Anku E K, Samad L O, Akafity G, Amoo S A, Hill L T
Department of Dietherapy and Nutrition, Cape Coast Teaching Hospital, Cape Coast, Ghana.
Department of Anaesthesia and Critical Care, Cape Coast Teaching Hospital, Cape Coast, Ghana.
South Afr J Crit Care. 2024 Apr 23;40(1):e1396. doi: 10.7196/SAJCC.2024.v40i1.1396. eCollection 2024.
Nutrition support is recognised as an important therapy for attenuating the catabolic effects of critical illnesses, including malnutrition prevention. However, variations in nutrition support practices make it difficult to achieve optimal outcomes in the intensive care unit (ICU).
To explore current nutrition support practices among healthcare professionals (doctors and nurses) in the ICU of a tertiary hospital in Ghana.
Via a cross-sectional survey, the nutrition support practices and self-reported skills of 30 ICU healthcare professionals (23 nurses and 7 doctors) providing nutrition support were explored. Results are presented as themes with frequencies and proportions. Categorical data were analysed using Fisher's exact test. Statistical significance was set at p<0.05.
Most of the respondents were young and had limited ICU experience. Almost half of the respondents were unaware of or were not familiar with the content of an in-house feeding protocol for both enteral nutrition (EN) and parenteral nutrition support, despite a majority reporting the feeding protocol as the main source of nutrition support information. There was a general lack of standardisation of execution of most nutrition support practices, especially with the pattern of EN delivery, usual method of optimising EN, and gastric residual volume threshold used to guide practice. Most respondents self-reported being average/satisfactory in the management of nutrition support.
The study revealed that healthcare professionals in our ICU had varying nutrition support practices and competencies. There is a need for standardised and practical feeding protocols in accessible formats, ongoing education, and training in nutrition support to improve nutrition support practices and competencies of healthcare professionals providing nutrition support in the ICU setting.
This study is the first to describe challenges of nutrition support practices in an intensive care unit (ICU) in Ghana and is among limited data on this topic from African countries. This study has provided important insights into both the needs and opportunities for enhancing clinical nutrition skills and knowledge, and the practical application of such improved knowledge. As such, these data are important for local quality improvement for both clinical care of ICU patients and for professional development of healthcare personnel in resource-constrained hospital settings.
营养支持被认为是减轻危重病分解代谢效应（包括预防营养不良）的重要治疗方法。然而，营养支持实践的差异使得在重症监护病房（ICU）难以实现最佳效果。
探讨加纳一家三级医院ICU中医疗保健专业人员（医生和护士）当前的营养支持实践。
通过横断面调查，对30名提供营养支持的ICU医疗保健专业人员（23名护士和7名医生）的营养支持实践和自我报告的技能进行了探讨。结果以主题及频率和比例呈现。分类数据采用Fisher精确检验进行分析。统计学显著性设定为p<0.05。
大多数受访者较为年轻，ICU经验有限。尽管大多数受访者称喂养方案是营养支持信息的主要来源，但近一半的受访者不了解或不熟悉肠内营养（EN）和肠外营养支持的内部喂养方案内容。大多数营养支持实践的执行普遍缺乏标准化，尤其是EN的输送模式、优化EN的常用方法以及用于指导实践的胃残余量阈值。大多数受访者自我报告在营养支持管理方面为中等/满意。
该研究表明，我们ICU中的医疗保健专业人员的营养支持实践和能力各不相同。需要以易于获取的形式制定标准化且实用的喂养方案，持续开展营养支持方面的教育和培训，以改善在ICU环境中提供营养支持的医疗保健专业人员的营养支持实践和能力。
本研究首次描述了加纳重症监护病房（ICU）营养支持实践的挑战，并且是来自非洲国家关于该主题的有限数据之一。本研究为提高临床营养技能和知识的需求与机会以及此类改进知识的实际应用提供了重要见解。因此，这些数据对于改善ICU患者的临床护理以及资源有限医院环境中医疗人员的专业发展的本地质量具有重要意义。
