title: Nurses' prioritization of enteral nutrition in intensive care units: a national survey.
abstract: Enteral nutrition is important in critically ill patients to improve patient outcomes, with nurses playing a pivotal role in the delivery and ongoing care of enteral nutrition. A significant deficit in nurses' knowledge and education relating to enteral nutrition has been identified, leading to iatrogenic malnutrition and potentially compromising patient care. Enteral nutrition appears to be prioritized lower than many other aspects of care. However, there is scant research to show how nurses prioritize enteral nutrition.
  
  
  
  This study aimed to explore how nurses prioritize enteral nutrition when caring for a critically ill patient.
  
  
  
  A descriptive online questionnaire, administered in May 2014, was utilized to explore the study aim. Descriptive statistics were performed to evaluate quantitative data. Content analysis was used to evaluate qualitative data.
  
  
  
  A total of 359 responses were included in data analysis (response rate 20.8%). All respondents were registered nurses working within an Australian intensive care unit or high dependency unit. Nurses agreed that enteral nutrition was very important and should be commenced as soon as possible. However, life-saving procedures always took priority and there were often multiple barriers that hindered optimal delivery of enteral nutrition.
  
  
  
  Respondents relied on their clinical judgement to inform decisions in relation to enteral nutrition in critically ill patients. Most respondents agreed that enteral nutrition was an important aspect of patient care, but acknowledged that other aspects of care were prioritized more highly. Despite this, some delays to enteral nutrition were perceived to be avoidable, and nurses recognized a need to advocate on the patient's behalf to increase the visibility of enteral nutrition.
  
  
  
  The findings of this study demonstrate that enteral nutrition is often prioritized lower than other competing care needs in the critically ill patient. Given the importance of enteral nutrition to patient recovery, changes to clinical practice to improve enteral nutrition management are necessary.
authors.affiliation: School of Nursing & Midwifery and Centre for Quality and Patient Safety, Deakin University, Burwood, Victoria, Australia.
authors.forename: Melissa J
authors.identifier: 0000-0003-1170-3951
authors.initials: MJ
authors.lastname: Bloomer
authors.affiliation: School of Nursing & Midwifery, Monash University, Frankston, Victoria, Australia.|Intensive Care Unit, Peninsula Health, Frankston, Victoria, Australia.
authors.forename: Angelique B
authors.initials: AB
authors.lastname: Clarke
authors.affiliation: School of Nursing and Midwifery, Monash University, Frankston, Victoria, Australia.
authors.forename: Julia
authors.initials: J
authors.lastname: Morphet
mesh_terms: D000328:Adult; D001315:Australia; D064648:Critical Care Nursing; D004750:Enteral Nutrition / Q000451:nursing*; D005260:Female; D006292:Health Priorities / Q000458:organization & administration*; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration; D008297:Male; D024802:Nurse's Role; D036301:Qualitative Research; D011795:Surveys and Questionnaires
keywords: Critical care education; Critical care nursing; Intensive care, management aspects; Nutrition