Construction and Application of a “Five- Proactive” Predictive Nursing Management System in A Tertiary Hospital: A Practice Innovation for High-Quality Development

Abstract

Background: Under the National Health Commission’s Further Improvement of Nursing Service Action Plan (2023–2025) and the context of high-quality development in public hospitals, traditional reactive nursing models have shown limitations in patient safety and quality outcomes. Objective: To develop and implement a predictive nursing management system integrating “Prediction–Early Warning–Prevention–Emergency Response” and a supporting “Five-Prevention System” (risk prediction, safety early warning, proactive prevention, emergency preparedness, and practical simulation). Methods: Taihe Hospital, a large tertiary hospital in Shiyan, China, systematically introduced a predictive nursing model starting in 2024. Interventions included tiered training (14 themes, 648 sessions, 19,622 nurse attendances), information technology upgrades (I-EWS, tri‑color risk warning system), risk stratification (unit/nurse manager/nurse levels), performance incentives, and regular emergency drills. Outcome indicators included adverse event reporting, complication rates, length of stay, and patient/nurse satisfaction. Results: After implementation, the proportion of reported grade‑IV adverse events significantly increased (indicating earlier detection of potential risks). Elective surgery complication rates, unplanned readmission rates, and average length of stay all decreased. Nurse professional value and patient satisfaction improved markedly. Several serious adverse events (e.g., postoperative neck hematoma leading to airway compression) were prevented through early warning and intervention. Conclusions: The predictive nursing “Five‑Prevention System” is feasible and effective in shifting nursing practice from reactive to proactive, improving patient safety and nurse empowerment. The model provides a replicable pathway for nursing management transformation in large public hospitals.