An elderly bone fracture patient grading nursing path generation method

Abstract

This application discloses a method for generating a graded nursing pathway for elderly patients with fractures, comprising the following steps: S1, collecting nursing-related data of elderly patients with fractures, wherein the nursing-related data includes at least basic patient information and nursing assessment information; S2, based on the nursing-related data, calculating assessment values ​​for multiple nursing risk dimensions, wherein the multiple nursing risk dimensions include at least pain risk dimension, pressure injury risk dimension, fall risk dimension, and delirium risk dimension; S3, determining the patient's nursing level according to the assessment values ​​of the multiple nursing risk dimensions and a preset nursing level classification rule; S4, automatically generating an initial nursing pathway matching the patient based on the nursing level and the assessment values ​​of the multiple nursing risk dimensions, wherein the initial nursing pathway includes at least several nursing task nodes and the execution frequency of each nursing task node.

Description

Technical Field

[0001] This invention relates to the field of nursing information processing technology, specifically to a method for generating a graded nursing pathway for elderly patients with fractures. Background Technology

[0002] Elderly patients with fractures face multiple risks during hospitalization due to their age, the complexity of the fracture site, and the presence of multiple underlying diseases. These risks include, but are not limited to, the risk of loss of pain control, pressure injury, falls, delirium, and malnutrition. The risk status varies significantly among patients and changes dynamically as the disease progresses and treatment continues.

[0003] Currently, nursing pathways for elderly fracture patients mainly rely on the experience and judgment of nursing staff and are manually formulated, which has the following problems: First, there is a lack of systematic assessment and quantitative processing of the multiple nursing risks of patients, making it difficult to accurately identify the true nursing needs of patients; second, the formulation and adjustment of nursing pathways mainly rely on human experience, lacking a standardized and regulated pathway generation mechanism, resulting in an unreasonable allocation of nursing resources; third, there is a lack of timely response to the dynamic changes in the patient's risk status during the nursing process, and when the patient's risk level changes, the adjustment of the nursing pathway is often delayed, affecting the quality of nursing care; fourth, there is a lack of an automatic matching mechanism based on risk level for the frequency of nursing tasks, the interval between rounds, and key observation items, making it difficult to achieve individualization and precision in the nursing process.

[0004] Therefore, there is an urgent need for a technical solution that can collect and quantify the multi-care risks of elderly fracture patients in a structured manner, automatically generate corresponding nursing pathways according to the risk level, and adjust the nursing pathways in real time based on dynamic data, so as to improve the efficiency of nursing management, improve the rationality of nursing resource allocation, improve the accuracy of nursing pathway matching, and improve the standardization of the nursing process. Summary of the Invention

[0005] The purpose of this invention is to provide a method for generating graded nursing pathways for elderly patients with fractures, in order to solve the technical problems in the existing technology of nursing pathways for elderly patients with fractures, such as lack of systematic risk assessment, insufficient standardization of pathway generation, lag in dynamic adjustment response, and unreasonable allocation of nursing resources. This method aims to improve the accuracy of nursing pathway matching, enhance nursing management efficiency, improve the rationality of nursing resource allocation, improve the timeliness of risk identification, and enhance the standardization and individualization of the nursing process.

[0006] To achieve the above objectives, the present invention adopts the following technical solution: A method for generating a graded nursing pathway for elderly patients with fractures includes the following steps: S1. Collect nursing-related data for elderly patients with fractures, including at least basic patient information and nursing assessment information; S2. Based on the aforementioned nursing-related data, calculate assessment values ​​for multiple nursing risk dimensions, including at least pain risk dimension, pressure injury risk dimension, fall risk dimension, and delirium risk dimension; S3. Based on the assessment values ​​of the multiple nursing risk dimensions, and according to the preset nursing level classification rules, determine the patient's nursing level; S4. Based on the nursing level and the assessment values ​​of the multiple nursing risk dimensions, automatically generate an initial nursing path matching the patient. The initial nursing path includes at least several nursing task nodes and the execution frequency of each nursing task node. S5. During the nursing care process, the patient's dynamic nursing data is continuously collected, and the nursing risk is reassessed based on the dynamic nursing data to obtain updated assessment values ​​for multiple nursing risk dimensions; S6. Determine whether the updated assessment values ​​of the multiple nursing risk dimensions trigger path adjustment conditions, wherein the path adjustment conditions include at least a change in nursing level or a breach of a key risk threshold; S7. When the path adjustment condition is triggered, an adjusted nursing path is generated based on the updated assessment values ​​of multiple nursing risk dimensions, and path adjustment instructions and early warning information are output; S8. Output the nursing task package corresponding to the adjusted nursing path. The nursing task package includes at least a nursing task list, execution time nodes, and task priorities.

