organisational readiness, ongoing support and integration into routine educational and clinical practice.