Coordination and modularization: the experience of the joint prevention and control mechanism to COVID emergencies in China.

Background: The integration of disparate emergency resources and the improvement of emergency response teamwork are the underlying trends and shared requirements for building resilience in an era of multiple global public health crises. Objective: This study investigated the emergency response with emergency collaboration networks of each functional module and the overall Joint Epidemic Prevention and Control Mechanism (JPCM) network in China's COVID outbreak prevention and control. Methods: The study employed a scholarly framework of "the integration of JPCM coordination and emergency collaborative modularization" to explore the attributes of JPCM using social network analysis. The data were obtained from administrative records from JPCM's official website, spanning January 2020 to December 2022. Results: The study examined the JPCM coordination and found several functional working modules of JPCM, such as Interrupt Spread, Manage Supply, Medical Rescue, Restore Work and Production, and Implement Responsibility modules. The network structure indicators showed that the Manage Supply module had the most extensive network connectivity, the shortest communication distance, and the most consistent collaboration. The E-I index of the overall JPCM network and the Manage Supply network were - 0.192 and - 0.452, respectively (at p < 0.001 and p < 0.05), indicating more internal relationships than external relationships. The E-I index of the Medical Rescue and Implement Responsibility collaboration networks were 0.122 and 0.147, respectively (at p < 0.001 and p < 0.05), indicating more external relationships than internal relationships. The QAP regression analysis showed that the most vital driver on the overall JPCM network was the Interrupt Spread module, followed by the Implement Responsibility and Medical Rescue modules. Discussion: The Interrupt Spread module initiated emergency coordination with most departments and agencies. The Manage Supply module ensured the flow of medical supplies and survival essentials, while the Medical Rescue module addressed the core aspects of the health emergency response. The Restore Work and Production module repaired the halt in production and livelihoods caused by the outbreak, strengthening and developing emergency coordination and roles across emergency organizations. The Implement Responsibility module provided more heterogeneous emergency response resources for the overall JPCM coordination, complementing the COVID cross-organizational emergency response coordination. Conclusion: The study on the JPCM case in China improves public health emergency management and aids informed decision-making.

The 5 C model and Mpox vaccination behavior in Germany: a cross-sectional survey.

BACKGROUND: Due to the authorization of the Mpox vaccines, we aimed to identify determinants of the intention to get vaccinated, actively trying to receive vaccination, and for successfully receiving a vaccination in Germany employing the 5 C model of vaccination readiness. METHODS: Data stem from a cross-sectional online survey that was available online from August 13, 2022 to August 31, 2022. To assess the influence of the 5 C Model on vaccination behavior, we conducted a multinomial logistic regression. RESULTS: 3,338 participants responded to the survey, with 487 already vaccinated and 2,066 intending to receive a vaccination. Confidence and collective responsibility were positively associated with intention to get vaccinated, while complacency was negatively correlated. A higher score on the calculation scale increased the odds of intention to receive vaccination but not with actively having tried to receive a vaccination. Fewer perceived constraints were associated with higher odds to be vaccinated. Patients in practices that focus on HIV treatment were more likely to intend to get vaccinated, to have tried to get vaccinated and to be vaccinated, regardless of indication. While level of education had no impact, having an indication to get vaccinated was a strong predictor of vaccination behavior in all groups. CONCLUSION: Future vaccination campaigns should aim to reduce specific constraints of the target group and make vaccines widely available in primary care institutions beyond HIV-focused practices.

Ten years of hand hygiene excellence: a summary of outcomes, and a comparison of indicators, from award-winning hospitals worldwide.

