Prioritizing Nursing Interventions for Older Adults with Multimorbidity: Can Nursing-Sensitive Indicators Predict Work Environment and Patient Safety? An Exploratory Co-Creation Project

Background: The relationship between patient safety and the work environment of nurses is hypothesized to have significant implications for both the attrition of nurses from the profession and patient safety. Older patients with multimorbidity are particularly vulnerable in the context of nursing shortages; they often interact with multiple specialties and are at increased risk for adverse events such as restraint use, falls, and medication errors. Nursing-sensitive indicators can potentially predict breaches in patient safety by highlighting changes in patient health status influenced by nursing care. However, the precise nature of this relationship remains unclear.

Objective: To enhance patient safety and the work environment of nurses by developing an intervention that prioritizes nursing interventions in the care of older patients over 65 with multimorbidity. The study aims to determine whether nursing-sensitive indicators related to the work environment can predict patient safety risks.

Methodology: The study is conducted with stakeholders, drawing on principles of action research, and divided into two phases: Phase one involves mapping knowledge, definitions, and concepts through a scoping review with stakeholders to explore the relationship between the work environment of nurses and patient safety for older adults with multimorbidity. Phase two is a case study where an intervention is co-created with nurses in a hospital ward and researchers to improve the work environment and patient safety. The intervention will be tested and evaluated for quality.

Conclusion and perspective: The intervention can potentially retain the nursing workforce, alter workflows, educate staff, optimize resource allocation, enhance care efficiency, and prioritize nursing interventions.