关键词: 脑卒中；卒中相关性肺炎；临床决策支持系统；防控；闭环管理

Abstract: Objective: To construct a closed-loop management module for Stroke-Associated Pneumonia (SAP) based on the Clinical Decision Support System (CDSS), so as to improve the level of SAP prevention and control and optimize patients' prognosis. Methods: A multidisciplinary team was established to build a SAP management knowledge base and a closed-loop management module, which was piloted and optimized after testing. Forty patients with acute stroke were selected respectively before and after the module application to compare the SAP incidence rate, length of hospital stay, time to first prevention and control measures, accuracy of nursing records, pass rate of nurses' knowledge on SAP prevention and control, and nurses' satisfaction with the module. Results: After the application, the SAP incidence rate of the observation group was 5.0%, which was significantly lower than 25.0% of the control group; the length of hospital stay and the time to first SAP prevention and control measures of the observation group were both shorter than those of the control group; the accuracy of nursing records of the observation group was 94.12%, higher than 71.43% of the control group. The nurses' score on SAP prevention and control knowledge increased from 80.50±10.37 to 89.65±6.64, and the average score of nurses' satisfaction with the system in all dimensions was over 4 points. Statistically significant differences were observed in all the above indicators (P<0.05). Conclusion: The CDSS-based closed-loop management module for SAP can effectively reduce the SAP incidence rate, shorten the length of hospital stay and the time to first prevention and control measures, improve the nursing quality and nurses' satisfaction, which plays a positive role in enhancing the management level of SAP.

Key words: stroke; Stroke-Associated Pneumonia; Clinical Decision Support System; prevention and control; closed-loop management