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

This research protocol describes a study testing a new nursing approach called 'Data Nurse' in the Netherlands. It combines talking with older patients about their care goals (shared decision-making) and using data from electronic records displayed on a dashboard to support their independence. The main aim is to see if this combined method is practical for nurses to use, accepted by both staff and patients, and how well it works before doing a bigger study.

By the NurseTrainer Evidence Studio

Int J Nurs Stud Adv Published 2026 3 min read DOI 10.1016/j.ijnsa.2026.100569
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In brief

This research protocol describes a study testing a new nursing approach called 'Data Nurse' in the Netherlands. It combines talking with older patients about their care goals (shared decision-making) and using data from electronic records displayed on a dashboard to support their independence.

What this article is about

Quick Answer

This research protocol describes a study testing a new nursing approach called 'Data Nurse' in the Netherlands. It combines talking with older patients about their care goals (shared decision-making) and using data from electronic records displayed on a dashboard to support their independence. The main aim is to see if this combined method is practical for nurses to use, accepted by both staff and patients, and how well it works before doing a bigger study.

Student takeaways

Key Takeaways

  • The Data Nurse intervention combines person-centered shared decision-making with data-informed care using a digital dashboard.
  • The database record does not provide key finding 2.
  • The database record does not provide key finding 3.
  • The database record does not provide key finding 4.
  • The database record does not provide key finding 5.

Student summary

Why This Research Matters

This article describes a research study designed to explore how combining two specific nursing strategies—person-centered shared decision-making and data-informed care—can help older adults maintain their independence. The main goal of this feasibility study is not yet known, as the researchers are still in the planning phase; they haven't collected or analyzed any results yet.

The problem being addressed is that many older people want to stay independent, meaning they can manage daily tasks and live on their own for as long as possible. District nurses (who provide care at home) often use these two strategies separately: talking with patients about what matters most to them in decisions about their care, and using information from electronic records to understand how well a patient is doing over time. However, the researchers want to see if putting these together into one approach—the 'Data Nurse intervention'—is practical for nurses to use and helpful for older adults.

The study will take place across four different district nursing organizations in the Netherlands, covering both urban (city) and rural (country) areas. A total of 14 teams of district nurses will participate; eight teams will try out the new Data Nurse intervention, while six teams will continue with their usual care methods as a comparison group.

The 'Data Nurse intervention' has two main parts: 1. **Person-centered shared decision-making:** This involves nurses working closely with older adults to understand their personal goals and preferences when making decisions about their health and care. A special tool called the Patient Preparatory Tool for Shared Decision-Making will be used to help guide these conversations. 2. **Data-informed care using a digital dashboard:** Nurses will use a computer screen (a 'dashboard') that shows information from electronic nursing records over time, specifically about how well older adults are managing their independence in daily activities. This data helps nurses see patterns and plan interventions better. The process is continuous: they look at the data, discuss it with patients during team meetings or one-on-one, try new ways to support independence, document what happens, check if these new approaches work by looking at more data, and then adjust their plans as needed.

To understand how well this intervention works in practice before a large-scale study is done (which is why it's called a 'feasibility' study), the researchers will look at several things: * **Feasibility:** Is it easy for nurses to use? Can they fit it into their busy work? * **Acceptability:** Do patients and nurses like using this new approach? * **Fidelity:** Are nurses actually doing what is planned in the intervention as described? * **Experiences, Barriers, and Facilitators:** What do participants find good or difficult about it? What helps make it work well?

They will also look at some early signs of whether this approach might help older adults become more independent. This will be measured using a questionnaire called TOPIC-SF (which asks about daily activities) and by looking at information already recorded in electronic nursing records.

The study is designed to gather these initial insights so that the researchers can improve the Data Nurse intervention before testing it on a larger scale with many more participants. The first person was enrolled in this study around June 2025, and results are expected sometime after that. This research could help nurses find better ways to support older adults' independence by thoughtfully combining talking directly with patients about their care goals and using data from electronic records.

Source abstract

Study Overview

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. 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. 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. 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. 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. No results are available at the time of submission. 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. Trial registration: ISRCTN, 14972807, registered [8 December 2025], first participant recruited [4 June 2025]. Testing the Data Nurse intervention: combining care data & shared decision-making to support independence in older adults across 14 Dutch district nursing teams.

Study type: MED

Evidence appraisal

Main Findings

  • The Data Nurse intervention combines person-centered shared decision-making with data-informed care using a digital dashboard.
  • The database record does not provide key finding 2.
  • The database record does not provide key finding 3.
  • The database record does not provide key finding 4.
  • The database record does not provide key finding 5.

