目的 探讨老年髋部骨折术后患者跌倒恐惧的影响因素，构建个体化风险预测列线图模型并进行临床效能验。方法 采用便利抽样法，选取2025年4月-2025年10月在我院骨科住院并接受手术治疗的老年髋部骨折患者227例作为研究对象。采用一般资料调查表、国际版跌倒效能量表、医院综合焦虑抑郁量表、社会支持评定量表、简易体能状况量表、康复自我效能量表、临床衰弱量表及肌少症筛查问卷等进行横断面调查。采用卡方检验筛选预测变量，多因素Logistic回归分析确定跌倒恐惧的独立影响因素，并基于R语言构建列线图预测模型。通过Bootstrap法进行内部验证，采用校准曲线和受试者工作特征曲线评估模型的区分度与校准度。结果 227例患者中，150例存在跌倒恐惧。多因素Logistic回归分析显示：年龄≥75岁（OR=3.28）、视力不良（OR=6.017）、焦虑抑郁（OR=3.738），衰弱（OR=3.821），肌少症（OR=2.704），康复自我效能低（OR=0.275），为患者发生跌倒恐惧的风险因素。基于上述6个预测因子构建的列线图模型，其ROC曲线下面积为0.839（95%CI：0.832-0.916），。校准曲线显示预测概率与实际发生率一致性良好（Bootstrap验证，P=0.028），DCA结果显示，当阈值概率在0.1-0.9时，该模型净收益优于假设所有患者均接受或均不接受治疗的策略。结论 本研究构建的列线图模型能有效预测老年髋部骨折术后患者发生跌倒恐惧的风险，有助于临床医护人员早期识别高危人群并进行多维度靶向干预。

目的 调查护理人员对预防跌倒知识掌握的情况,以提高其对防跌倒相关知识的认知水平,减少住院患者跌倒的发生。方法 用自编住院患者跌倒相关知识掌握量表对护理人员进行问卷调查。结果 护理人员对跌倒知识的掌握正确率最高为跌倒分级64.04%、最低为跌倒后干预措施17.10%。外科护理人员对患者跌倒风险评估时机的把握为88.69%,妇儿科护理人员的正确率（71.11%）高（χ²=21.319,P=0.003）,住院患者发生跌倒后的处理正确率急诊为76.67%,高于门诊的42.67%（χ²=27.651,P<0.001）;在把握患者跌倒风险评估的时机方面工作年限<5年的护理人员为 89.81%,比工作年限>20年的护理人员（64.15%）更容易把握患者跌倒风险评估的时机（χ²=18.921,P<0.001）,工作年限11~20年的护理人员对住院患者预防跌倒的干预措施正确率为24.66%,比工作年限<5年的护理人员（11.46%）高（χ²=9.678,P=0.022）;工作年限>20年的护理人员对住院患者发生跌倒后的处理正确率为58.49%比工作年限<20年以下的护理人员（34.25%）高（χ²=12.787,P=0.005）。结论 护理人员跌倒预防相关知识掌握度总体较低,应加强对护理人员关于患者跌倒预防知识的系统培训,减少住院患者跌倒的发生。

Objective To investigate the mastery of falls prevention knowledge among nursing staffs,in order to improve their cognitive level of falls prevention related knowledge and reduce the occurrence of falls in hospitalized patients．Methods A questionnaire survey was conducted among nursing staffs with a self-designed questionnaire on the mastery of falls related knowledge among hospitalized patients．Results The highest accuracy rate of nursing staffs' mastery of falls knowledge was 64.04% for falling classification,and the lowest was 17.10% for falls intervention measures．Nursing staffs' accuracy of the timing of patient fall risk assessment was 88.69% in surgery,which was higher than 71.11% in nursing staff in obstetrics,gynecology,and pediatrics（χ²=21.319,P=0.003）．The accuracy of emergency treatment for hospitalized patients after falls was 76.67%,which was higher than 42.67% in outpatient treatment（χ²=27.651,P<0.001）．The accuracy of the timing of patient fall risk assessment in nursing staffs with less than 5 years of work experience was 89.81%,which was better than nursing staff with more than 20 years of work experience（64.15%）（χ²=18.921,P<0.001）．Nursing staff with 11-20 years of work experience had a correct intervention rate for preventing falls in hospitalized patients of 24.66%,which was higher than nursing staffs with less than 5 years of work experience（11.46%）（χ²=9.678,P=0.022）．The accuracy rate of handling falls in hospitalized patients by nursing staffs with more than 20 years of work experience was 58.49%,which was higher than that of nursing staff with less than 20 years of work experience,which is 34.25%（χ²=12.787,P=0.005）．Conclusions Overall,nursing staff had a low level of falls prevention knowledge,and systematic training on patient fall prevention should be strengthened to reduce the occurrence of falls in hospitalized patients．

目的 通过回顾分析某三级医院神经外科近5年发生的意外跌倒事件,以指导改进护理防范策略。方法 对2012年3月—2017年6月期间某三级医院神经外科发生的21例住院期间意外跌倒事件进行数据采集、对照研究及回顾分析。结果 61.9%事件发生于00:00~07:59时间段,71.4%无陪人在旁,85.71%年龄大于等于60岁。与非跌倒组相比,跌倒组患者有更多例数的肢体乏力(P=0.005),依从性差的比例更高(P＜0.001),特殊药物应用及跌倒史未见统计差异。结论 应重视跌倒事件多发时间段,加强对无陪人、年龄大、肢体乏力、依从性差患者的护理,优化跌倒风险评估体系及预防措施。