Barriers to Delivery of Enteral Nutrition in Intensive Care Settings in Saudi Arabia: A Comparative Study of the Perceptions of Health Care Providers Working in Adult and Paediatric ICUs

Zaher, Sara

doi:10.2147/rmhp.s394035

Cited by 3 publications

(1 citation statement)

References 33 publications

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“…This results in substandard feeding (Brierley-Hobson et al, 2019 ; Lee et al, 2018 ). Additionally, various issues related to enteral nutrition, such as abdominal distension, diarrhea, and aspiration, may arise, impacting the progress of enteral nutrition in children (Zaher, 2022 ; Zhang et al, 2021 ). Some studies (Chen et al, 2022 ; Feiyue et al, 2023 ) have indicated that substandard feeding through early enteral nutrition in critically ill patients can prolong their ICU stay and increase medical expenses.…”

Section: Introductionmentioning

confidence: 99%

Substandard feeding in children undergoing mechanical ventilation in pediatric intensive care unit: A retrospective cohort study in China

Li,

Wang,

Chen

2023

Belitung Nurs J

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Background: Enteral nutrition is a common yet vital practice in the pediatric intensive care unit (PICU). However, the status of substandard feeding of enteral nutrition in PICU children undergoing mechanical ventilation remains unclear and can be detrimental to the children’s prognosis. Objective: This study aimed to evaluate the incidence, nursing care status, and influencing factors of substandard feeding in children undergoing mechanical ventilation in the PICU. Methods: This study employed a retrospective cohort design. Children undergoing mechanical ventilation and enteral nutrition in the PICU of a public hospital in China from 1 June 2021 to 31 December 2022 were selected using convenience sampling, and their characteristics were collected and evaluated. Pearson correlation analysis and multivariate logistic regression analysis were conducted to assess the influencing factors of substandard feeding in PICU children with mechanical ventilation. Results: A total of 156 PICU children undergoing mechanical ventilation were included for analysis in this study. The rate of substandard feeding in PICU children was 65.38%. Statistically significant differences were observed in diarrhea, vomiting, the use of sedatives, and average infusion speed between the substandard feeding group and the standard group (p <0.05). Pearson correlation results indicated that diarrhea (r = 0.595), vomiting (r = 0.602), and average infusion speed (r = 0.562) were correlated with substandard feeding and characteristics of included ICU children undergoing mechanical ventilation (p <0.05). Logistic regression results found that diarrhea (OR = 2.183, 95%CI: 1.855~2.742), vomiting (OR = 3.021, 95%CI: 2.256~4.294), and average infusion speed ≤40 mL/h (OR = 2.605, 95%CI: 1.921~3.357) were independent risk factors for substandard feeding in mechanically ventilated children in the ICU (p <0.05). Conclusion: The rate of substandard feeding in children with mechanical ventilation in the PICU was high. Diarrhea, vomiting, and slow infusion speed are important influencing factors for substandard feeding. It is suggested that nurses and other healthcare professionals take targeted measures, including the prevention and care of diarrhea and vomiting, as well as monitoring and adjusting the infusion speed of enteral nutrition, to reduce the occurrence of substandard feeding.

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Section: Introductionmentioning

confidence: 99%

Substandard feeding in children undergoing mechanical ventilation in pediatric intensive care unit: A retrospective cohort study in China

Li,

Wang,

Chen

2023

Belitung Nurs J

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What influences the implementation of clinical guidelines related to enteral nutrition in the intensive care unit: A mixed‐methods systematic review

