Design and Implementation of a Nursing Clinical Decision Support System to Promote Guideline AdherenceLYERLA, FRANK PhD, RNCIN: Computers, Informatics, Nursing: July-August 2008 - Volume 26 - Issue 4 - p 227-233 doi: 10.1097/01.NCN.0000304800.93003.b4 Feature Article Abstract Author Information This article describes the development and implementation of a nursing clinical decision support system that prompts nurses to place mechanically ventilated patients in a semirecumbent position in the absence of contraindications. A literature review is provided regarding (1) ventilator-associated pneumonia and recommendations from expert panels to maintain mechanically ventilated patients in a semirecumbent position (unless contraindicated) and (2) clinical decision support systems. Use of clinical decision support systems has primarily been developed for physicians; however, there is growing interest in expanding this technology to nurses working in the clinical area. Despite recommendations from organizations such as the Center for Disease Control and Prevention to maintain mechanically ventilated patients in a head-elevated position, there is evidence that the practice is not adequately adhered to. Therefore, a nursing clinical decision support system (in the form of a reminder) that prompts nurses to adhere to this recommendation was designed and implemented. Author Affiliation: Southern Illinois University Edwardsville School of Nursing. Corresponding author: Frank Lyerla, PhD, RN, Southern Illinois University Edwardsville, Alumni Hall Box 1066, Edwardsville, IL 62026 (firstname.lastname@example.org). © 2008 Lippincott Williams & Wilkins, Inc.