ARTICLE
31 August 2026

Effectiveness of an Information-Based Graded Nursing Platform Based on the Donabedian Structure-Process-Outcome Model: A Historical Control Study

Kefei Yu1 Na Wang1* Rui Shen1 Xiaohan Yan1
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1 Nursing Department, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, Hubei, China
© 2026 by the Author. Licensee Whioce Publishing, Singapore. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC BY-NC 4.0) ( https://creativecommons.org/licenses/by-nc/4.0/ )
Abstract

Objective: To explore the application effect of an information-based graded nursing platform for hospitalized patients, developed based on the Donabedian Structure-Process-Outcome (SPO) Framework. Methods: A historical control design was adopted. Hospitalized patients in a tertiary hospital in Shiyan City from January to March 2025 (control group, n=3,473) and from October to December 2025 (experimental group, n=2,586) were enrolled. The experimental group received the information-based graded nursing platform, while the control group received conventional graded nursing. Indicators related to structure, process, and outcome dimensions were compared between the two groups. Results: The total satisfaction score of nurses with information facilities in the experimental group increased significantly from 17.29±2.25 before the intervention to 21.37±2.29 after the intervention (P<0.001). The nursing round implementation rate (88.66% vs. 65.37%) and the nursing grading compliance rate (96.48%±3.62% vs. 90.23%±3.57%) were significantly higher in the experimental group than in the control group (P<0.01). The incidence of nursing adverse events (0.1‰ vs. 0.049‰) was significantly lower in the experimental group (P<0.01). Nurses’ disease observation abilities (professional ability, critical thinking ability, and professional quality) in the experimental group were significantly improved compared with those before the intervention (P<0.05). Conclusion: The information-based graded nursing intervention program, constructed based on the Donabedian Structure-Process-Outcome Model, significantly improves the nursing round implementation rate and nursing grading compliance rate, reduces the incidence of adverse events, and enhances nurses’ disease observation abilities. It provides a feasible solution for implementing the “Grading Standards for Nursing (WS/T 431-2023)” in tertiary hospitals.

Keywords
Graded nursing
Nursing quality improvement
Information-based nursing
Structure-Process-Outcome model
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