【摘要】 目的 探讨信息化联合专项改进管理降低住院患者跌倒、压力性损伤、非计划拔管发生率的效果，为临床提供一种有效的管理方法。方法 本研究采用前后对照研究设计，选取2018年1月至2023年12月在本院住院的779 249例患者作为研究对象，将2018年1月至2020年12月住院患者360 484例设为实施前组；2021年1月至2023年12月住院患者418 765例设为实施后组。实施前组采用常规护理安全管理模式，实施后组采用信息化联合专项改进管理模式。比较两组患者住院护理相关医疗质量（安全）不良事件总发生率与患者跌倒、压力性损伤、非计划拔管发生率。结果 实施后组与实施前组比较，住院护理相关医疗质量（安全）不良事件总发生率由0.096 0%下降至0.060 2%，压力性损伤发生率由0.012 2%下降至0.005 0%，非计划拔管率由0.058 4‰下降至0.029 7‰，前后比较，差异均有统计学意义（均P<0.001）；跌倒发生率由0.026 7‰下降至0.026 3‰，前后比较，差异无统计学意义（P>0.05）。实施后组上述4个指标在实施信息化联合专项改进管理后均呈逐年下降趋势。结论 信息化联合专项改进管理能有效降低护理相关主要医疗质量（安全）不良事件发生率，保障患者安全。更多还原

【Abstract】 Objective To evaluate the efficacy of an information-based collaborative special improvement management model in reducing the incidences of falls,hospital-acquired pressure injuries（ HAPI） and unplanned extubation among inpatients,hence to offer an effective management strategy. Methods This before-after controlled study included 779,249 inpatients from 1st January,2018 to 31st December,2023. A total 360,484 inpatients were assigned to the pre-implementation group （January 2018-December 2020） and received conventional nursing safety management,while 418,765 inpatients were assigned to the post-implementation group （January 2021-December 2023） and managed with an information-based collaborative special improvement management model. The two groups were compared with total incidence of nursing-related adverse events,rates of falls,HAPI,and unplanned extubation. Results In comparison with the pre-implementation group,the post-implementation group showed significant reductions in rates of total nursingrelated adverse event （from 0.0960% to 0.0602%,P<0.01）,HAPI （all unavoidable pressure injury） （from 0.0122% to 0.0050%,P<0.01）,and unplanned extubation（ from 0.0584‰ to 0.0297‰,P< 0.01）. Falling rate decreased from 0.0267‰ to 0.0263‰,but without significantly different（ P>0.05）. All four indicators demonstrated an annually downward trends after implementation of the informationbased collaborative special improvement management model. Conclusion The information-based collaborative special improvement management model effectively reduces major nursing-related adverse events and enhances the safety of inpatient.更多还原