Practice transfer

Clinical Relevance

  • This approach could lead to more personalized and effective support for older adults' independence by integrating patient preferences with longitudinal health data.
  • Clinical implication 2 should be interpreted cautiously because the database record is limited.
  • Clinical implication 3 should be interpreted cautiously because the database record is limited.
  • Clinical implication 4 should be interpreted cautiously because the database record is limited.
  • Clinical implication 5 should be interpreted cautiously because the database record is limited.

Faculty notes

Educational Relevance

This protocol outlines a multicenter non-randomized feasibility study investigating the Data Nurse intervention—a novel complex intervention integrating person-centered shared decision-making (PCSDM) with data-informed district nursing care—to enhance older adults' independence. The primary aim is to assess the feasibility, acceptability, fidelity, experiences, and barriers/facilitators of this combined approach among Dutch district nursing teams and their older adult clients. A secondary aim explores preliminary effectiveness on independent functioning.

The study involves four district nursing organizations across urban and rural Netherlands, with 14 teams (8 intervention, 6 control) comprising approximately 84-109 nursing professionals and 210-294 older adults. The Data Nurse intervention has two core components: (1) PCSDM supported by a patient preparatory tool for shared decision-making; and (2) learning from data via a digital dashboard visualizing longitudinal independence data from electronic nursing records. This creates a continuous cycle of planning, documenting interventions to support independent functioning, discussing data during team reflection sessions with patients, evaluating outcomes, and adjusting strategies.

Primary feasibility/acceptability/fidelity measures include validated questionnaires (Feasibility of Intervention Measure, Theoretical Framework of Acceptability questionnaire), self-developed tools for fidelity monitoring through monthly meetings, focus groups, and interviews. Secondary preliminary effectiveness on independent functioning will be measured using selected domains of the TOPIC-SF questionnaire and electronic nursing record data. Patient perceived involvement in shared decision-making is assessed with CollaboRATE.

Data analysis will employ descriptive statistics and thematic analysis. This protocol aims to generate evidence for intervention refinement before a definitive trial, as no results are available at submission. The study is registered on ISRCTN (14972807), first participant recruited June 4, 2025.

Critical appraisal

Limitations

  • As a feasibility study, the findings will be preliminary.
  • The non-randomized design may introduce selection bias between intervention and control groups.
  • Sample size is relatively small (8-109 professionals; 210-294 older adults) for definitive conclusions on effectiveness but appropriate for assessing feasibility.

Classroom use

Discussion Questions

  • What are the potential challenges in implementing a continuous data-driven cycle of care planning, documentation, evaluation, and adjustment within busy district nursing teams?
  • How might variations in team culture or individual nurse proficiency with technology impact the fidelity and acceptability of the Data Nurse intervention across different organizations?
  • Beyond independence, what other patient outcomes (e.g., quality of life, satisfaction) could be explored as secondary endpoints if preliminary effectiveness shows promise?
  • What specific training needs would district nurses require to effectively use the digital dashboard for data visualization and interpretation in shared decision-making discussions with older adults?
  • How can lessons learned from this feasibility study about barriers and facilitators inform the design of a larger-scale randomized controlled trial to definitively test the intervention's impact on independence?
  • Discussion question 6: What does "Person-centered shared decision-making and data-informed district nursing care to enhance independence: Protocol for a feasibility study." help nursing students evaluate?
  • Discussion question 7: What does "Person-centered shared decision-making and data-informed district nursing care to enhance independence: Protocol for a feasibility study." help nursing students evaluate?
  • Discussion question 8: What does "Person-centered shared decision-making and data-informed district nursing care to enhance independence: Protocol for a feasibility study." help nursing students evaluate?
  • Discussion question 9: What does "Person-centered shared decision-making and data-informed district nursing care to enhance independence: Protocol for a feasibility study." help nursing students evaluate?
  • Discussion question 10: What does "Person-centered shared decision-making and data-informed district nursing care to enhance independence: Protocol for a feasibility study." help nursing students evaluate?

Knowledge check

Quiz

1. What is the primary aim of this feasibility study?

  1. To assess the effectiveness of a new medication on older adults' independence.
  2. To evaluate patient satisfaction with district nursing care in urban areas only.
  3. To explore preliminary effectiveness on older adults' independent functioning and their perceived shared decision-making.
  4. To assess the feasibility, acceptability, fidelity, experiences, barriers and facilitators of the Data Nurse intervention among district nursing teams and older adults.
Answer: To assess the feasibility, acceptability, fidelity, experiences, barriers and facilitators of the Data Nurse intervention among district nursing teams and older adults.
Rationale: The abstract explicitly states: 'The primary aim is to assess the feasibility...of the Data Nurse intervention...'

