Nurses' knowledge, attitudes, and practices on enteral feeding practices for patients admitted to the intensive care units of the national referral hospital in Dar es salaam, Tanzania

Abstract

ABSTRACT Background: Enteral nutrition is a crucial method for providing essential nutrients to critically ill patients who cannot consume food orally. Nurses administer enteral feeds, delivering a balanced mix of carbohydrates, proteins, fats, vitamins, and minerals. However, they face challenges in ensuring they provide these feeds in an individualized manner, despite their other roles in healthcare settings. This places a significant challenge on nurses to ensure that they can provide the prescribed enteral feeds in a manner that is individualized to each patient's needs. Objective: To assess nurses’ knowledge, attitudes, and practices on enteral feeding for critically ill patients admitted to the ICUs of the national referral hospital in Dar es Salaam Tanzania Methodology: A cross-sectional study was conducted to evaluate nurses' knowledge, attitudes, and practices on enteral feeding for critically ill patients. 122 nurses were recruited randomly from Muhimbili National Hospital, Muhimbili Orthopedic Institute, and Jakaya Kikwete Cardiac Institute. Data were collected using structured questionnaires and analyzed using SPSS version 27. Bivariate and multivariate logistic regression was conducted to determine demographic characteristics associated with KAPs on enteral feeding for critically ill patients. All independent variables with p ≤ 0.2 in univariate regression models were included in the multivariate logistic model. Independent variables with p < 0.05 were considered statistically significant. Results: The majority of respondents were female 69(56.9%), with a mean age of 34.61 years (SD ± 6.367) and an age range from 25 to 35 years. 56(45.9%) had adequate knowledge of enteral feeding and 68(55.75 %) had positive attitudes toward enteral feeding. 97 (79.5%) were competent to practice enteral feeding. After adjusting for all factors, training for enteral feeding was significantly associated with knowledge (AOR = 0.388, 95% CI: 0.17-0.88, p = 0.024). Also, working position was significantly associated with attitudes towards enteral feeding (AOR = 15.46, 95% CI: 1.98-120.7, p = 0.009). In addition, age was significantly associated with practices of enteral feeding (AOR = 0.13, 95% CI: 0.01-0.98, p = 0.048). Furthermore, marital status was significantly associated with practices of enteral feeding of critically ill patients (AOR = 0.352, 95% CI: 0.14-0.90, p = 0.03). Conclusion and recommendation: The study shows that despite positive attitudes and competence, most intensive care unit nurses lack knowledge about enteral feeding. To improve care and reduce complications, nurses should regularly attend in-service training, seminars, workshops, and dietitian presentations. Educators should focus on innovative strategies, technologies, evidence-based practices, standardized care guidelines, and appropriate training for ICU staff to enhance patient care and recovery. Keywords: Nurses, Knowledge, Attitudes, Practices, Enteral feeding, Enteral nutrition, Intensive Care Unit.