Lessons Learned From Implementing a Novel Feeding Protocol: Results of a Multicenter Evaluation of Educational Strategies.
Background: This study describes the results of an evaluation of educational strategies used to implement a novel enteral feeding protocol in 9 North American intensive care units (ICUs). Materials and Methods: Members of the protocol implementation teams at each ICU distributed a questionnaire to ICU nurses after the implementation of the Enhanced Protein-Energy Provision via the Enteral Route Feeding Protocol in Critically Ill Patients (PEP uP) protocol. Eight different educational strategies were evaluated. Questionnaires were distributed in both paper and electronic format to all nursing staff and used both a visual analog Likert-type scale and open-ended questions. Results: The response rate to the questionnaire was 166 of 434 or 38.2%. More than 70% of respondents rated 5 of the educational strategies as very useful or somewhat useful, including the long PowerPoint presentation at in-services and critical care rounds, the short PowerPoint presentation for 1-on-1 and group bedside teaching, and a self-learning module. The percentage of nurses who found the bedside protocol tools of the enteral feeding order set, gastric feeding flowchart, and volume-based feeding schedule either "very easy" or "somewhat easy" to use were 64.0%, 60.5%, and 59.1%, respectively. Conclusion: The use of multiple teaching formats, including the long and short PowerPoint presentations and self-teaching module, appeared to meet the learning needs of most of the group. The majority of the bedside tools developed to facilitate the implementation of the PEP uP protocol were considered easy to use.
Medical/Surgical Intensive Care Unit, St Michael's Hospital, Toronto, Ontario, Canada.
Michele
M
McCall
Clinical Evaluation Research Unit, Kingston General Hospital, Kingston, Ontario, Canada Department of Community Health and Epidemiology, Queen's University, Kingston, Ontario, Canada.
Naomi
N
Cahill
Clinical Evaluation Research Unit, Kingston General Hospital, Kingston, Ontario, Canada.
Lauren
L
Murch
Department of Critical Care Medicine and Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, and Interdepartmental Division of Critical Care, University of Toronto, Toronto, Ontario, Canada.
Tasnim
T
Sinuff
Canadian Association of Critical Care Nurses, London, Ontario.
Tricia
T
Bray
Canadian Association of Critical Care Nurses, London, Ontario.
Teddie
T
Tanguay
Clinical Evaluation Research Unit, Kingston General Hospital, Kingston, Ontario, Canada Department of Community Health and Epidemiology, Queen's University, Kingston, Ontario, Canada Department of Medicine, Queen's University, Kingston, Ontario, Canada dkh2@queensu.ca.
Daren K
DK
Heyland
clinical protocols; education; education research; enteral nutrition; questionnaires