[0007] Furthermore, the patient's basic information includes age, gender, fracture location, treatment method, and comorbid underlying diseases. The fracture location includes at least one of the following: hip fracture, femoral fracture, pelvic fracture, spinal fracture, or limb fracture. The treatment method includes postoperative treatment or conservative treatment. The nursing assessment information includes at least one of the following: pain score, activity level, pressure injury risk score, fall risk score, delirium risk score, nutritional status score, sleep status score, excretion assessment, catheter placement status, and caregiver cooperation level.

[0008] Further, in step S2, assessment values ​​for multiple nursing risk dimensions are calculated based on the nursing-related data, specifically including: For the pain risk dimension, a pain risk assessment value is calculated based on the pain score, fracture location, and treatment method. For the stress injury risk dimension, a stress injury risk assessment value is calculated based on the activity level, age, nutritional status score, and stress injury risk score. For the fall risk dimension, a fall risk assessment value is calculated based on the age, activity level, fall risk score, and underlying medical conditions. For the delirium risk dimension, a delirium risk assessment value is calculated based on the age, sleep status score, delirium risk score, and comorbid underlying diseases.

[0009] Further, in step S3, the patient's nursing level is determined according to the assessment values ​​of the multiple nursing risk dimensions and a preset nursing level classification rule, specifically including: A comprehensive nursing risk score is calculated, which is based on a weighted sum or a maximum value determination of the assessment values ​​of the multiple nursing risk dimensions. Based on the comparison between the comprehensive nursing risk score and the preset nursing level threshold, the patient is classified into a Level 1 nursing level, a Level 2 nursing level, or a Level 3 nursing level. Specifically, when the comprehensive nursing risk score is higher than the first threshold, the patient's nursing level is determined to be Level 1 nursing level; When the comprehensive nursing risk score is between the second threshold and the first threshold, the patient's nursing level is determined to be Level II nursing level; When the comprehensive nursing risk score is lower than the second threshold, the patient's nursing level is determined to be Level III nursing level.

[0010] Further, in step S4, an initial care path matching the patient is automatically generated based on the care level and the assessment values ​​of the multiple care risk dimensions, specifically including: Based on the nursing level, a basic nursing pathway template corresponding to the level is extracted from a preset nursing pathway template library; Based on the assessment values ​​of the multiple nursing risk dimensions, high-risk dimensions are identified, and corresponding enhanced nursing task nodes are added for the high-risk dimensions; The execution frequency of each nursing task node is determined, and the execution frequency is positively correlated with the assessment value of the nursing level and the corresponding risk dimension. The initial nursing pathway is generated, and the nursing task nodes in the initial nursing pathway include at least one of the following: patrol task node, pain reassessment task node, skin observation task node, turning reminder task node, bed exit assistance task node, rehabilitation training reminder task node, excretion intervention reminder task node, and nighttime key observation task node.

[0011] Furthermore, the dynamic nursing data includes dynamic event information, which includes at least one of the following: nocturnal agitation events, sudden increase in pain events, decreased ability to move independently events, skin abnormality events, significant decrease in appetite events, abnormal bowel movements events, catheter abnormality events, and relapse risk warning events; Step S5, which involves reassessing nursing risks based on the dynamic nursing data, specifically includes: When the dynamic event information is detected, the assessment value of the corresponding nursing risk dimension is updated according to the type and severity of the dynamic event information; The assessment values ​​of the multiple nursing risk dimensions are recalculated to obtain the updated assessment values ​​of the multiple nursing risk dimensions.

[0012] Further, step S6, determining whether the updated assessment values ​​of the multiple nursing risk dimensions trigger the path adjustment conditions, specifically includes: Based on the updated assessment values ​​of the multiple nursing risk dimensions, the comprehensive nursing risk score is recalculated, and the nursing level is redefined. Determine whether the redefined nursing care level is different from the current nursing care level; if different, determine if the conditions for a change in nursing care level have been triggered. Determine whether any of the updated assessment values ​​for multiple nursing risk dimensions exceeds a preset critical risk threshold. If it does, then a critical risk threshold breach condition is triggered. When at least one of the conditions for a change in the level of care or the condition for exceeding the critical risk threshold is triggered, the path adjustment condition is determined to be triggered.

[0013] Furthermore, the generation of the adjusted care pathway in step S7 specifically includes: When the conditions for a change in nursing care level are triggered, the nursing care path template is updated based on the newly determined nursing care level, and the execution frequency of each nursing care task node is adjusted. When the critical risk threshold is exceeded, for the risk dimension that exceeds the critical risk threshold, a corresponding emergency care task node is added, and the execution priority of the relevant task nodes for that risk dimension is increased; The adjusted care pathway is generated, along with an early warning message containing information on risk changes and the reasons for the adjustment.

