title: Jordanian nurses' knowledge and responsibility for enteral nutrition in the critically ill.
abstract: BACKGROUND
  Poor nursing adherence to evidence-based guidelines has negative consequences leading to higher mortality rates, delayed recovery and longer length of stay. Evidence-based practice has the potential to minimize complications and discrepancies between nurses.
  
  
  OBJECTIVE
  This study aimed to assess nurses' practice and perception of their knowledge and responsibility in relation to enteral nutrition (EN) in the critically ill.
  
  
  METHODS
  This descriptive correlational design was applied to nurses working in intensive care units (ICUs) from three health care sectors in Jordan (Governmental, Military and Private sectors). Nurses were recruited using a stratified sampling technique. A pre-prepared questionnaire focusing on nurses' practice and perception towards EN was used.
  
  
  RESULTS
  A total of 253 ICU nurses completed the questionnaire. Nurses revealed a tendency to undertake nutritional care despite the recognition clinical nutrition is a secondary role. In terms of nursing processes, nurses showed greater levels of knowledge and responsibility for 'preventing complications' and 'evaluation' more than 'assessment' and 'identifying goals'. Nurses inadequately assess both gastric residuals and tube placement before feeding. Diarrhoea was the most frequent complication followed by abdominal pain, vomiting, tube dislodgment and weight loss. However, nurses realized that the incidences of complications is less likely when applying evidence-based protocol.
  
  
  CONCLUSIONS
  It is necessary to establish a preliminary assessment for patients' nutritional needs prior to using EN. Aspiration reduction measures are still deficient and need further attention. An evidence-based protocol for EN should be adopted in the critically ill.
  
  
  CONCLUSIONS
  This article provides insight into the current practice of Jordanian intensive care nurses in different health care sectors. The study can contribute to redirect the perception of nurses towards nutrition in the critically ill in addition to enhance positive adherence to evidence base.
authors.affiliation: Faculty of Nursing, Zarqa University, Zarqa, Jordan.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Al Kalaldeh
authors.affiliation: Faculty of Health and Social Care, Professor of Nursing, University of Hull, Hull HU6 7RX, UK.
authors.forename: Roger
authors.initials: R
authors.lastname: Watson
authors.affiliation: Faculty of Health and Social Care, Professor of Nursing, University of Hull, Hull HU6 7RX, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Hayter
mesh_terms: D000328:Adult; D003422:Critical Care; D064648:Critical Care Nursing; D016638:Critical Illness; D004750:Enteral Nutrition / Q000009:adverse effects / Q000379:methods / Q000451:nursing*; D055317:Evidence-Based Practice; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007597:Jordan; D008297:Male; D024802:Nurse's Role; D009736:Nursing Process; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Enteral nutrition; Evidence-based practice; Intensive care; Nurse