Transforming Care: Co-produced Interventions to Enhance Patient Safety in Complex Mental Health Settings – A PhD Study

The shortage of nurses, particularly in caring for patients over 65 with coexisting physical and mental health conditions, is a critical issue within healthcare. Patients face fragmented care due to complex treatment needs, increasing risks like medication errors and readmissions. These challenges are prominent in mental health settings, where patients may present with aggression and unpredictable behavior. Poor nursing work environments (high workloads, low staffing) affect nurses' mental health, leading to burnout and compromised quality and care.

Aim
To enhance patient safety and improve the work environment for nurses by developing an intervention to support the prioritization of nursing interventions in caring for elderly patients with multimorbidity.

Methods
Sub-study 1: A scoping review to explore the link between nurses’ work environment and patient safety for elderly patients with multimorbidity, identifying key nursing-sensitive indicators.

Sub-study 2: A co-production process to develop an intervention (e.g., decision support tools or educational programs) with clinical stakeholders and lecturers, integrating findings from sub-study 1 and electronic safety data.

Sub-study 3: Workshops with nurses and lecturers for feedback and refinement, followed by testing in a psychiatric ward and nursing education to assess the intervention's impact.

Expected outcomes include a prototype that enhances nurses' ability to prioritize care in complex situations, thus improving quality and efficiency. This may increase self-efficacy, positively impact well-being and job satisfaction; key to reducing burnout and turnover. Project outcomes are incorporated into the nursing curricula to equip future nurses for complex demands.

This study highlights the need to address patient safety and nurses’ work environment in caring for patients with complex needs. Aggression, absconding, and the use of restraint, common in mental health settings, are critical predictors of safety issues, as they often indicate underlying care challenges. The intervention leverages nurse-sensitive indicators to improve prioritization, reducing risks related to fragmented care. By co-developing, the tool aligns with real-world needs and enhances adaptability. Incorporating the prototype into nursing education and electronic health platforms prepares future and current nurses to manage complex care. Future research should assess long-term effectiveness and impact on patient safety and nurse well-being.