[0014] Furthermore, the nursing task package output in step S8 also includes family education tasks and pre-discharge assessment tasks, wherein the pre-discharge assessment task includes generating a post-discharge follow-up plan.

[0015] The beneficial effects of this invention are as follows: 1. This invention achieves a systematic identification of patient care needs by collecting nursing-related data from elderly fracture patients and performing structured assessments and quantitative calculations on multiple nursing risk dimensions. This improves the timeliness and accuracy of risk identification and avoids the subjectivity and bias of traditional manual judgment.

[0016] 2. This invention classifies patients into nursing levels according to preset nursing level classification rules, and automatically generates matching nursing pathways based on nursing level and risk dimension, thereby achieving standardization and normalization of nursing pathway generation, improving the accuracy of nursing pathway matching, and improving the rationality of nursing resource allocation.

[0017] 3. This invention continuously collects dynamic nursing data and reassesses nursing risks during nursing execution. When path adjustment conditions are triggered, the adjusted nursing path is automatically generated, realizing dynamic optimization and timely response of nursing path, improving nursing management efficiency, and increasing the degree of individualization of the nursing process.

[0018] 4. This invention outputs nursing task packages that include a nursing task list, execution time nodes, and task priorities, providing nursing staff with directly executable operational guidance, improving the standardization of the nursing process, and reducing the complexity of nursing work.

[0019] 5. The overall solution of this invention focuses on the structured processing of nursing information, the quantitative assessment of nursing risks, the automatic generation and dynamic adjustment of nursing pathways, forming a complete nursing auxiliary decision-making technology process with good practicality and operability. Attached Figure Description

[0020] Figure 1 This is a flowchart of the method for generating a graded nursing pathway for elderly patients with fractures according to the present invention; Detailed Implementation

[0021] The present invention will now be described in further detail with reference to the accompanying drawings and specific embodiments. Example 1

[0022] like Figure 1 As shown in the figure, this embodiment provides a method for generating a graded nursing pathway for elderly patients with fractures, including the following steps: S1. Collect nursing-related data for elderly patients with fractures. The nursing-related data shall include at least the patient's basic information and nursing assessment information.

[0023] In this embodiment, the patient's basic information includes age, gender, fracture location, treatment method, and underlying medical conditions. The fracture location can be at least one of the following: hip fracture, femoral fracture, pelvic fracture, spinal fracture, or limb fracture. Treatment methods include postoperative treatment or conservative treatment.

[0024] Nursing assessment information includes pain score, activity level, pressure injury risk score, fall risk score, delirium risk score, nutritional status score, sleep status score, excretion assessment, catheter placement status, and caregiver cooperation level.

[0025] Specifically, pain scores can be assessed using the numerical rating scale (NRS), ranging from 0 to 10. Activity level can be assessed using the Barthel Index or a grading system, such as levels for complete bed rest, bedside activity, bedside activity, and indoor activity. Pressure injury risk scores can be assessed using the Braden or Norton scores. Fall risk scores can be assessed using the Morse fall score or other standardized fall risk assessment tools. Delirium risk scores can be assessed using the CAM score or other delirium risk assessment tools. Nutritional status scores can be assessed using the MNA score or other nutritional assessment tools.

[0026] Data collection can be achieved through the data entry interface of the nursing information system, the data interface of the electronic medical record system, and the data collection function of the mobile nursing terminal.

[0027] S2. Based on the nursing-related data, calculate the assessment values ​​of multiple nursing risk dimensions, including at least the pain risk dimension, the pressure injury risk dimension, the fall risk dimension, and the delirium risk dimension.

[0028] In this embodiment, different calculation methods are used for different dimensions of nursing risk: For the pain risk dimension, a pain risk assessment value is calculated based on pain score, fracture location, and treatment method. Specifically, the pain risk assessment value = pain score × fracture location coefficient × treatment method coefficient. The fracture location coefficient is set according to the pain characteristics of the fracture site; for example, the coefficient for a hip fracture is 1.2, for a femoral fracture it is 1.1, and for a limb fracture it is 1.0. Among the treatment method coefficients, the coefficient for postoperative treatment is 1.2, and the coefficient for conservative treatment is 1.0.

[0029] For the pressure injury risk dimension, a pressure injury risk assessment value is calculated based on activity level, age, nutritional status score, and pressure injury risk score. Specifically, the pressure injury risk assessment value = pressure injury risk score + activity level bonus + age bonus + nutritional status bonus. The activity level is calculated as follows: 3 points for complete bed rest, 2 points for bedtime activities, and 1 point for bedside activities. 2 points are awarded for ages over 80, and 1 point for ages between 70 and 80. A nutritional status score below the standard value is awarded 1-3 points depending on the severity.

