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Objective To investigate the effect of delicacy management in continuous quality improvement of orthopedic nursing. Methods A set of interventions based on delicacy management model were carried out in the orthopedic department, including spreading of refined management, management of human resource, improving training system, enhancing job responsibility, optimizing working procedure, management of equipments and drugs, optimizing performance appraisal and so on. The incidence rate of adverse events in nursing care before implementation of refined management (July 2017 to June 2018) and after implementation of refined management (July 2018 to June 2016) was compared. Results The incidence rate of adverse events in nursing care dropped from 0.92% before implementation of refined management to 0.32% after implementation of refined management. Conclusion The application of delicacy management is potentially effective to reduce the risk of adverse events in orthopedic nursing and continuously improve the quality of nursing service. [ABSTRACT FROM AUTHOR]