How do physicians and nurses differ in their perceived barriers to effective enteral nutrition in the intensive care unit?
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Background Patients hospitalized in intensive care units are susceptible to chronic malnutrition from changes in protein and energy metabolism in response to trauma. Therefore, nutritional support, especially enteral nutrition, is one of the most important treatment measures for these patients. However, there are several barriers in the hospitals in treating patients with enteral nutrition. This study was performed to compare the perceptions of care providers (physicians and nurses) on the barriers to enteral nutrition in intensive care units. Methods This was a cross-sectional descriptive and analytic study. This study included 263 nurses and 104 physicians in the intensive care units of Kerman University of Medical sciences, in south east of Iran. A questionnaire of enteral nutrition barriers in intensive care units was used. IBM SPSS ver. 19 was used to analyze data. Results There was a significant difference between the two groups in the three subscales of intensive care units (P=0.034), dietician support (P<0.001) and critical care provider attitudes and behavior (P=0.031). There was also a significant difference between having completed educational courses and the score of enteral nutrition barriers in the two groups (P<0.05); the people who received an educational course had a better perception of enteral nutrition barriers. Conclusions Physicians and nurses agreed with the perception of enteral nutrition barriers, but there was a difference in their perception on some barriers. Strategies such as in-service training and increasing the knowledge and skills of physicians and nurses can reduce these differences.
Abstract
Background Patients hospitalized in intensive care units are susceptible to chronic malnutrition from changes in protein and energy metabolism in response to trauma. Therefore, nutritional support, especially enteral nutrition, is one of the most important treatment measures for these patients. However, there are several barriers in the hospitals in treating patients with enteral nutrition. This study was performed to compare the perceptions of care providers (physicians and nurses) on the barriers to enteral nutrition in intensive care units. Methods This was a cross-sectional descriptive and analytic study. This study included 263 nurses and 104 physicians in the intensive care units of Kerman University of Medical sciences, in south east of Iran. A questionnaire of enteral nutrition barriers in intensive care units was used. IBM SPSS ver. 19 was used to analyze data. Results There was a significant difference between the two groups in the three subscales of intensive care units (P=0.034), dietician support (P<0.001) and critical care provider attitudes and behavior (P=0.031). There was also a significant difference between having completed educational courses and the score of enteral nutrition barriers in the two groups (P<0.05); the people who received an educational course had a better perception of enteral nutrition barriers. Conclusions Physicians and nurses agreed with the perception of enteral nutrition barriers, but there was a difference in their perception on some barriers. Strategies such as in-service training and increasing the knowledge and skills of physicians and nurses can reduce these differences.
참고문헌 (25)
- McClave SA, "Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.)", JPEN J Parenter Enteral Nutr, 40, pp.159~211 (2016)
- Lewis SR, "Enteral versus parenteral nutrition and enteral versus a combination of enteral and parenteral nutrition for adults in the intensive care unit", Cochrane Database Syst Rev, 6, pp.CD012276~ (2018)
- Tappenden KA, "Critical role of nutrition in improving quality of care : an interdisciplinary call to action to address adult hospital malnutrition", JPEN J Parenter Enteral Nutr, 37, pp.482~497 (2013)
- Wei X, "The association between nutritional adequacy and long-term outcomes in critically ill patients requiring prolonged mechanical ventilation : a multicenter cohort study", Crit Care Med, 43, pp.1569~1579 (2015)
- O’Leary-Kelley C, "Nutrition support protocols: enhancing delivery of enteral nutrition", Crit Care Nurse, 37, pp.e15~e23 (2017)
- Ridley E, "Full-feeding with enteral nutrition is not always"full-feeding"in research and clinical practice", JPEN J Parenter Enteral Nutr, 39, pp.383~ (2015)
- 조재화, "Lack of evidence for a nutritional support team in a trauma intensive care unit?", Acute and Critical Care, 35(3), pp.205~206 (2020), 대한중환자의학회[DOI]
- Elke G, "Enteral versus parenteral nutrition in critically ill patients : an updated systematic review and meta-analysis of randomized controlled trials", Crit Care, 20, pp.117~ (2016)
- Mula C, "Nurses’ competency and challenges in enteral feeding in the intensive care unit (ICU) and high dependency units (HDU) of a referral hospital, Malawi", Malawi Med J, 26, pp.55~59 (2014)
- Cochrane LJ, "Gaps between knowing and doing: understanding and assessing the barriers to optimal health care", J Contin Educ Health Prof, 27, pp.94~102 (2007)
- Cahill NE, "Barriers to feeding critically ill patients : a multicenter survey of critical care nurses", J Crit Care, 27, pp.727~734 (2012)
- Darawad MW, "ICU nurses’ perceived barriers to effective enteral nutrition practices: a multicenter survey study", Open Nurs J, 12, pp.67~75 (2018)
- Cahill NE, "Nutrition therapy in the critical care setting : what is"best achievable"practice? An international multicenter observational study", Crit Care Med, 38, pp.395~401 (2010)
- Kim H, "Why patients in critical care do not receive adequate enteral nutrition? A review of the literature", J Crit Care, 27, pp.702~713 (2012)
- Chapple LA, "Barriers to nutrition intervention for patients with a traumatic brain injury : views and attitudes of medical and nursing practitioners in the acute care setting", JPEN J Parenter Enteral Nutr, 42, pp.318~326 (2018)
- Cahill NE, "Understanding adherence to guidelines in the intensive care unit : development of a comprehensive framework", JPEN J Parenter Enteral Nutr, 34, pp.616~624 (2010)
- Shayesteh F, "Assessment of nutritional intake in intensive care unit patients of Ghaem hospital", Med J Mashhad Univ Med Sci, 58, pp.217~224 (2015)
- Cahill NE, "Revised questionnaire to assess barriers to adequate nutrition in the critically ill", JPEN J Parenter Enteral Nutr, 40, pp.511~518 (2016)
- O’Flynn J, "The prevalence of malnutrition in hospitals can be reduced : results from three consecutive cross-sectional studies", Clin Nutr, 24, pp.1078~1088 (2005)
- ASPEN Board of Directors and the Clinical Guidelines Task Force, "Guidelines for the use of parenteral and enteral nutrition in adult and pediatric patients", JPEN J Parenter Enteral Nutr, 26(1 Suppl), pp.1SA~138SA (2002)
- Chan EY, "Nasogastric feeding practices : a survey using clinical scenarios", Int J Nurs Stud, 49, pp.310~319 (2012)
- Ashouri E, "A comparison of performing tube feeding with the standard procedures at selected educational and treatment centers of Isfahan University of Medical Sciences, Iran", Iran J Nurs Midwifery Res, 17(2 Suppl 1), pp.S80~S84 (2012)
- Zahra ZS, "Knowledge assessment and comparing the performance of intensive care unit nurses in regard to tube feeding with existing standards in educational and treatment centers of Qom University of Medical Sciences, Iran", Qom Univ Med Sci J, 10, pp.45~54 (2016)
- Mehrnosh N, "Performance of critical care nurses in nasogastric tube nutrition in Ardabil Hospitals", J Health Care, 20, pp.186~195 (2018)
- Darawad MW, "Investigating critical care nurses’ perception regarding enteral nutrition", Nurse Educ Today, 35, pp.414~419 (2015)