Assessment of barriers to optimum enteral nutrition practices as perceived by critical care providers

Background

Nutritional support is a vital intervention for critically ill patients. Despite the existence of several clinical practice guidelines focused on enteral nutrition of critically ill, there is still a gap between guideline recommendations and actual nutrition practices. The purpose of this study is to understand the role of the clinical pharmacist in identifying the barriers to applying optimum enteral nutritional practices from the perspective of critical care providers. A descriptive cross-sectional design was utilized using self-administered questionnaire. A total of 90 critical care providers comprising of 3 categories: physicians (n = 30), clinical pharmacists (n = 30), and nurses (n = 30) were recruited. "The barriers to enteral feeding critically ill patients" questionnaire was used to explore the barriers that hinder them from optimal delivery of enteral nutrition.

Results

Not enough dietitian coverage during holidays was the most important barrier facing the physicians. As for the clinical pharmacists, the most important barrier was waiting for the dietitian to assess the patient. Regarding the nurses, familiarity with nutrition guidelines was the most important barrier. There was a highly significant difference between physicians, clinical pharmacists, and nurses regarding subscales’ scores and overall scores of Barriers Questionnaire except for the resources and provider attitudes.

Conclusion

Barriers to optimum enteral nutrition practices were explored with more attention on barriers regarding dietitian support and critical care providers' attitudes. This article provides the basis for the creation of interventions intended to overcome these barriers and enhance enteral nutrition practices.