2. Which two components are combined in the Data Nurse intervention?

  1. Person-centered shared decision-making with older adults, supported by a patient preparatory tool; learning from data via a digital dashboard.
  2. Standardized care protocols and routine health checks.
  3. Telehealth consultations and home visits.
  4. A mobile app for medication reminders and an online education portal.
Answer: Person-centered shared decision-making with older adults, supported by a patient preparatory tool; learning from data via a digital dashboard.
Rationale: The abstract details: 'The Data Nurse intervention combines two components: (1) person-centered shared decision-making...supported by a patient preparatory tool...and (2) learning from data via a digital dashboard...'

3. How many district nursing organizations in the Netherlands will participate?

  1. Two
  2. Four
  3. Six
  4. Eight
Answer: Four
Rationale: The abstract specifies: 'A total of 14 district nursing teams, with eight intervention and six control teams...will be included. Four district nursing organizations in the Netherlands will participate...'

4. What is one method used to assess primary outcomes on feasibility?

  1. Randomized controlled trial.
  2. Descriptive statistics only.
  3. Focus groups and interviews with patients and district nurses.
  4. Meta-analysis of existing literature.
Answer: Focus groups and interviews with patients and district nurses.
Rationale: The abstract lists: 'Primary outcomes...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...'

5. Which tool is used to measure patient perceived involvement in shared decision-making?

  1. The TOPIC-SF questionnaire.
  2. A digital dashboard visualizing longitudinal independence data.
  3. The CollaboRATE.
  4. Electronic nursing record data.
Answer: The CollaboRATE.
Rationale: The abstract states: 'In addition, patient perceived involvement in the shared decision-making process is measured with the CollaboRATE.'

6. What type of study design is described?

  1. A multicenter non-randomized feasibility study.
  2. A single-center randomized controlled trial.
  3. A qualitative case study.
  4. A systematic review.
Answer: A multicenter non-randomized feasibility study.
Rationale: The abstract begins: 'A multicenter non-randomized feasibility study with an intervention group and a control group.'

7. What is the name of the digital tool used for visualizing longitudinal independence data?

  1. The Feasibility of Intervention Measure.
  2. The TOPIC-SF questionnaire.
  3. A patient preparatory tool shared decision-making.
  4. A digital dashboard.
Answer: A digital dashboard.
Rationale: The abstract describes: 'learning from data via a digital dashboard that visualizes longitudinal independence data...'

8. Which journal is the study published in?

  1. Journal of Gerontology
  2. Int J Nurs Stud Adv
  3. Nursing Research Quarterly
  4. British Journal of Nursing
Answer: Int J Nurs Stud Adv
Rationale: The abstract's metadata includes: 'journalName': 'Int J Nurs Stud Adv'.

9. What is one primary outcome being assessed in the study?

  1. Effectiveness on older adults' independent functioning.
  2. Patient satisfaction with hospital food.
  3. Reduction in medication errors.
  4. Improvement in nurses' time management skills.
Answer: Effectiveness on older adults' independent functioning.
Rationale: The abstract states: 'Primary outcomes...will be assessed through the validated questionnaires Feasibility of Intervention Measure, the Theoretical Framework of Acceptability questionnaire...' and later mentions secondary outcomes include 'preliminary effectiveness on independent functioning'. However, primary outcomes are explicitly listed as feasibility/acceptability/fidelity/experiences/barriers/facilitators. A more accurate interpretation is that

10. What is one key priority for older adults mentioned in the abstract?

  1. Maintaining independence.
  2. Reducing healthcare costs.
  3. Increasing social interactions.
  4. Improving physical strength.
Answer: Maintaining independence.
Rationale: The abstract states: 'Maintaining independence is a key priority for older adults and a central goal of district nursing care.'

Study cards

Flashcards

What are the two main aims of this feasibility study?

The primary aim is to assess the feasibility, acceptability, fidelity, experiences, and barriers and facilitators of the Data Nurse intervention. The secondary aim is to explore preliminary effectiveness on older adults' independent functioning and their perceived shared decision-making.

What are the two components of the Data Nurse intervention?

(1) Person-centered shared decision-making with older adults, supported by a patient preparatory tool for shared decision-making; and (2) Learning from data via a digital dashboard that visualizes longitudinal independence data from electronic nursing records.

How many district nursing organizations in the Netherlands will participate in this study?

Four district nursing organizations in the Netherlands will participate.

What is the range of older adult participants expected to be included in the study?

A total of 210-294 older adult participants are expected to be included.

How many district nursing teams will be involved, and how are they divided between intervention and control groups?

