Abstract:The improvement of medical care quality is a significant interest for the future years. The fight against nosocomial infections (NI) in the intensive care units (ICU) is a good example. We will focus on a set of observations which reflect the dynamic aspect of the decision, result of the application of a Medical Decision Support System (MDSS). This system has to make dynamic decision on temporal data. We use dynamic Bayesian network (DBN) to model this dynamic process. It is a temporal reasoning within a real-time environment; we are interested in the Dynamic Decision Support Systems in healthcare domain (MDDSS).