BACKGROUND: Hand hygiene is a crucial measure for the prevention of healthcare-associated infections (HAIs). The Hand Hygiene Excellence Award (HHEA) is an international programme acknowledging healthcare facilities for their leadership in implementing hand hygiene improvement programmes, including the World Health Organisation's Multimodal Improvement Strategy. This study aimed at summarising the results of the HHEA campaign between 2010 and 2021 and investigating the relationship between different hand hygiene parameters based on data from participating healthcare facilities. METHODS: A retrospective analysis was performed on datasets from HHEA forms, including data on hand hygiene compliance, alcohol-based handrub (ABHR) consumption, and Hand Hygiene Self-Assessment Framework (HHSAF) scores. Descriptive statistics were reported for each variable. The correlation between variables was inspected through Kendall's test, while possible non-linear relationships between hand hygiene compliance, ABHR consumption and HHSAF scores were sought through the Locally Estimated Scatterplot Smoothing or logistic regression models. A tree-structured partitioning model was developed to further confirm the obtained findings. RESULTS: Ninety-seven healthcare facilities from 28 countries in three world regions (Asia-Pacific, Europe, Latin America) were awarded the HHEA and thus included in the analysis. HHSAF scores indicated an advanced hand hygiene promotion level (median 445 points, IQR 395-480). System change (100 [95-100] points) and institutional safety climate (85 [70-95] points) showed the highest and lowest score, respectively. In most cases, hand hygiene compliance was above 70%, with heterogeneity between countries. ABHR consumption above 20 millilitres per patient-day (ml/PD) was widely reported, with overall increasing trends. HHSAF scores were positively correlated with hand hygiene compliance (τ = 0.211, p = 0.007). We observed a positive correlation between compliance rates and ABHR consumption (τ = 0.193, p < 0.001), although the average predicted consumption was stable around 55-60 ml/PD for compliance rates above 80-85%. Logistic regression and partitioning tree analyses revealed that higher HHSAF scores were more likely in the high-ABHR consumption group at cut-offs around 57-59 ml/PD. CONCLUSION: Ten years after its inception, the HHEA proves to be a valuable hand hygiene improvement programme in healthcare facilities worldwide. Consistent results were provided by the different hand hygiene indicators and the HHSAF score represents a valuable proxy measure of hand hygiene compliance.

Hygiene requirements for cleaning and disinfection of surfaces: recommendation of the Commission for Hospital Hygiene and Infection Prevention (KRINKO) at the Robert Koch Institute.

This recommendation of the Commission for Hospital Hygiene and Infection Prevention (KRINKO) addresses not only hospitals, but also outpatient health care facilities and compiles current evidence. The following criteria are the basis for the indications for cleaning and disinfection: Infectious bioburden and tenacity of potential pathogens on surfaces and their transmission routes, influence of disinfecting surface cleaning on the rate of nosocomial infections, interruption of cross infections due to multidrug-resistant organisms, and outbreak control by disinfecting cleaning within bundles. The criteria for the selection of disinfectants are determined by the requirements for effectiveness, the efficacy spectrum, the compatibility for humans and the environment, as well as the risk potential for the development of tolerance and resistance. Detailed instructions on the organization and implementation of cleaning and disinfection measures, including structural and equipment requirements, serve as the basis for their implementation. Since the agents for surface disinfection and disinfecting surface cleaning have been classified as biocides in Europe since 2013, the regulatory consequences are explained. As possible addition to surface disinfection, probiotic cleaning, is pointed out. In an informative appendix (only in German), the pathogen characteristics for their acquisition of surfaces, such as tenacity, infectious dose and biofilm formation, and the toxicological and ecotoxicological characteristics of microbicidal agents as the basis for their selection are explained, and methods for the evaluation of the resulting quality of cleaning or disinfecting surface cleaning are presented.

Soil intake modifies the gut microbiota and alleviates Th2-type immune response in an ovalbumin-induced asthma mouse model.

Background: A low-clean living environment (LCLE) can increase gut microbial diversity and prevent allergic diseases, whereas gut microbial dysbiosis is closely related to the pathogenesis of asthma. Our previous studies suggested that soil in the LCLE is a key factor in shaping intestinal microbiota. We aimed to explore whether sterilized soil intake as a prebiotic while being incubated with microbes in the air can attenuate mouse asthma inflammation by modifying gut microbiota. Methods: 16S rRNA gene sequencing was used to analyze the gut microbial composition, in combination with immune parameters measured in the lung and serum samples. Results: 16S rRNA gene sequencing results showed significant differences in the fecal microbiota composition between the test and control mice, with a higher abundance of Allobaculum, Alistipes, and Lachnospiraceae_UCG-001, which produce short-chain fatty acids and are beneficial for health in the test mice. Soil intake significantly downregulated the concentrations of IL-4 and IL-9 in serum and increased the expression of IFN-γ, which regulated the Th1/Th2 balance in the lung by polarizing the immune system toward Th1, alleviating ovalbumin-induced asthma inflammation. The effect of sensitization on gut microbiota was greater than that of air microbes and age together but weaker than that of soil. Conclusions: Soil intake effectively reduced the expression of inflammatory cytokines in asthmatic mice, possibly by promoting the growth of multiple beneficial bacteria. The results indicated that the development of soil-based prebiotic products might be used for allergic asthma management, and our study provides further evidence for the hygiene hypothesis.

Exploring variations in IPC competencies: a cross-sectional study among healthcare professionals in Northwest China.