Li,

Sun,

Zuo

et al. 2024

Journal of Advanced Nursing

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AimsTo systematically evaluate and analyse literature concerning the factors influencing the implementation of clinical practice guidelines related to enteral nutrition in the adult intensive care unit.BackgroundGuidelines serve as crucial tools for guiding clinical practice. However, a significant gap persists between current clinical practice and guidelines pertaining to enteral nutrition. It is essential to identify the reasons behind this disparity to foster clinical transformation.MethodsA mixed‐methods systematic review.Data SourcesA systematic search was conducted across PubMed, Embase, Medline, Cochrane, PsycINFO and CNKI databases to identify impediments and facilitators to the implementation of ICU clinical practice guidelines related to enteral nutrition. The types of studies included quantitative, qualitative and mixed‐methods studies. The search spanned from January 2003 to January 2024 and was updated in May 2024. The quality assessment of the included literature was conducted using the Mixed‐Methods Study Evaluation Tool (MMAT). Data analysis was performed using a data‐based convergent integration approach. The protocol for this study was prospectively registered (PROSPERO2023, CRD42023483287).ResultsTwenty papers were finally included, and 65 findings were extracted, integrating a total of three categories, Category 1: healthcare provider factors, including three sub‐themes: knowledge of guideline‐related knowledge and awareness of guideline application; social/professional roles and identity domains; beliefs, attitudes and self‐efficacy; collaboration, Category 2: practice environments, including two sub‐themes: environmental factors and resource areas; systems and behavioural norms, Category 3: patient values and nutritional support preferences including two sub‐themes: patient disease status and value orientation.ConclusionHealthcare professionals should analyse obstacles and facilitators to guideline implementation from multiple perspectives, strengthen healthcare collaboration, improve education and training systems, correct misperceptions and increase awareness of evidence‐based practice.

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Understanding nursing perspective towards barriers to the optimal delivery of enteral nutrition in intensive care settings

Zaher,

Sumairi,

Ajabnoor

2024

BMC Nurs

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Background The management process of Enteral Nutrition (EN) typically involves the interaction between a team of health care practitioners. Nurses being the closest to the patients, have crucial responsibilities and play a major role in feeding delivery along with other medical treatments. This study was conducted to investigate the perception of the nurses working in adult and paediatric intensive care Units (ICUs) regarding the EN barriers and identify the factors that influenced their perception. Methods The data in this cross-sectional study was collected via online survey between 15 October 2021 and January 2022. All nurses working in adult or paediatric ICUs across Saudi Arabia were eligible to participate. The tool used for the data collection was adapted from Cahill et al. (2016) and then reviewed and modified by the researchers. The survey collected information about the demographics of the nurses, and it included 24 potential EN barriers where the participants were asked to rate their importance on a scale from 1 to 5. Descriptive statistics were performed to describe the variables, univariant analysis were performed to compare the perceptions of the nurses regarding the EN barriers based on their characteristics followed by stepwise linear regression analysis. Results A total of 136 nurses working in adult and paediatric ICUs were included in this study. The results showed that the most important barriers as perceived by the nurses was “Frequent displacement of feeding tube, requiring reinsertion” [3.29 ± 1.28], “Delays in initiating motility agents in patients not tolerating enteral nutrition” [3.27 ± 1.24] and “Enteral formula not available on the unit”. [3.27 ± 1.24]. Our results showed that the responses of the participants statistically varied based on their work settings, gender, region, and educational level for some items in the survey (P-value ≤ 0.05). In the regression analysis, gender was the only variable statistically influenced the total Likert rating scores of the participants (r = -0.213, p-value = 0.013). Conclusion This study identified several barriers that exist in the nursing practice of EN in critical care settings. There are distinct differences in the perception of the nurses to these barriers based on their characteristics. Understanding such differences is important for implementing future strategies for units that needed the most help in prioritizing EN delivery.

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Barriers to Delivery of Enteral Nutrition in Intensive Care Settings in Saudi Arabia: A Comparative Study of the Perceptions of Health Care Providers Working in Adult and Paediatric ICUs

Cited by 3 publications

References 33 publications

Substandard feeding in children undergoing mechanical ventilation in pediatric intensive care unit: A retrospective cohort study in China

Substandard feeding in children undergoing mechanical ventilation in pediatric intensive care unit: A retrospective cohort study in China

What influences the implementation of clinical guidelines related to enteral nutrition in the intensive care unit: A mixed‐methods systematic review

Understanding nursing perspective towards barriers to the optimal delivery of enteral nutrition in intensive care settings

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