目的：探讨基于信息化平台分层管理预防住院患者跌倒护理实践的效果。方法：分别选取2021年1月至9月和2022年1月至9月东南大学附属中大医院成人住院患者为观察组(56 121例)和试验组(59 561例)。观察组采用常规跌倒预防管理措施，试验组实施基于信息化平台的分层管理措施，比较两组患者跌倒结果指标、临床过程指标及效益指标。结果：试验组跌倒发生率及伤害占比、季度发生≥2起跌倒不良事件护理单元占比均低于观察组，差异有统计学意义(P＜0.05)。过程指标中防跌倒措施落实达标率、护士跌倒风险等级评估准确率及知晓率均高于观察组，差异有统计学意义(P＜0.001)。跌倒伤害外科手术占比及由此增加的住院床日数和费用均数比较，绝对值有下降趋势但差异无统计学意义(P>0.05)。结论：基于信息化平台的分层管理预防住院患者跌倒的护理实践，护士应用便利，通过前馈控制、过程控制、反馈控制的管理，从动态评估及个体化因素全面分析住院患者的跌倒风险，依据不同风险等级针对性提供干预措施。此模式保证防跌倒措施的持续落实，有效降低跌倒不良事件的发生，为跌倒护理管理质量得到可持续发展提供保障。

[1] IRANDA D M,NIETO R L,CONCHEIRO M P,et al.Occupational therapy and the use of technology on older adult fall prevention:a scoping review[J].Int J Environ Res Public Health,2021,18(2):702.
[2] 刘加婷,邓子银,赵丽蓉，等.护士在临床中应用《住院患者跌倒预防临床实践指南》的质性研究[J].护士进修杂志,2023,38(12):1118-1122.
[3] MATARESE M,IVZIKU D,BARTOLOZZI F,et al.Systematic review of fall risk screening tools for older patients in acute hospitals[J].J Adv Nurs,2015,71(6):1198-1209.
[4] MERRETT A,THOMAS P,STEPHENS A,et al.A collaborative approach to fall prevention[J].Can Nurse,2021,107(8):24- 29.
[5] 中国医院协会.中国医院协会患者安全目标(2022版)[J].中国医院,2021,21(1):81.
[6] 中华人民共和国卫生部.国家卫生健康委办公厅关于印发《三级医院评审标准(2020年版)实施细则的通知[国卫办医发(2021)19号［EB/OL].(2021-10-09)[2021-11-10].http://www.nhc.gov.cn/yzygj/s7657/202110/b9fceda937184f259ecae7ece8522d24.shtml.
[7] 江苏省卫生健康委.江苏省三级综合医院评审标准实施细则(2023版)[EB/OL].(2023-09-09).https://wjw.jiangsu.gov.cn/art/2023/9/22/art_55461_11023452.htmll.
[8] 曹建芬,石兰萍,刘畅,等.智能化护理风险防控系统的建立与应用[J].护理学杂志,2021,36(24):53-56.
[9] 陈云,江雅,陈妙霞，等.基于风险预警系统理论的护理风险层级管理体系构建及应用[J].现代临床护理,2022,21(4):60-65.
[10] 王嘉.层级护理管理在提高老年脑血管病患者护理质量方面的应用效果观察[C]//第三届全国医药研究论坛论文集(一).西安：榆林市医学会,2023:11.
[11] 中华护理学会.成人住院患者跌倒风险评估及预防:T/CNAS18-2020[S/OL].(2021-02-01)[2022-12-15].http://hltb.kxj.org.cn/index/tuanti/standard.html?team_standard_id=25.
[12] 蔡莹莹,张俊峰,郑可欣,等.老年肿瘤患者跌倒评估及管理最佳证据总结[J].护理学报,2021,28(18):22-27.
[13] SATTAR S,KENIS C,HAASE K,et al.Falls in older patients with cancer:Nursing and Allied Health Group of International Society of Geriatric Oncology review paper[J].J Geriatr Oncol,2020,11(1):1-7.