[0030] For the fall risk dimension, a fall risk assessment value is calculated based on age, activity level, fall risk score, and underlying medical conditions. Specifically, the fall risk assessment value = fall risk score + age bonus + activity level bonus + underlying medical condition bonus. Specifically, 2 points are added for ages over 75, and 1 point is added for ages between 65 and 75. 1-2 points are added for lower activity levels. For underlying medical conditions such as hypertension, diabetes, and cardiovascular disease, 0.5 points are added for each condition.

[0031] For the delirium risk dimension, a delirium risk assessment value is calculated based on age, sleep status score, delirium risk score, and underlying medical conditions. Specifically, the delirium risk assessment value = delirium risk score + age bonus + sleep status bonus + underlying medical condition bonus. Specifically, 3 points are added for ages over 80, and 2 points are added for ages between 70 and 80. 1-2 points are added for poor sleep status scores. 0.5-1 points are added for underlying medical conditions.

[0032] S3. Based on the assessment values ​​of the multiple nursing risk dimensions, and in accordance with the preset nursing level classification rules, determine the patient's nursing level.

[0033] In this embodiment, a comprehensive nursing risk score is first calculated. The comprehensive nursing risk score is based on a weighted sum or a maximum value determination of the assessment values ​​of multiple nursing risk dimensions.

[0034] When using a weighted summation method, the comprehensive nursing risk score = pain risk assessment value × 0.25 + pressure injury risk assessment value × 0.25 + fall risk assessment value × 0.25 + delirium risk assessment value × 0.25. The weighting coefficients can also be adjusted according to the importance of different risk dimensions.

[0035] When using the maximum value determination method, the comprehensive nursing risk score = max(pain risk assessment value, pressure injury risk assessment value, fall risk assessment value, delirium risk assessment value).

[0036] Then, based on the comparison between the comprehensive nursing risk score and the preset nursing level threshold, the patients are classified into Level 1, Level 2, or Level 3 nursing care.

[0037] Specifically, when the comprehensive nursing risk score is higher than the first threshold (e.g., 80 points), the patient's nursing level is determined to be Level 1, indicating that the patient needs high-intensity nursing intervention.

[0038] When the comprehensive nursing risk score is between the second threshold (e.g., 50 points) and the first threshold (e.g., 80 points), the patient's nursing level is determined to be Level II, indicating that the patient requires moderate-intensity nursing intervention.

[0039] When the comprehensive nursing risk score is below the second threshold (e.g., 50 points), the patient's nursing level is determined to be Level III, indicating that the patient needs routine nursing intervention.

[0040] S4. Based on the nursing level and the assessment values ​​of the multiple nursing risk dimensions, an initial nursing path matching the patient is automatically generated. The initial nursing path includes at least several nursing task nodes and the execution frequency of each nursing task node.

[0041] In this embodiment, the basic nursing pathway template corresponding to the nursing level is first extracted from the preset nursing pathway template library.

[0042] The nursing pathway template library pre-stores primary, secondary, and tertiary nursing pathway templates.

[0043] The Level 1 nursing pathway template includes: rounds (frequency: once every 1 hour), pain reassessment (frequency: once every 2 hours), skin observation (frequency: once every 2 hours), turning reminder (frequency: once every 2 hours), bed exit assistance (frequency: full assistance), and key nighttime observation (frequency: once every 1 hour).

[0044] The secondary nursing pathway template includes: rounds (frequency: once every 2 hours), pain reassessment (frequency: once every 4 hours), skin observation (frequency: once every 4 hours), turning reminder (frequency: once every 3 hours), bed exit assistance (frequency: partially assisted), and key nighttime observation (frequency: once every 2 hours).

[0045] The three-level nursing pathway template includes: rounds (frequency: once every 4 hours), pain reassessment (frequency: once every 6 hours), skin observation (frequency: once daily), turning reminder (frequency: as needed), bed exit assistance (frequency: self-management under guidance), and key nighttime observation (frequency: once every 4 hours).

[0046] Then, based on the assessment values ​​of multiple nursing risk dimensions, high-risk dimensions are identified, and corresponding enhanced nursing task nodes are added for high-risk dimensions.

[0047] For example, when the pain risk assessment value exceeds a preset threshold, a pain management enhancement task node is added, including tasks such as pain cause analysis, implementation of pain intervention measures, and evaluation of pain relief effects.

