Lost in (knowledge) translation!

Critical care nutrition guidelines have been developed to help busy practitioners decide how to feed their critically ill patients. However, despite the publication of guidelines and efforts to disseminate and implement them, there are large gaps between what the recommendations say and what is happening at the bedside. Consequently, the nutrition therapy received by many patients remains suboptimal. Knowledge translation is a term increasingly used in healthcare to describe the process of moving evidence learned from clinical research and summarized in clinical practice guidelines to incorporation into clinical and policy decision making. In this article, knowledge about the implementation of critical care nutrition guidelines is applied to Graham et al's knowledge-to-action model to illuminate the issues pertinent to knowledge translation in critical care nutrition. This model has 2 components: knowledge creation and action. The action component consists of 8 phases of the action cycle that represent activities needed to move knowledge into practice and are derived from planned-action theory. Components of this model are illustrated via empirically derived research, commentaries, and published studies from the field of critical care nutrition. It is hoped that this article and related articles in this issue of JPEN will help critical care nutrition practitioners to better understand the often complex and convoluted road of translating knowledge into practice so that as a community we are no longer "lost" but have direction that can bring about positive changes in nutrition practice.