Person-centered shared decision-making and data-informed district nursing care to enhance independence: Protocol for a feasibility study

Abstract

Background Maintaining independence is a key priority for older adults and a central goal of district nursing care. Although person-centered shared decision-making and the use of routinely collected care data are recognized as strategies to support independence, their combined use in district nursing care has not yet been studied. Objective This study has two aims. The primary aim is to assess the feasibility, acceptability, fidelity, experiences, and barriers and facilitators of the Data Nurse intervention among district nursing teams and older adults. The secondary aim is to explore preliminary effectiveness on older adults' independent functioning and their perceived shared decision-making. Design and setting A multicenter non-randomized feasibility study with an intervention group and a control group. Four district nursing organizations in the Netherlands will participate, representing urban and rural areas. Participants A total of 14 district nursing teams, with eight intervention and six control teams, with approximately 84–109 district nursing professionals and 210–294 older adult participants will be included. Methods The Data Nurse intervention combines two components: (1) person-centered shared decision-making with older adults, supported by a patient preparatory tool shared decision-making, and (2) learning from data via a digital dashboard that visualizes longitudinal independence data from electronic nursing records. In this continuous cycle, interventions to support independent functioning are planned and documented; independence data are visualized and discussed during team reflection sessions, discussed with patients, and interventions to support independent functioning are evaluated and adjusted as needed. Primary outcomes on feasibility, acceptability, fidelity, experiences, barriers and facilitators will be assessed through the validated questionnaires Feasibility of Intervention Measure, the Theoretical Framework of Acceptability questionnaire, the Theoretical Domains Framework, self-developed questionnaires, focus groups, and interviews with patients and district nurses. Fidelity will be monitored through monthly meetings using a self- developed questionnaire. Secondary outcomes on preliminary effectiveness on independent functioning will be measured using selected domains of the TOPIC-SF questionnaire and electronic nursing record data. In addition, patient perceived involvement in the shared decision-making process is measured with the CollaboRATE. Data will be analyzed using descriptive statistics and thematic analysis. Results No results are available at the time of submission. Conclusions This protocol describes a feasibility study to generate evidence on the feasibility and preliminary effectiveness of a novel complex intervention combining person-centered shared decision-making with data-informed care in district nursing to enhance independence. Findings will inform the intervention refinement. Registration Trial registration: ISRCTN, 14972807, registered [8 December 2025], first participant recruited [4 June 2025]. Social media abstract Testing the Data Nurse intervention: combining care data & shared decision-making to support independence in older adults across 14 Dutch district nursing teams.