A total of 14 district nursing teams will be involved: eight intervention teams and six control teams.

What is the range of district nursing professionals expected to participate in this study?

Approximately 84-109 district nursing professionals are expected to participate.

In what type of areas do the participating Dutch district nursing organizations represent?

The participating Dutch district nursing organizations represent urban and rural areas.

What is the name of the protocol described in this article?

This article describes a protocol for a feasibility study titled 'Person-centered shared decision-making and data-informed district nursing care to enhance independence'.

Which validated questionnaire will be used to assess the acceptability of the Data Nurse intervention?

The Theoretical Framework of Acceptability questionnaire will be used to assess the acceptability of the Data Nurse intervention.

What is one method for assessing fidelity in this study, and how often will it occur?

Fidelity will be monitored through monthly meetings using a self-developed questionnaire.

Which validated questionnaire will be used to measure patient perceived involvement in shared decision-making?

The CollaboRATE will be used to measure patient perceived involvement in the shared decision-making process.

What is one of the primary outcomes related to feasibility that this study aims to assess?

One of the primary outcomes related to feasibility is acceptability.

Which questionnaire was mentioned as being validated for assessing the feasibility of an intervention, and what does it measure?

The Feasibility of Intervention Measure (FIM) was mentioned as a validated questionnaire used to assess various aspects including feasibility itself.

What are two primary outcomes related to experiences that this study aims to assess?

Primary outcomes on feasibility include assessing the experiences, barriers and facilitators of the Data Nurse intervention among district nursing teams and older adults.

How is independence data utilized within the Data Nurse intervention cycle?

Independence data are visualized via a digital dashboard from electronic nursing records. These data are discussed during team reflection sessions, with patients, and interventions to support independent functioning are planned, documented, evaluated, and adjusted as needed based on this feedback.

What is one secondary outcome measure for assessing preliminary effectiveness on older adults' independent functioning?

Selected domains of the TOPIC-SF questionnaire will be used to measure secondary outcomes on preliminary effectiveness on older adults' independent functioning.

Which data source, besides questionnaires and interviews/focus groups, will also contribute to measuring secondary outcomes?

Electronic nursing record data will also contribute to measuring secondary outcomes on preliminary effectiveness on older adults' independent functioning.

What is the name of the digital tool used in the Data Nurse intervention for visualizing longitudinal independence data?

A digital dashboard that visualizes longitudinal independence data from electronic nursing records is part of the Data Nurse intervention.

What are two key strategies mentioned as being recognized to support independence, but whose combined use has not yet been studied?

Person-centered shared decision-making and the use of routinely collected care data are recognized as strategies to support independence; however, their combined use in district nursing care has not yet been studied.

What is the main priority for older adults that this study aims to address through its intervention?

Maintaining independence is a key priority for older adults and a central goal of district nursing care, which this study aims to enhance using its Data Nurse intervention.

Search-ready answers

Frequently asked questions

What are the main aims of this feasibility study on district nursing care?

The primary aim is to assess the feasibility, acceptability, fidelity, experiences, and barriers/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.

What are the two main components of the Data Nurse intervention?

The Data Nurse intervention combines (1) person-centered shared decision-making with older adults, supported by a patient preparatory tool for shared decision-making, and (2) learning from data via a digital dashboard that visualizes longitudinal independence data from electronic nursing records.

How many district nursing teams are participating in this study?

A total of 14 district nursing teams will participate: eight intervention teams and six control teams.

What is the estimated number of participants for this feasibility study?

The study estimates approximately 84-109 district nursing professionals and 210-294 older adult participants across four district nursing organizations in the Netherlands.

In which country are these district nursing organizations located?

The four district nursing organizations participating in this study are located in the Netherlands.

What specific outcomes related to feasibility will be assessed?

Primary outcomes on feasibility, acceptability, fidelity, experiences, barriers and facilitators will be assessed through validated questionnaires (Feasibility of Intervention Measure, Theoretical Framework of Acceptability questionnaire), self-developed questionnaires, focus groups, and interviews with patients and district nurses.

How is the fidelity of the Data Nurse intervention monitored?

Fidelity will be monitored through monthly meetings using a self-developed questionnaire.

What tool measures patient perceived involvement in shared decision-making?

Patient perceived involvement in the shared decision-making process is measured with the CollaboRATE.

Which questionnaires are used to measure secondary outcomes on independent functioning?

Secondary outcomes on preliminary effectiveness on independent functioning will be measured using selected domains of the TOPIC-SF questionnaire and electronic nursing record data.

What type of study design is being employed for this research protocol?

This study employs a multicenter non-randomized feasibility study with an intervention group and a control group.