[0048] When the pressure injury risk assessment value exceeds the preset threshold, add pressure ulcer prevention reinforcement task nodes, including tasks such as using pressure relief pads, strengthening skin care, and increasing the frequency of turning over.

[0049] When the fall risk assessment value exceeds the preset threshold, add fall prevention reinforcement task nodes, including tasks such as bedside safety assessment, use of bed rails, enhanced bed exit assistance, and environmental safety inspection.

[0050] When the delirium risk assessment value exceeds the preset threshold, delirium prevention reinforcement task nodes are added, including tasks such as sleep environment optimization, cognitive function training, and drug side effect monitoring.

[0051] In addition, the nursing pathway may also include task nodes such as rehabilitation training reminders, task nodes for excretion intervention, and task nodes for family education.

[0052] Finally, an initial care path is generated, which includes each care task node and its execution frequency, forming a structured care plan.

[0053] S5. During the nursing care process, the patient's dynamic nursing data is continuously collected, and the nursing risk is reassessed based on the dynamic nursing data to obtain updated assessment values ​​for multiple nursing risk dimensions.

[0054] In this embodiment, dynamic nursing data includes dynamic event information. Dynamic event information includes at least nocturnal agitation events, sudden increases in pain events, decreased voluntary mobility events, skin abnormalities events, significant decreases in appetite events, bowel abnormalities events, catheter abnormalities events, and relapse risk warning events.

[0055] When dynamic event information is detected, the assessment values ​​of the corresponding nursing risk dimensions are updated according to the type and severity of the dynamic event information.

[0056] For example, when a sudden increase in pain is detected, the pain risk assessment score is increased accordingly, for example, by 5-10 points.

[0057] When nocturnal agitation is detected, the delirium risk assessment score will be increased accordingly, for example, by 3-5 points.

[0058] When an abnormal skin event is detected, the pressure injury risk assessment score will be increased accordingly, for example, by 5-8 points.

[0059] When an event indicating a decline in independent activity is detected, the fall risk assessment value and the stress injury risk assessment value will both be increased accordingly.

[0060] Then, the assessment values ​​of multiple nursing risk dimensions are recalculated to obtain updated assessment values ​​of multiple nursing risk dimensions.

[0061] S6. Determine whether the updated assessment values ​​of the multiple nursing risk dimensions trigger path adjustment conditions, wherein the path adjustment conditions include at least a change in nursing level or a breach of a key risk threshold.

[0062] In this embodiment, the comprehensive nursing risk score is first recalculated based on the updated assessment values ​​of multiple nursing risk dimensions, and the nursing level is then redefined.

[0063] Determine if the reassigned nursing care level differs from the current nursing care level. If they differ, then the conditions for a change in nursing care level are triggered. For example, if a patient was originally at nursing care level three, but a sudden increase in pain leads to an increase in their comprehensive nursing risk score, and they are reassigned to nursing care level two, then the conditions for a change in nursing care level are triggered.

[0064] Simultaneously, it determines whether any of the updated assessment values ​​for multiple nursing risk dimensions exceed a preset critical risk threshold. If so, it is determined that a critical risk threshold breach condition has been triggered. For example, if the critical risk threshold for pain risk assessment is set at 85 points, when the pain risk assessment value reaches 90 points, even if the nursing level has not changed, the critical risk threshold breach condition is triggered.

[0065] When at least one of the conditions for a change in care level or a breach of a critical risk threshold is triggered, the path adjustment condition is determined.

[0066] S7. When the path adjustment condition is triggered, an adjusted nursing path is generated based on the updated assessment values ​​of multiple nursing risk dimensions, and a path adjustment instruction and warning information are output.

[0067] In this embodiment, when a change in nursing level is triggered, the nursing pathway template is updated based on the newly determined nursing level, and the execution frequency of each nursing task node is adjusted. For example, if the nursing level is upgraded from level three to level two, the frequency of the rounds task node is adjusted from once every 4 hours to once every 2 hours, and the frequency of the pain reassessment task node is adjusted from once every 6 hours to once every 4 hours.

[0068] When a critical risk threshold is exceeded, corresponding emergency care task nodes are added for the risk dimensions that exceed the critical risk threshold, and the execution priority of the task nodes related to that risk dimension is increased. For example, if the pain risk assessment value exceeds the critical risk threshold, an emergency pain assessment task node and an emergency pain intervention task node are added, and the priority of the pain reassessment task node is set to "high priority," while the frequency of pain reassessment is adjusted to once every hour.

[0069] After generating the adjusted nursing pathway, an alert message containing information on risk changes and the reasons for the adjustment is also generated. The alert message includes the patient's name, bed number, risk changes, the conditions that triggered the adjustment, the adjusted nursing care level, and the risk dimensions that require special attention.

