title: Research in Review: Driving Critical Care Practice Change.
abstract: During the past year, studies were published that will lead to practice change, address challenges at the bedside, and introduce new care strategies. This article summarizes some of this important work and considers it in the context of previous research and practice. Examples of research-based practice changes include the performance and assessment of septic shock resuscitation, and the integration of tourniquets and massive transfusions in civilian trauma. Care challenges addressed include ethical considerations in light of the Ebola epidemic, infection prevention associated with chlorhexidine bathing, bedside alarm management, evidence to enhance moral courage, and interventions to mitigate thirst in critically ill patients. Research that portends future care includes a discussion of fecal microbiota transplant for patients with refractory infection with refractory infection with Clostridium difficile.
authors.affiliation: Elizabeth Bridges is a clinical nurse researcher and associate professor at the University of Washington Medical Center/School of Nursing, Seattle, Washington. Margaret McNeill is a clinical nurse specialist, perianesthesia, Department of Professional and Clinical Development, Frederick Regional Health System, Frederick, Maryland. Nancy Munro is senior acute care nurse practitioner, Critical Care Medicine Department, National Institutes of Health, Bethesda, Maryland. ebridges@u.washington.edu.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Bridges
authors.affiliation: Elizabeth Bridges is a clinical nurse researcher and associate professor at the University of Washington Medical Center/School of Nursing, Seattle, Washington. Margaret McNeill is a clinical nurse specialist, perianesthesia, Department of Professional and Clinical Development, Frederick Regional Health System, Frederick, Maryland. Nancy Munro is senior acute care nurse practitioner, Critical Care Medicine Department, National Institutes of Health, Bethesda, Maryland.
authors.forename: Margaret
authors.initials: M
authors.lastname: McNeill
authors.affiliation: Elizabeth Bridges is a clinical nurse researcher and associate professor at the University of Washington Medical Center/School of Nursing, Seattle, Washington. Margaret McNeill is a clinical nurse specialist, perianesthesia, Department of Professional and Clinical Development, Frederick Regional Health System, Frederick, Maryland. Nancy Munro is senior acute care nurse practitioner, Critical Care Medicine Department, National Institutes of Health, Bethesda, Maryland.
authors.forename: Nancy
authors.initials: N
authors.lastname: Munro
mesh_terms: D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D001494:Baths / Q000379:methods*; D002055:Burnout, Professional / Q000453:epidemiology; D002710:Chlorhexidine / Q000627:therapeutic use; D002986:Clinical Trials as Topic / Q000941:ethics; D016360:Clostridioides difficile; D000068376:Compassion Fatigue / Q000453:epidemiology; D003422:Critical Care / Q000379:methods*; D003428:Cross Infection / Q000517:prevention & control; D004761:Enterocolitis, Pseudomembranous / Q000382:microbiology / Q000628:therapy*; D005189:False Positive Reactions; D000069467:Fecal Microbiota Transplantation; D019142:Hemorrhagic Fever, Ebola / Q000188:drug therapy / Q000517:prevention & control; D006801:Humans; D018447:Medical Futility / Q000523:psychology; D008991:Monitoring, Physiologic; D012772:Shock, Septic / Q000628:therapy; D017603:Signal Detection, Psychological; D013894:Thirst; D014111:Tourniquets; D014612:Vaccines; D014947:Wounds and Injuries / Q000628:therapy
chemical_list: D000891:Anti-Infective Agents, Local; D014612:Vaccines; D002710:Chlorhexidine