BACKGROUND: This cross-sectional study investigates infection prevention and control (IPC) competencies among healthcare professionals in northwest China, examining the influence of demographic factors, job titles, education, work experience, and hospital levels. METHODS: Data from 874 respondents across 47 hospitals were collected through surveys assessing 16 major IPC domains. Statistical analyses, including Mann-Whitney tests, were employed to compare competencies across variables. RESULTS: Significant differences were identified based on gender, job titles, education, work experience, and hospital levels. Females demonstrated higher IPC competencies, while senior positions exhibited superior performance. Higher educational attainment and prolonged work experience positively correlated with enhanced competencies. Variances across hospital levels underscored context-specific competencies. CONCLUSION: Demographic factors and professional variables significantly shape IPC competencies. Tailored training, considering gender differences and job roles, is crucial. Higher education and prolonged work experience positively impact proficiency. Context-specific interventions are essential for diverse hospital settings, informing strategies to enhance IPC skills and mitigate healthcare-associated infections effectively.

Patient concerns and physician strategies for addressing COVID-19 vaccine hesitancy.

OBJECTIVE: COVID-19 vaccination is critical for reducing serious illness and hospitalizations, yet many remain hesitant. We conducted a survey of frontline physicians to identify patient concerns and physician strategies to address COVID-19 vaccine-hesitancy. METHODS: A national random sample of physicians in frontline specialties selected from a comprehensive list of practicing physicians in the U.S. were emailed a survey in August 2021. Multiple choice and open-ended questions inquired about patient concerns related to the COVID-19 vaccines and strategies used by physicians to counter vaccine misinformation and encourage vaccine-hesitant patients. Weighting was applied to achieve representativeness and reduce non-response bias. Network analysis examined co-occurring patient concerns. Open-ended responses on communication strategies were coded via thematic analysis. Multi-variable logistic regression examined associations between physician and pandemic characteristics with patient concerns and use of communication strategies. RESULTS: 531 physicians responded: primary care (241); emergency medicine (142); critical care (84); hospitalists (34); and infectious disease (30). Weighted response balance statistics showed excellent balance between respondents and nonrespondents. On average, physicians reported four patient vaccine concerns. Safety, side effects, vaccine misinformation, and mistrust in government were most common, and often co-occurring. 297 physicians described communication strategies: 180 (61 %) provided vaccine education and 94 (32 %) created a safe space for vaccine discussion. Narrative responses from physicians provided compelling examples of both successes and communication challenges arising from misinformation. Compared with emergency medicine, critical care (OR 2.45, 95 % CI 1.14, 5.24), infectious disease (OR 2.45, 95 % CI 1.00, 6.02), and primary care physicians (OR 1.66, 95 % CI 1.02, 2.70) were more likely to provide communication strategies. CONCLUSIONS: Many physicians engage with vaccine hesitant patients using a variety of strategies. Dissemination of effective system and physician-level communication interventions could enhance physician success.

Modeling and analysis of a tourism supply chain considering service level and advertising in the context of regular epidemic prevention and control under COVID-19.

In the context of regular epidemic prevention and control, this paper considers a two-stage tourism supply chain consisting of a scenic spot that attracts tourists through advertising and a travel agency that invests in service improvement and epidemic prevention. By establishing theoretical game models of a tourism supply chain, we investigate how the service level and advertising level can affect the retail price, product service level, and profits of the supply chain. The results show that the service level of travel agencies could improve consumers' preferences, expand the market demand for tourism products, and improve the efficiency of the supply chain to achieve a win-win situation and increase the profits of the scenic spot and the travel agency. The retailer price, service level, promotion level, and supply chain profit all increase as the service coefficient and advertising coefficient increase, and the speed of the increase is higher for the centralized model than for other models. Some valuable information could be provided for supply chain enterprises to develop collaborative strategies and promote tourism supply chain management practices.

Evaluating the impact of genomic epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) on hospital infection prevention and control decisions.