[0070] S8. Output the nursing task package corresponding to the adjusted nursing path. The nursing task package includes at least a nursing task list, execution time nodes, and task priorities.

[0071] In this embodiment, the nursing task package is output in a structured form, including a nursing task list, execution time nodes, and task priorities.

[0072] The nursing task list outlines all nursing tasks that need to be performed, such as: "Patient rounds", "Pain assessment", "Skin observation", "Assisting with turning over", "Assisting with getting out of bed", "Guidance on rehabilitation training", "Elimination intervention", "Family education", etc.

[0073] The execution time nodes clearly define the specific execution time for each nursing task, such as: "8:00 Patient rounds", "10:00 Pain assessment", "12:00 Assisting with turning over", etc.

[0074] Task priorities indicate the priority level of each nursing task, such as "high priority", "medium priority" and "low priority", or use numbers 1-5 to indicate priority.

[0075] Nursing task packages may also include family education tasks and pre-discharge assessment tasks. Pre-discharge assessment tasks include generating a post-discharge follow-up plan, specifying the follow-up appointment time, rehabilitation training plan, and home care precautions.

[0076] The following is an example to illustrate this: An elderly male patient, 82 years old, who underwent surgery for a hip fracture, had the following nursing data upon admission: Patient basic information: Age 82, male, fracture site is left femoral neck fracture, treatment method is hip replacement surgery, comorbidities include hypertension and type 2 diabetes.

[0077] Nursing assessment information: Pain score 6, activity level is completely bedridden, pressure injury risk score (Braden score) 14, fall risk score (Morse score) 55, delirium risk score (CAM score) indicates delirium risk, nutritional status score is low, sleep status score is poor, indwelling urinary catheter is in place, caregiver cooperation is good.

[0078] The system performs nursing risk assessment: Pain risk assessment score = 6 × 1.2 × 1.2 = 8.64 points; Pressure injury risk assessment score = 14 + 3 (complete bed rest) + 2 (age > 80) + 2 (malnutrition) = 21 points; Fall risk assessment score = 55 + 2 (age > 75) + 2 (poor mobility) + 1 (underlying medical conditions) = 60 points; Delirium risk assessment score = baseline score 10 + 3 (age > 80) + 2 (poor sleep) + 1 (underlying disease) = 16 points.

[0079] Calculate the comprehensive nursing risk score (using a weighted summation method, assuming equal weight for each risk dimension): Comprehensive nursing risk score = (8.64 + 21 + 60 + 16) / 4 = 26.41 points.

[0080] Because the fall risk assessment value was high, and the patient was older and had multiple risks, the system recalculated using the maximum value determination method. The comprehensive nursing risk score is calculated as max(8.64,21,60,16) = 60 points.

[0081] According to the nursing level classification rules, the comprehensive nursing risk score is 60 points, which is between the second threshold of 50 points and the first threshold of 80 points. Therefore, the patient's nursing level is determined to be Level II nursing level.

[0082] The system automatically generates an initial nursing pathway and extracts a secondary nursing pathway template, including: rounds task node (once every 2 hours), pain reassessment task node (once every 4 hours), skin observation task node (once every 4 hours), turning reminder task node (once every 3 hours), bed exit assistance task node (partial assistance), and nighttime key observation task node (once every 2 hours).

[0083] Since the fall risk assessment score of 60 exceeds the high-risk threshold (assuming it is 50), the system adds an enhanced nursing task node for the fall risk dimension: fall prevention enhancement task, which includes using bed rails, pre-exit safety assessment, environmental safety check, etc., and must be performed before each time the person gets out of bed.

[0084] After the initial nursing pathway is generated, the system outputs a nursing task package for nursing staff to execute.

[0085] On the third night of the nursing care period, the system detected dynamic event information: the patient experienced nocturnal agitation, the pain score rose from 6 to 8, and the sleep quality significantly decreased.

[0086] The system performs nursing risk reassessment based on dynamic event information: The pain risk assessment score has been updated to: 8 × 1.2 × 1.2 = 11.52 points; The delirium risk assessment score has been updated to: 16 + 5 (nocturnal agitation) = 21 points.

[0087] Recalculate the comprehensive nursing risk score: The comprehensive nursing risk score is calculated as max(11.52,21,60,21) = 60 points.

[0088] Although the overall nursing risk score remained unchanged and the nursing level remained at Level II, both the pain risk assessment score and the delirium risk assessment score increased. The system determined that the sudden increase in pain and the nocturnal agitation event triggered the critical risk threshold breach (assuming the critical risk thresholds for pain risk and delirium risk were 10 and 20 points, respectively).

