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Knowledge translation interventions for critically ill patients: a systematic review*.

Tasnim Sinuff1, John Muscedere, Neill K J Adhikari

  • 11Department of Critical Care Medicine, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada. 2Interdepartmental Division of Critical Care, University of Toronto, Toronto, ON, Canada. 3Department of Medicine, Queen's University, Kingston, ON, Canada. 4Clinical Evaluation Research Unit, Kingston General Hospital, Kingston, ON, Canada. 5Department of Critical Care Medicine, University of Calgary and Alberta Health Services, Calgary, AB, Canada. 6Department of Medicine, University of Calgary and Alberta Health Services, Calgary, AB, Canada. 7Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada. 8Institute of Public Health, University of Calgary, Calgary, AB, Canada. 9Center for Health Evaluation and Outcome Sciences, Vancouver, BC, Canada. 10Department of Medicine, Providence Health Care and University of British Columbia, Vancouver, BC, Canada. 11Department of Medicine, McMaster University, Hamilton, ON, Canada. 12Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada. 13Sunnybrook Health Sciences Centre, Toronto, ON, Canada. 14Winnipeg Regional Health Authority, Winnipeg, MB, Canada. 15Department of Community Health and Epidemiology, Queen's University, Kingston, ON, Canada. 16Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada. 17Department of Medicine, University of Toronto, Toronto, ON, Canada. 18Department of Critical Care Medicine, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON, Canada. 19Department of Medicine, University of Manitoba, Winnipeg, MB, Canada. 20Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada.

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Summary

Knowledge translation interventions, especially protocols with education, significantly improve critical care processes in the ICU. However, these interventions did not show improvements in patient clinical outcomes.

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Area of Science:

  • Critical Care Medicine
  • Health Services Research
  • Knowledge Translation

Background:

  • Implementing evidence-based practices in Intensive Care Units (ICUs) is crucial for improving patient care.
  • Knowledge translation (KT) interventions aim to bridge the gap between research findings and clinical practice.

Purpose of the Study:

  • To systematically review the impact of KT interventions on processes and outcomes of care within ICUs.
  • To assess the effectiveness of various KT strategies, including protocols, guidelines, and audit and feedback.

Main Methods:

  • A systematic review of randomized controlled trials and observational studies was conducted, searching electronic databases and reference lists.
  • Studies focused on clinical topics with at least five investigations.
  • Data on interventions, process measures, and patient outcomes were extracted and meta-analyzed.

Main Results:

  • 119 studies across nine clinical topics were included.
  • KT interventions incorporating protocols, with or without education, demonstrated significant improvements in continuous process measures.
  • No significant improvements in clinical outcomes such as mortality or length of stay were observed.

Conclusions:

  • Knowledge translation interventions, particularly those involving protocols and education, are effective in enhancing critical care processes.
  • Further research is needed to demonstrate the impact of KT interventions on patient-level clinical outcomes in the ICU.