Abstract: Objective: To sort out the practical pathways for advancing proactive nursing risk management through the optimization of nursing quality control positions, thereby providing a reference for medical institutions to improve their nursing risk control systems. Methods: In accordance with the graded classification and management requirements for medical quality and safety adverse events set by the National Health Commission, and combined with the hospital's actual management context, in-hospital graded management standards were formulated. Events that did not result in patient harm but revealed potential risks were defined as category A nursing adverse events (precursor phenomena) . Without adding new staff positions, the centralized reception, collation, and analysis of precursor phenomena were incorporated into the routine responsibilities of the existing nursing quality control positions. A blame-free reporting mechanism was also implemented. Results: From 2020 to 2024, the total number of reported precursor phenomena in the hospital was 2443, 3705, 4659, 4885 and 4436, respectively, showing an initial year-by-year increase followed by a decline. The scope of risk management expanded from medical order-related items to multiple systems, and unified collection and feedback of risk information were achieved. A quarterly analysis and feedback mechanism for precursor phenomena was established, which strengthened the functions of the existing nursing quality control positions and further optimized the allocation of nursing human resources. Conclusion: By expanding the functions of nursing quality control positions and shifting the management focus forward, incorporating precursor phenomena into centralized management can effectively promote nursing risk prevention and control, and optimize post functions and the utilization of human resources.

Key words: quality control; nursing quality; human resources; adverse event