[0089] The system generates the adjusted nursing pathway: To address pain risk, we added emergency pain assessment and pain intervention task nodes, adjusted the frequency of pain reassessment from once every 4 hours to once every 2 hours, and set the priority to high priority.

[0090] In response to the risk of delirium, additional tasks have been added to strengthen delirium prevention, including optimizing the sleep environment, observing cognitive function, and monitoring drug side effects. The frequency of key nighttime observations has been adjusted from once every 2 hours to once every 1 hour.

[0091] The system simultaneously outputs an alert: "Patient Zhang (Bed 12), nursing risk has changed: pain risk assessment score increased from 8.64 to 11.52, delirium risk assessment score increased from 16 to 21, triggering the critical risk threshold breach condition. Current nursing level: Level II. Key risk dimensions to focus on: pain management, delirium prevention. The nursing pathway has been automatically adjusted; nursing staff are requested to focus on pain reassessment tasks (every 2 hours) and nighttime key observation tasks (every 1 hour)." The system outputs an updated nursing task package, which includes an adjusted list of nursing tasks, execution time points, and task priorities, for nursing staff to execute.

[0092] After two days of intensive nursing intervention, the patient's pain was effectively controlled, nocturnal agitation improved, pain score decreased to 4, and sleep quality improved. The system reassessed the nursing risk, and both pain and delirium risk assessment values ​​decreased, no longer triggering critical risk threshold breach conditions. The system automatically adjusted the nursing pathway back to the original secondary nursing pathway template and output the corresponding nursing task package.

[0093] Before a patient is discharged, the system performs a pre-discharge assessment and generates a post-discharge follow-up plan, including: a telephone follow-up in the first week after discharge to understand pain control and recovery of mobility; an outpatient follow-up in the second week after discharge to assess the effectiveness of rehabilitation training; and a home visit in the first month after discharge to assess the implementation of home care and fall prevention measures. Simultaneously, a family education package is generated, including guidance on home rehabilitation training, pain management methods, fall prevention precautions, and nutritional support recommendations.

[0094] Through the complete nursing pathway generation, execution, dynamic adjustment, and discharge follow-up process described above, standardized and individualized nursing management for elderly fracture patients has been achieved, improving nursing quality and efficiency.

Claims

1. A method for generating a graded nursing pathway for elderly patients with fractures, characterized in that... This includes the following steps: S1. Collect nursing-related data for elderly patients with fractures, including at least basic patient information and nursing assessment information; S2. Based on the aforementioned nursing-related data, calculate assessment values ​​for multiple nursing risk dimensions, including at least pain risk dimension, pressure injury risk dimension, fall risk dimension, and delirium risk dimension; S3. Based on the assessment values ​​of the multiple nursing risk dimensions, and according to the preset nursing level classification rules, determine the patient's nursing level; S4. Based on the nursing level and the assessment values ​​of the multiple nursing risk dimensions, automatically generate an initial nursing path matching the patient. The initial nursing path includes at least several nursing task nodes and the execution frequency of each nursing task node. S5. During the nursing care process, the patient's dynamic nursing data is continuously collected, and the nursing risk is reassessed based on the dynamic nursing data to obtain updated assessment values ​​for multiple nursing risk dimensions; S6. Determine whether the updated assessment values ​​of the multiple nursing risk dimensions trigger path adjustment conditions, wherein the path adjustment conditions include at least a change in nursing level or a breach of a key risk threshold; S7. When the path adjustment condition is triggered, an adjusted nursing path is generated based on the updated assessment values ​​of multiple nursing risk dimensions, and path adjustment instructions and early warning information are output; S8. Output the nursing task package corresponding to the adjusted nursing path. The nursing task package includes at least a nursing task list, execution time nodes, and task priorities.

2. The method for generating a graded nursing pathway for elderly fracture patients according to claim 1, characterized in that... The patient's basic information includes age, gender, fracture location, treatment method, and comorbid underlying diseases. The fracture location includes at least one of the following: hip fracture, femoral fracture, pelvic fracture, spinal fracture, or limb fracture. The treatment method includes postoperative treatment or conservative treatment. The nursing assessment information includes at least one of the following: pain score, activity level, pressure injury risk score, fall risk score, delirium risk score, nutritional status score, sleep status score, excretion assessment, catheter placement status, and caregiver cooperation level.

