title: Revised Questionnaire to Assess Barriers to Adequate Nutrition in the Critically Ill.
abstract: The objective of this study was to revise and improve a questionnaire to assess barriers to providing adequate enteral nutrition (EN) in critically ill adults.
  
  
  
  Changes were made to the questionnaire based on feedback from previous respondents. The revised questionnaire, including 20 potential barriers, was pilot tested in 3 hospitals in North America. Nurses were asked to rate each item based on the degree to which it hinders the provision of EN in their intensive care unit (ICU). The acceptability of the revised questionnaire was evaluated using 5 open-ended questions appended at the end of the questionnaire.
  
  
  
  A total of 81 nurses completed the revised barriers questionnaire. A total of 72 of 73 (99%) respondents felt that the questionnaire was easy to understand, and 64 of 73 (88%) felt that the individual questions were clear. On average, respondents rated the degree to which potential barriers hindered the delivery of EN to the patient as "very little" or "a little." Statistically significantly differences in mean responses were observed across the 3 ICUs for 8 of the 20 items. The indices of internal reliability were assessed to be acceptable.
  
  
  
  The revised questionnaire to assess barriers to EN seems acceptable and clinically sensible and now appears to comprehensively list all possible modifiable barriers to delivering EN. This questionnaire needs further study to determine whether measuring barriers with this questionnaire can translate into improved EN delivery to critically ill patients.
authors: Department of Public Health Sciences, Queen's University, Kingston, ON, Canada cahilln@kgh.kari.net.
authors: Naomi E
authors: NE
authors: Cahill
authors: Clinical Evaluation Research Unit, Kingston General Hospital, Kingston, ON, Canada.
authors: Xuran
authors: X
authors: Jiang
authors: Department of Public Health Sciences, Queen's University, Kingston, ON, Canada Clinical Evaluation Research Unit, Kingston General Hospital, Kingston, ON, Canada Department of Medicine, Queen's University, Kingston, ON, Canada.
authors: Daren K
authors: DK
authors: Heyland
mesh_terms: D000328:Adult; D016638:Critical Illness / Q000628:therapy*; D004750:Enteral Nutrition / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D009656:North America; D009726:Nurses; D015596:Nutrition Assessment; D009752:Nutritional Status; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires
keywords: barriers; critical care; guideline implementation; instrument development; nutrition; reliability