Third-year, bachelor-level nursing students’ experiences of using the Subacute Acute Functional Decline in the Elderly (SAFE) assessment tool in clinical practice – a qualitative study in the Norwegian context

Introduction: Nursing education in Norway involves a comprehensive approach that includes theoretical knowledge and practical skills, especially in home-based health services. This study aimed to investigate the experiences and challenges nursing students encounter while using the Subacute and Acute Dysfunction in the Elderly (SAFE) tool during their clinical practice, particularly in home-based settings. Methods A qualitative descriptive study was conducted, involving focus group interviews with 15 nursing students in their final semester who had clinical practice in home-based nursing care in Oslo, Norway. Data were collected through three focus groups, adhering to COREQ criteria. Results Three aggregated dimensions were identified: SAFE enhances student clinical assessment skills, SAFE integration affects student clinical instruction, and SAFE inspires student insight into nursing challenges. Issues such as inconsistent training, inadequate guidance and challenges accessing previous assessments and standardized documentation impact the effective implementation of SAFE in clinical practice. Conclusion Study findings highlight that incorporating the SAFE tool into nursing education may improve students’ clinical assessment skills, particularly within home-based nursing for older patients. Effective integration depends on combining theoretical knowledge with practical application, including simulations and supervised clinical experiences. Structured training and mentorship are essential to leverage the full benefits of SAFE, emphasizing the need for a balanced educational approach. Overcoming these challenges is crucial for enhancing the quality of nursing education and improving home-based patient care.