Abstract: Objective: To construct a four-level linkage care model based on the "Internet+" Specialized Nursing Alliance and evaluate its application effects, providing a reference for improving the nursing service capabilities of primary hospitals. Methods: A four-level linkage care model with the participation of multiple subjects, including "provincial hospital, county/city hospital, district hospital, and community health service center" was established. A four-level linkage teleconsultation information platform was designed, and a specialist alliance was formed. Teleconsultation, specialist nurse training, specialized nursing service guidance on clinical and home nursing work were implemented through a mobile mini-program. Results: Up to April 2025, the specialized nursing alliance guided 577 nurses from 183 medical institutions across 21 provinces and cities nationwide, comprising 136 institutions within Zhejiang province and 47 outside the province. There was 1 provincial hospital, 108 county-level hospitals (with 352 nurses), 49 district-level hospitals (with 172 nurses), and 25 community health service centers (with 53 nurses). A total of 120 online video consultations for complex cases were assisted for primary specialized nurses. Both the overall satisfaction and the satisfaction of patients with expert services were 100%. After the teleconsultation, the wound, stomas or PICC complication healing rate among patients was 81.19%, the improvement rate was 18.80%, and no nursing adverse events occurred. Conclusion: The four-level linkage care model based on the "Internet+" Specialized Nursing Alliance can empower primary care nurses, enhance their capabilities in clinical nursing and home care service.

Key words: internet+ nursing; four-level linkage; informatization platform; specialized nursing alliance; teleconsultation