Department of Community Health and Epidemiology, Queen's University, Kingston, Ontario, Canada.
J Crit Care. 2012 Dec;27(6):727-34. doi: 10.1016/j.jcrc.2012.07.006. Epub 2012 Sep 13.
The aims of this study were to describe the barriers to enterally feeding critically ill patients from a nursing perspective and to examine whether these barriers differ across centers.
A cross-sectional survey was conducted in 5 hospitals in North America. A 45-item questionnaire was administered to critical care nurses to evaluate the barriers to enterally feeding patients.
A total of 138 of 340 critical care nurses completed the questionnaire (response rate of 41%). The 5 most important barriers to nurses were as follows: (1) other aspects of patient care taking priority over nutrition, (2) not enough feeding pumps available, (3) enteral formula not available on the unit, (4) difficulties in obtaining small bowel access in patients not tolerating enteral nutrition, and (5) no or not enough dietitian coverage during weekends and holidays. For 18 (81%) of 22 potential barriers, the rated magnitude of importance was similar across the 5 intensive care units.
Nurses in our multicenter survey identified important barriers to providing adequate enteral nutrition to their critically ill patients. The importance of these barriers does not appear to differ significantly across different clinical settings. Future research is required to evaluate if tailoring interventions to overcome these identified barriers is an effective strategy of improving nutrition practice.
本研究旨在从护理角度描述危重症患者肠内喂养的障碍，并探讨这些障碍是否存在于不同中心之间的差异。
在北美 5 家医院进行了一项横断面调查。对重症监护护士进行了 45 项问卷评估，以评估患者肠内喂养的障碍。
共有 340 名重症监护护士中的 138 名完成了问卷（应答率为 41%）。护士面临的 5 个最重要的障碍如下：（1）患者护理的其他方面优先于营养，（2）没有足够的喂养泵，（3）单位没有可用的肠内配方，（4）在不耐受肠内营养的患者中，获取小肠通道存在困难，（5）周末和节假日没有或没有足够的营养师覆盖。对于 22 个潜在障碍中的 18 个（81%），这 5 个重症监护病房的重要性评分相似。
我们的多中心调查中的护士确定了为危重症患者提供足够肠内营养的重要障碍。这些障碍的重要性在不同的临床环境中似乎没有显著差异。需要进一步研究评估是否针对这些已确定的障碍进行干预以改善营养实践是否是一种有效的策略。
