关键词: 重症监护病房；身体约束；决策支持系统，临床

Abstract: Objective: To construct a Clinical Decision Support System (CDSS) for physical restraints in ICU patients and explore its clinical application effect, in order to provide convenience for nurses' restraint decision making. Methods: A research team was set up to construct and validate the prediction model of physical restraint for ICU patients. A CDSS for physical restraints in ICU patients was constructed based on the prediction model. Totally 764 ICU patients from August 2022 to March 2023 in a tertiary hospital in Jiangsu province were selected as the research participants. The patients were divided into intervention group (n=366) and control group (n=398) by random method. In control group, nurses made a decision about physical restraint based on empirical assessment. And the physical restraint CDSS for ICU patients was used to help nurses to make a decision about physical restraint in intervention group. The physical restraints rate, delirium incidence rate and unplanned extubation rate of the two groups were compared, and the consistency of CDSS and restraint decision wheel was verified. Results: After using the CDSS, the physical restraints rate was 24.9%, and the incidence of delirium was 2.2% in intervention group, which were significantly lower compared with the control group (P<0.05). There was no statistically significant difference in the incidence of unplanned extubation between the two groups (P>0.05). The Kappa consistency test between CDSS and restraint decision wheel was 0.853 (P<0.001), showing good consistency. Conclusion: The physical restraint CDSS in ICU patients can be applied to clinical practice and assist nurses in decision-making. It can effectively reduce the rate of physical restraint and delirium without increasing the rate of unplanned extubation.

Key words: Intensive Care Unit; physical restraints; decision support system, clinical