Genomic epidemiology enhances the ability to detect and refute methicillin-resistant Staphylococcus aureus (MRSA) outbreaks in healthcare settings, but its routine introduction requires further evidence of benefits for patients and resource utilization. We performed a 12 month prospective study at Cambridge University Hospitals NHS Foundation Trust in the UK to capture its impact on hospital infection prevention and control (IPC) decisions. MRSA-positive samples were identified via the hospital microbiology laboratory between November 2018 and November 2019. We included samples from in-patients, clinic out-patients, people reviewed in the Emergency Department and healthcare workers screened by Occupational Health. We sequenced the first MRSA isolate from 823 consecutive individuals, defined their pairwise genetic relatedness, and sought epidemiological links in the hospital and community. Genomic analysis of 823 MRSA isolates identified 72 genetic clusters of two or more isolates containing 339/823 (41 %) of the cases. Epidemiological links were identified between two or more cases for 190 (23 %) individuals in 34/72 clusters. Weekly genomic epidemiology updates were shared with the IPC team, culminating in 49 face-to-face meetings and 21 written communications. Seventeen clusters were identified that were consistent with hospital MRSA transmission, discussion of which led to additional IPC actions in 14 of these. Two outbreaks were also identified where transmission had occurred in the community prior to hospital presentation; these were escalated to relevant IPC teams. We identified 38 instances where two or more in-patients shared a ward location on overlapping dates but carried unrelated MRSA isolates (pseudo-outbreaks); research data led to de-escalation of investigations in six of these. Our findings provide further support for the routine use of genomic epidemiology to enhance and target IPC resources.

Identification of Early Warning Signals of Infectious Diseases in Hospitals by Integrating Clinical Treatment and Disease Prevention.

The global incidence of infectious diseases has increased in recent years, posing a significant threat to human health. Hospitals typically serve as frontline institutions for detecting infectious diseases. However, accurately identifying warning signals of infectious diseases in a timely manner, especially emerging infectious diseases, can be challenging. Consequently, there is a pressing need to integrate treatment and disease prevention data to conduct comprehensive analyses aimed at preventing and controlling infectious diseases within hospitals. This paper examines the role of medical data in the early identification of infectious diseases, explores early warning technologies for infectious disease recognition, and assesses monitoring and early warning mechanisms for infectious diseases. We propose that hospitals adopt novel multidimensional early warning technologies to mine and analyze medical data from various systems, in compliance with national strategies to integrate clinical treatment and disease prevention. Furthermore, hospitals should establish institution-specific, clinical-based early warning models for infectious diseases to actively monitor early signals and enhance preparedness for infectious disease prevention and control.

Utilizing data platform management to implement "5W" analysis framework for preventing and controlling corruption in grassroots government.

In the era of information technology advancement, big data analysis has emerged as a crucial tool for government governance. Despite this, corruption remains a challenge at the grass-roots level, primarily attributed to information asymmetry. To enhance the efficacy of corruption prevention and control in grass-roots government, this study introduces the concept of data platform management and integrates it with the "5W" (Who, What, When, Where, Why) analysis framework. The research is motivated by the observation that existing studies on corruption prevention primarily concentrate on the formulation of laws and regulations, neglecting the potential improvement in actual effectiveness through the utilization of data platforms and analytical frameworks. The research employs methodologies grounded in the Strengths, Weaknesses, Opportunities, Threats (SWOT) analysis framework, the Plan, Do, Check, Act (PDCA) cycle analysis framework, and the 5W analysis framework. Throughout the iterative process of implementing data platform management, various timeframes are established, and the impact of the three models is evaluated using indicators such as public participation and government satisfaction. The research reveals that the SWOT framework can formulate targeted strategies, the PDCA framework continuously optimizes work processes, and the 5W framework profoundly explores the root causes of corruption. The outcomes indicate a 10.76% increase in the public participation level score with the 5W model, rising from 71.67%, and a 23.24% increase in the governance efficiency score, reaching 66.12%. The SWOT model excels in case handling prescription and corruption reporting rate. The synergistic application of the three models demonstrates a positive impact. In conclusion, the amalgamation of data platform management and a multi-model approach effectively enhances the corruption prevention capabilities of grass-roots governments, offering insights for the establishment of transparent and efficient grass-roots governance.

Risk Factors for Occupational Blood Exposure, Compliance with Policies of Infection Prevention and Control, and Costs Associated with Post Exposure Management Among Nursing Staff.

