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Updated: Jan 20, 2026
06:04
Objective Nociceptive Assessment in Ventilated ICU Patients: A Feasibility Study Using Pupillometry and the Nociceptive Flexion Reflex
Published on: July 4, 2018
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Strategies to effect change in the ICU
1University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
Current Opinion in Critical Care
|August 30, 2019
Summary
Implementing evidence-based practices in intensive care units (ICUs) faces challenges. Awareness and adoption of guidelines like Choosing Wisely and the ABCDE bundle are limited, highlighting the need for implementation science.
Area of Science:
- Critical care medicine
- Implementation science
- Healthcare quality improvement
Background:
- Intensive care unit (ICU) care delivery requires effective implementation of evidence-based practices.
- Translating clinical research into improved patient outcomes necessitates understanding implementation barriers.
Purpose of the Study:
- To review recent advancements (last 2 years) in implementing critical care interventions.
- To identify barriers and facilitators for applying best practices in the ICU.
Main Methods:
- Literature review focusing on implementation science in critical care.
- Analysis of studies evaluating the adoption of ICU guidelines and bundles.
Main Results:
- Low awareness of initiatives like the Choosing Wisely campaign among ICU teams.
- Significant barriers to implementing the ABCDE bundle exist, spanning clinician, protocol, and systemic factors.
- Audit and feedback show moderate success in improving antibiotic prescribing in ICUs.
Conclusions:
- Effective implementation of critical care best practices requires moving beyond discovery to application.
- Future research should employ robust methodologies to demonstrate causal impact of implementation strategies.
- Addressing multifaceted barriers is crucial for advancing ICU patient care quality.
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