The conceptualization of safe care for older inpatients: A model based on socio-ecological theory

Abstract

Background: Safe care for older adults is a crucial component of clinical practice. Understanding the conceptual connotation of safe care for older hospitalized patients can help improve the safety of geriatric care from multiple dimensions, thereby ensuring patient safety.
Objective: To explore the concept of safe care for older inpatients in the context of population aging and to develop a conceptual model.
Study design: Concept analysis.
Methods: Walker and Avant’s method was used to clarify the concept of safe care. Eight electronic databases (Wanfang Data, China National Knowledge Infrastructure, VIP Database, Web of Science, Embase via Ovid, CINAHL via EBSCO, Cochrane Central Register of Controlled Trials, and PubMed) were searched from inception to March 2025 to identify studies focused on safe care.
Results: This concept analysis included 32 articles. Based on these articles, safe care for older inpatients was defined as follows: “Older inpatients are free from harm, feel safe, actively participate in their care with care- givers, and adapt to the hospital environment, culture, and regulations.” This concept included four defining attributes, four antecedents, three consequences, and three groups of empirical referents related to safe care for older inpatients. In addition, we constructed a model case, a borderline case, and a contrary case.
Conclusions: We developed a conceptual model of safe care for older inpatients that involved theoretical re- lationships among its antecedents, attributes, consequences, and empirical referents. This conceptual model provides a new perspective for healthcare professionals and medical institutions to implement safe care.

Keywords

aged / concept analysis / inpatients / patient safety / socio-ecological theory

Ethics approval

This study was approved by the Ethics Committee on Biomedical Research, West China Hospital of Sichuan University (No. 20221598).

Funding

This study was supported by Sichuan Science and Technology Program [grant number 2025ZNSFSC0018].

CRediT authorship contribution statement

Xiuying Hu: Writing - review & editing, Methodology, Conceptualization. Fang Wang: Formal analysis, Investigation. Li Liu: Writing—review and editing, Investigation. Nanjia Liu: Methodology, Formal analysis, Investigation. Lupei Yan: Writing - original draft, Investigation, Formal analysis, Conceptualization, Methodology. All the authors have read and approved the final version of this manuscript.

Declaration of Generative AI and AI-assisted technologies in the writing process

The authors declare that no Generative AI or AI-assisted technolo- gies were used in the writing process.

Data availability

The datasets generated and/or analyzed during the current study are not publicly available but are available from the corresponding author upon reasonable request.

Declaration of Competing Interest

Xiuying Hu is an editorial board member of Healthcare and Rehabilitation but has not been involved in the journal’s review or de- cisions related to this manuscript. The authors declare that they have no known competing financial interests or personal relationships related to this work.

Acknowledgments

None.

Appendix A. Supporting information

Supplementary data associated with this article can be found in the online version at doi:10.1016/j.hcr.2026.100077.

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