The Delphi-method to identify nursing sensitive risks with regard to patient safety—A single center project

Background Clinical risk management in hospitals is vital to ensuring patient safety by identifying potential risks. Various methods exist for risk identification, categorized into retrospective/reactive and prospective/proactive approaches. Prospective methods aim to anticipate risks before they manifest. Despite its potential efficacy, the Delphi method remains underutilized in the context of hospital patient care risk identification. Methods A Delphi study was conducted to identify nursing-sensitive risks with regard to patient safety in one university-affiliated hospital. The study involved three rounds of expert questioning, focusing on identifying and evaluating risks using a structured anonymous communication process. Experts from various nursing specialties were asked to describe significant nursing-sensitive risks in their areas. The risks were then assessed for their consequences and likelihood of occurrence. Results Fifteen experts completed the first round, identifying 43 risks, which were consolidated into 32 unique risks. Consensus on risk assessment was achieved for 38 out of 64 evaluations (59%) in the second round and improved to 77% consensus in the final round for the remaining disagreements. Experts identified challenges in assessing risks outside their specific expertise, which affected consensus achievement. Feedback indicated a preference for face-to-face discussions to enhance understanding. Conclusion The Delphi method presents a viable alternative for identifying nursing-sensitive risks related to patient safety. Anonymity and structured communication promote objective evaluation, though expertise verification and potential bias from hierarchical dynamics remain challenges. Future research should consider a two-phase or modified Delphi approach to enhance expert risk assessment and consider multiprofessional input for a comprehensive evaluation.