3. The method for generating a graded nursing pathway for elderly fracture patients according to claim 2, characterized in that... In step S2, assessment values ​​for multiple nursing risk dimensions are calculated based on the nursing-related data, specifically including: For the pain risk dimension, a pain risk assessment value is calculated based on the pain score, fracture location, and treatment method. For the stress injury risk dimension, a stress injury risk assessment value is calculated based on the activity level, age, nutritional status score, and stress injury risk score. For the fall risk dimension, a fall risk assessment value is calculated based on the age, activity level, fall risk score, and underlying medical conditions. For the delirium risk dimension, a delirium risk assessment value is calculated based on the age, sleep status score, delirium risk score, and comorbid underlying diseases.

4. The method for generating a graded nursing pathway for elderly fracture patients according to claim 1, characterized in that... In step S3, the patient's nursing level is determined according to the assessment values ​​of the multiple nursing risk dimensions and a preset nursing level classification rule, specifically including: A comprehensive nursing risk score is calculated, which is based on a weighted sum or a maximum value determination of the assessment values ​​of the multiple nursing risk dimensions. Based on the comparison between the comprehensive nursing risk score and the preset nursing level threshold, the patient is classified into a Level 1 nursing level, a Level 2 nursing level, or a Level 3 nursing level. Specifically, when the comprehensive nursing risk score is higher than the first threshold, the patient's nursing level is determined to be Level 1 nursing level; When the comprehensive nursing risk score is between the second threshold and the first threshold, the patient's nursing level is determined to be Level II nursing level; When the comprehensive nursing risk score is lower than the second threshold, the patient's nursing level is determined to be Level III nursing level.

5. The method for generating a graded nursing pathway for elderly fracture patients according to claim 4, characterized in that... In step S4, an initial nursing pathway matching the patient is automatically generated based on the nursing level and the assessment values ​​of the multiple nursing risk dimensions, specifically including: Based on the nursing level, a basic nursing pathway template corresponding to the level is extracted from a preset nursing pathway template library; Based on the assessment values ​​of the multiple nursing risk dimensions, high-risk dimensions are identified, and corresponding enhanced nursing task nodes are added for the high-risk dimensions; The execution frequency of each nursing task node is determined, and the execution frequency is positively correlated with the assessment value of the nursing level and the corresponding risk dimension. The initial nursing pathway is generated, and the nursing task nodes in the initial nursing pathway include at least one of the following: patrol task node, pain reassessment task node, skin observation task node, turning reminder task node, bed exit assistance task node, rehabilitation training reminder task node, excretion intervention reminder task node, and nighttime key observation task node.

6. The method for generating a graded nursing pathway for elderly fracture patients according to claim 1, characterized in that... The dynamic nursing data includes dynamic event information, which includes at least one of the following: nocturnal agitation events, sudden increase in pain events, decreased ability to move independently events, skin abnormality events, significant decrease in appetite events, abnormal bowel movements events, catheter abnormality events, and relapse risk warning events. Step S5, which involves reassessing nursing risks based on the dynamic nursing data, specifically includes: When the dynamic event information is detected, the assessment value of the corresponding nursing risk dimension is updated according to the type and severity of the dynamic event information; The assessment values ​​of the multiple nursing risk dimensions are recalculated to obtain the updated assessment values ​​of the multiple nursing risk dimensions.

7. The method for generating a graded nursing pathway for elderly fracture patients according to claim 4, characterized in that... Step S6, determining whether the updated assessment values ​​of the multiple nursing risk dimensions trigger the path adjustment conditions, specifically includes: Based on the updated assessment values ​​of the multiple nursing risk dimensions, the comprehensive nursing risk score is recalculated, and the nursing level is redefined. Determine whether the redefined nursing care level is different from the current nursing care level; if different, determine if the conditions for a change in nursing care level have been triggered. Determine whether any of the updated assessment values ​​for multiple nursing risk dimensions exceeds a preset critical risk threshold. If it does, then a critical risk threshold breach condition is triggered. When at least one of the conditions for a change in the level of care or the condition for exceeding the critical risk threshold is triggered, the path adjustment condition is determined to be triggered.

8. The method for generating a graded nursing pathway for elderly fracture patients according to claim 7, characterized in that... The step S7, which generates the adjusted nursing pathway, specifically includes: When the conditions for a change in nursing care level are triggered, the nursing care path template is updated based on the newly determined nursing care level, and the execution frequency of each nursing care task node is adjusted. When the critical risk threshold is exceeded, for the risk dimension that exceeds the critical risk threshold, a corresponding emergency care task node is added, and the execution priority of the relevant task nodes for that risk dimension is increased; The adjusted care pathway is generated, along with an early warning message containing information on risk changes and the reasons for the adjustment.

9. The method for generating a graded nursing pathway for elderly fracture patients according to claim 1, characterized in that... The nursing task package output in step S8 also includes family education tasks and pre-discharge assessment tasks. The pre-discharge assessment task includes generating a post-discharge follow-up plan.

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