Nurses’ Practices and Perceived Challenges of Meeting Nutrition Needs of Critically Ill Patients Through Enteral Feeding: A Qualitative Study at Tertiary Hospitals, Tanzania

Abstract

Background: Enteral feeding is used when hospital patients are unable to meet their nutritional needs orally. It is important to understand current practices and challenges from nurses’ perceptions. Aim: To explore nurses’ practices and challenges for meeting the nutrition needs of critically ill patients. Methods: An exploratory qualitative design was used involving 16 in-depth interviews of nurses working in Intensive Care Units. Twenty observations of nurses’ enteral feeding practices were conducted to supplement the data. The interviews were analyzed using qualitative thematic analysis and observation data were analysed using simple statistics. Results: Only five nurses assessed nutritional status, one nurse adhered to infection prevention control measures before feeding, and eight nurses assessed proper tube placement. Nurses perceived failure to provide optimal nutritional support in patients with critical illness is due to a lack of enough and appropriate food, lack of appropriate feeding equipment, nurses’ incompetence in assessing and feeding patients, and inappropriate feeding practices by relatives. Conclusion: Nurses’ feeding practices were found to be inappropriate and accompanied with challenges that expose patients to complications and suboptimal nutritional care with enteral feeding. For optimal and safe practice in providing nutrition support, enforcement of quality improvement measures that foster nurses’ commitment to the observance of safety protocols of enteral feeding, availability of appropriate feeding tubes, continuous training for nurses, and close supervision of relatives who feed their patients is required.