In healthcare settings, the rapid integration of technological innovations often fails to reflect the practical realities of frontline nursing. Traditionally, these innovations have emerged from a top-down design approach, resulting in tools that may not align with daily clinical workflows or address the challenges nurses face. This misalignment can reduce adoption and limit the potential benefits of technology in patient care.
A recent qualitative study at a Dutch academic hospital explored the impact of involving nurses directly in the co-creation of nursing technologies. By focusing on the experiences of nurses and their managers, the study revealed how bottom-up innovation fosters improved professional engagement, collaboration and product usability.
Strengthening the Appeal of the Nursing Profession
The study demonstrated that the co-creation process enhances the attractiveness of nursing by expanding the role of nurses beyond clinical care. Nurses who participated in developing new technologies reported increased job satisfaction, feeling valued for their expertise and problem-solving capabilities. Being recognised as contributors to innovation led to a sense of professional pride and engagement, particularly as these nurses helped design solutions to issues they personally encountered in their practice.
Involvement in co-creation allowed nurses to take on diverse roles, from product development to departmental advocacy. This multi-faceted engagement not only deepened their connection to the organisation but also motivated them to remain in their roles, reducing turnover intent. Participants noted that working in an environment where they could contribute ideas made their jobs more stimulating and meaningful. For some, this opportunity even sparked further interest in improving practice, inspiring others within their teams to take similar initiative.
By incorporating their hands-on knowledge into the design of tools and devices, nurses became central to the innovation process. This participatory environment created a stronger professional identity and helped counter the perception of nursing as limited to task-based duties. The bottom-up model empowered nurses, positioning them as key stakeholders in the future of patient care.
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Fostering a Culture of Inclusion and Support
Co-creation also promoted a culture of collaboration across departments and disciplines. Participants described how inclusive processes encouraged better communication and engagement, especially when nurses, managers, designers and technical students worked together. Such collaboration enhanced mutual respect and improved the likelihood that new tools would be embraced by end users.
Importantly, internal development efforts—especially those involving co-creation—were more likely to be perceived as relevant and valuable. Participants highlighted how projects initiated from within their teams generated more enthusiasm than externally imposed solutions. While external innovations were not dismissed, nurses expressed greater trust in technologies born from their own environment.
Support from leadership was a critical enabler of co-creation success. Managers who allocated time and resources for staff participation played a pivotal role in sustaining innovation. Without this backing, nurses struggled to engage meaningfully due to workload constraints. The presence of a dedicated innovation department was also instrumental, serving as a hub for project facilitation and knowledge sharing.
Beyond internal collaboration, co-creation with patients and families led to more personalised and practical innovations. When families were involved in design decisions, their input improved product relevance and increased the likelihood of consistent use. Nurses observed that this kind of user-centred development enhanced both satisfaction and safety, strengthening trust between patients and care teams.
Balancing Benefits and Challenges in Technological Integration
The innovations developed through bottom-up co-creation were generally described as user-friendly, safe and effective. Participants praised their ease of use and the fact that they could be seamlessly integrated into everyday tasks without special training. These features made the tools immediately useful, reinforcing their value in fast-paced clinical settings.
Products such as clamps for adjusting pressure transducers, infusion line organisers and emergency kits were all cited as improvements that saved time, reduced physical strain and enhanced patient safety. Nurses also appreciated that the designs addressed common frustrations, such as tangled wires or missing supplies, by offering durable and practical alternatives. The visual appeal and perceived quality of the tools helped reduce reliance on ad-hoc workarounds.
However, the study also uncovered barriers to consistent adoption. Some participants encountered design flaws or noted that certain tools were inconvenient in size or appearance, limiting their usability. Others raised concerns about availability, storage and the risk of products being mistaken for disposables and discarded. These practical issues often led to a reversion to familiar practices, highlighting the importance of iterative feedback and follow-up support in the implementation phase.
Changing habits posed another challenge. Even when tools were clearly beneficial, incorporating them into routine practice required effort. Without ongoing reinforcement, some nurses reverted to older methods, particularly under pressure. This resistance underscored the need for continued engagement, training and visible leadership support to normalise innovation within care routines.
The integration of bottom-up co-creation in nursing environments has significant potential to reshape how technological innovations are developed and adopted in healthcare. By involving nurses in the design and implementation of tools tailored to their workflows, the approach fosters a stronger professional identity, enhances collaboration and results in practical, usable products. While challenges such as time constraints and change management remain, the study affirms that co-creation is a promising strategy for driving meaningful improvements in nursing practice. A culture that embraces frontline expertise and shared innovation can lead to more effective, satisfying and sustainable healthcare delivery.
Source: JMIR Human Factors
Image Credit: iStock