Objective: To examine the risk factors linked with occupational blood exposure (OBE) among nursing staff (NS), we pinpoint deficiencies in the compliance with policies of infection prevention and control, and assess the expenditures associated with infection prevention and control. Methods: Healthcare workers that completed an "Occupational Blood Exposure Report Form" were divided into NS (observation) group and non-NS (control) group. Univariate and multivariable analyses were conducted to compare both groups in various aspects. We also explored design patents intended to minimize occupational exposure. Results: The highest incidence of OBE was observed in the department of neurosurgery. Among NS, OBE incidence was found to be influenced by independent risk factors, such as gender, age, occupational title, work location, and incidence of sharps injuries. Protective factors against OBEs included the use of arterial blood gas needles and suture needles. Personal protective equipment (PPE) usage rates were low in both groups prior to OBEs (0.74% vs 0.00%, P > 0.05). Correct emergency management could be improved promptly by both groups following an OBE (P > 0.05). However, the observation group exhibited a higher proportion of blood expression after a sharps injury and a higher re-evaluation rate at 6 months post-exposure compared to the control group (P < 0.05). In 2018, the per capita costs of infection prevention and control for NS were the Chinese Yuan (RMB) 339.43 per individual. In response to these findings, two utility model patents have been authorized. Conclusion: The risk and protective factors related to the occurrence of OBEs were investigated in this study, suggesting that there is a need for improvement in the rate of PPE usage and the re-evaluation rate of OBEs among NS. Additionally, focused training on emergency blood expression and compliance with policies among non-NS personnel is deemed necessary.

Candida auris in US Correctional Facilities.

Candida auris is an emerging fungal pathogen that typically affects patients in healthcare settings. Data on C. auris cases in correctional facilities are limited but are needed to guide public health recommendations. We describe cases and challenges of providing care for 13 patients who were transferred to correctional facilities during January 2020-December 2022 after having a positive C. auris specimen. All patients had positive specimens identified while receiving inpatient care at healthcare facilities in geographic areas with high C. auris prevalence. Correctional facilities reported challenges managing patients and implementing prevention measures; those challenges varied by whether patients were housed in prison medical units or general population units. Although rarely reported, C. auris cases in persons who are incarcerated may occur, particularly in persons with known risk factors. Measures to manage cases and prevent C. auris spread in correctional facilities should address setting-specific challenges in healthcare and nonhealthcare correctional environments.

Outbreak of Invasive Serratia marcescens among Persons Incarcerated in a State Prison, California, USA, March 2020-December 2022.

Serratia marcescens is an environmental gram-negative bacterium that causes invasive disease in rare cases. During 2020-2022, an outbreak of 21 invasive Serratia infections occurred in a prison in California, USA. Most (95%) patients had a history of recent injection drug use (IDU). We performed whole-genome sequencing and found isolates from 8 patients and 2 pieces of IDU equipment were closely related. We also identified social interactions among patients. We recovered S. marcescens from multiple environmental samples throughout the prison, including personal containers storing Cell Block 64 (CB64), a quaternary ammonium disinfectant solution. CB64 preparation and storage conditions were suboptimal for S. marcescens disinfection. The outbreak was likely caused by contaminated CB64 and propagated by shared IDU equipment and social connections. Ensuring appropriate preparation, storage, and availability of disinfectants and enacting interventions to counteract disease spread through IDU can reduce risks for invasive Serratia infections in California prisons.

Infection Prevention and Control in Correctional Settings.

Correctional facilities house millions of residents in communities throughout the United States. Such congregate settings are critical for national infection prevention and control (IPC) efforts. Carceral settings can be sites where infectious diseases are detected in patient populations who may not otherwise have access to health care services, and as highlighted by the COVID-19 pandemic, where outbreaks of infectious diseases may result in spread to residents, correctional staff, and the community at large. Correctional IPC, while sharing commonalities with IPC in other settings, is unique programmatically and operationally. In this article, we identify common challenges with correctional IPC program implementation and recommend action steps for advancing correctional IPC as a national public health priority.

Identifying key mental health and improvement factors in hospital administrators working from home using a DEMATEL-based network analysis model.

Purpose: To identify the key mental health and improvement factors in hospital administrators working from home during COVID-19 normalization prevention and control. Methods: The survey was conducted from May to June 2023, and the practical experiences of 33 hospital administrators were collected using purposive sampling. The study examined a set of mental health factor systems. The relationship structure between the factors was constructed using the Decision-making Trial and Evaluation Laboratory (DEMATEL) method. Finally, the structure was transformed using the influence weight of each factor via the DEMATEL-based Analytic Network Process. Results: Regarding influence weight, the key mental health factors of hospital administrators are mainly "lack of coordination," "time management issues," and "work-life imbalances." The influential network relation map shows that improvements can be made by addressing "improper guidelines," "laziness due to being at home," and "job insecurity" because they are the main sources of influence. The reliability level of the results for the network structure and weight was 98.79% (i.e., the gap was 1.12% < 5%). Conclusion: The network analysis model based on DEMATEL proposed in this study can evaluate the mental health factors of hospital administrators during the pandemic period from a multidimensional and multidirectional perspective and may help improve mental health problems and provide suggestions for hospital administrators.