[14] FONG E.Falls(older people)prevention:implementation strategies[EB/OL].(2021-01-11)[2021-07-26].http://ovidsp.ovid.com/ovidweb.cgi?T=JS & PAGE=reference & D=jbi＆NEWS=N &An=JBI8145.
[15] BERRY S,SCHMADER K E,GIVENS J.Falls:prevention in nursing care facilities and the hospital setting [EB/OL].(2020-07-14)[2021-07-26].http://qhu.h5.goftpgaga.xyz/rwt/257/https/P75YPLUWPB4G83DBPSTT6Z5P/contents/falls-prevention-in nursing-care-facilities-and-the-hospital-setting?search=fall & source=Out% 20 of %20 date% 20-%20zh-Hans & selected Title=6-150.
[16] KIEL D P,SCHMADER K E,GIVENS J.Falls in older persons:riskfactors and patient evaluation [EB/OL].(2021-06-01)[2021-07-26].http://qhu.h5.goftpgaga.xyz/rwt/257/https/P75YPLUWPB4G83DBPSTT6Z5P/contents/falls-in-older-persons-risk-factors-and-patient-evaluation? Search=fall & source= search_result & selected Title=1~150 & usage_type=default & display_rank=1.
[17] Registered Nurses Association of Ontario.Preventing falls and reducing injury from falls fourth edition[EB/OL].(2017-01-01)[2021-08-27].https://rnao.ca/bpg/guidelines/prevention-falls-and-fall-injuries.
[18] The National Institute for Health and Care Excellence.Falls in older people:assessing risk and prevention[EB/OL].(2013-06-12) [2021-07-26].https://www.nice.org.uk/guidance/cg161.
[19] 国家卫生健康委员会.老年人跌倒干预技术指南[EB/OL].(2011-09-06)[2018-12-29].http://guide.medlive.cn/guideline/3021.
[20] National Institute for Health and Clinical Excellence.Falls in older people:assessing risk and prevention[EB/OL].(2015-03-25)[2021-12-06].https://www.nice.org.uk/guidance.
[21] DOTAN E,WALTER L C,BAUMGARTNER J,et al.NCCN guidelines version 1.2020:older adult oncology[EB/OL].(2020-02-07)[2020-10-24].https://www.nccn.org/professionals/physician_gls/pdf/senior.pdf.
[22] MOHILE S G,DALE W,SOMERFIELD M R,et al.Practical assessment and management of vulnerabilities in older patients receiving chemotherapy:ASCO gideline for geriatric oncology[J].J Clin Oncol,2018,36(22):2326-2347.
[23] 广东省药学会.老年人药物相关性跌倒预防管理专家共识[J].今日药学,2019,29(10):649-658.
[24] 中国康复医学会老年康复专业委员会专家共识组,上海市康复医学会专家共识组.预防老年人跌倒康复综合干预专家共识[J].老年医学与保健,2017,23(5):349-352.
[25] 中国老年保健医学研究会老龄健康服务与标准化分会,《中国老年保健医学》杂志编辑委员会.中国老年人跌倒风险评估专家共识(草案)[J].中国老年保健医学,2019,17(4):47-48.
[26] AVANECEAN D,CALLISTE D,CONTRERAS T,et al.Effectiveness of patient-centered interventions on falls in theacute care setting:a quantitative systematic review protocol[J].JBI Database System Rev and Implement Rep,2017,15(1):55-65.
[27] CAMERON I D,DYER S M,PANAGODA C E,et al.Interventions for preventing falls in older people in care facilities and hospitals[J].Cochrane Database Syst Rev,2018,9(9):CD005465.
[28] 李海红,马靓,张明艳,等.住院患者跌倒信息化管理体系的构建及应用[J].中国临床研究,2020,33(7):999-1002.
[29] 李曙光,蒋红,郎黎薇,等.预防患者跌倒APS规范化实践体系的构建及应用[J].护理学杂志,2019,34(13):1-4.
[30] 李晶.跌倒管理信息系统的建立及应用[J].中华护理杂志,2017,52(11):1347-1350.