How do we know that the care we provide is going to result in the best outcomes? Traditional practices in critical care, such as keeping patients in bed or using saline to suction endotracheal tubes, are debunked by existing research, offering the lesson that what seems right may actually contribute to worse outcomes. Feeling confident about our care is not always easy. At times, there is no evidence to guide us. The best evidence comes when bedside nurse champions collaborate with researchers and encourage staff and patient participation in projects. Still, recruiting critically ill patients into research projects is challenging as they are focused on their recovery and generating new information is not their priority.

The absence of concrete answers about best practices can be frustrating, however an appreciation that nursing practice is ever evolving also offers opportunities. There may be solutions no one has yet studied that are promising...

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