Candida auris in Greek healthcare facilities: Active surveillance results on first cases and outbreaks from eleven hospitals within Attica region.

BACKGROUND: Candida auris was sporadically detected in Greece until 2019. Thereupon, there has been an increase in isolations among inpatients of healthcare facilities. AIM: We aim to report active surveillance data on MALDI-TOF confirmed Candida auris cases and outbreaks, from November 2019 to September 2021. METHODS: A retrospective study on hospital-based Candida auris data, over a 23-month period was conducted, involving 11 hospitals within Attica region. Antifungal susceptibility testing and genotyping were conducted. Case mortality and fatality rates were calculated and p-values less than 0.05 were considered statistically significant. Infection control measures were enforced and enhanced. RESULTS: Twenty cases with invasive infection and 25 colonized were identified (median age: 72 years), all admitted to hospitals for reasons other than fungal infections. Median hospitalisation time until diagnosis was 26 days. Common risk factors among cases were the presence of indwelling devices (91.1 %), concurrent bacterial infections during hospitalisation (60.0 %), multiple antimicrobial drug treatment courses prior to hospitalisation (57.8 %), and admission in the ICU (44.4 %). Overall mortality rate was 53 %, after a median of 41.5 hospitalisation days. Resistance to fluconazole and amphotericin B was identified in 100 % and 3 % of tested clinical isolates, respectively. All isolates belonged to South Asian clade I. Outbreaks were identified in six hospitals, while remaining hospitals detected sporadic C. auris cases. CONCLUSION: Candida auris has proven its ability to rapidly spread and persist among inpatients and environment of healthcare facilities. Surveillance focused on the presence of risk factors and local epidemiology, and implementation of strict infection control measures remain the most useful interventions.

Nano protective membrane coated wheat to resist powdery mildew.

The plant pathogenic fungus Blumeria graminis f. sp. tritici infects wheat and reduces its yield. The policy of reducing fertilizer and biocide use in sustainable agriculture has prompted researchers to develop more green and efficient management strategies. In this study, a novel nanoprotective membrane (kaolin-nano titanium dioxide-liquid paraffin, referred to as KTP) that could effectively prevent powdery mildew of wheat was prepared by using 1 g/L kaolin, 2 g/L nanotitanium dioxide and 8% (v/v) liquid paraffin. The prevention and control effects of KTP spraying in advance in the pot and field experiments were 98.45% and 83.04%, respectively. More importantly, the weight of 1000 grains of wheat pretreated with KTP was 2.56 g higher than that of wheat infected with powdery mildew, significantly improving wheat yield. KTP delayed the germination of powdery mildew spores on the leaf surface, and inhibited the formation of mycelia. In addition, KTP did not affect the growth of wheat or the survival of earthworms. KTP nanoprotective membrane are a green and safe prevention and control materials that are which is expected to be widely used in agriculture to control wheat powdery mildew.

Fall risk perception in older adults: A concept analysis.

BACKGROUND: Fall prevention is crucial for older adults. Enhanced fall risk perception can encourage older adults to participate in fall prevention programs. However, there is still no unified definition of the concept of fall risk perception. OBJECTIVE: To explore the concept of fall risk perception in older adults. DESIGN: A concept analysis. DATA SOURCES: The literature was searched using online databases including PubMed, Cochrane Library, Embase, CINAHL Complete, PsycINFO, Web of Science, China National Knowledge Infrastructure, WangFang and SinoMed. Searches were also conducted in Chinese and English dictionaries. The literature dates from the establishment of the database to April 2023. METHODS: The methods of Walker and Avant were used to identify antecedents, attributes and consequences of the concept of "fall risk perception" in older adults. RESULTS: Eighteen publications were included eventually. The attributes were identified as: (1) dynamic change, with features of continuum and stage; (2) whether falls are taken seriously; (3) a self-assessment of the fall probability, which is driven by individual independence; and (4) involves multiple complex emotional responses. The antecedents were identified as: (1) demographic and disease factors; (2) psychological factors and (3) environmental factors. The consequences were identified as: (1) risk-taking behaviour; (2) risk compensation behaviour; (3) risk transfer behaviour; and (4) emotions. CONCLUSION: A theoretical definition of fall risk perception was identified. A conceptual model was developed to demonstrate the theoretical relationships between antecedents, attributes and consequences. This is helpful for the development of relevant theories and the formulation of fall prevention measures based on fall risk perception as the intervention target.