Nurses' Knowledge, Attitude, and Practice on Enteral Feeding of Critically Ill Patients at Kenyatta National Hospital

Abstract

Background: Enteral feeding/nutrition is the most efficient nutritional support strategy used by critical care nurses to feed patients in critical care units (CCUs) who are unable to meet their dietary demands orally. Enteral feeding promotes intestinal immunological function and prevents intestinal mucosal atrophy. Hence, besides meeting the increased nutritional demand, enteral feeding also reduces deaths and the duration of CCUs stay. According to reports, severely ill patients continue to receive low amounts of calories, proteins, vitamins and minerals in the CCUs. Therefore, there is a necessity to carry out investigations on the levels of knowledge, attitudes and practices of critical care nurses attending extremely ill patients, particularly in hospitals with high numbers of critically ill patients like Kenyatta National Hospital. Objective: This study’s objective was to assess the levels of knowledge, attitudes and practices among critical care nurses on enteral feeding of critically ill patients in Kenyatta National Hospital CCUs. Methodology: The present investigation adopted a cross-sectional quantitative study design. Using a stratified sampling design and proportionate sampling technique, a sample size of 135 critical care nurses who directly participated in the enteral feeding of severely ill patients at the Kenyatta National Hospitals’ CCUs were recruited. Data was collected using a standardized questionnaire while abiding by the established ethical guidelines in February 2023. Data was analyzed using Statistical Package for Social Sciences. Descriptive statistics were expressed as frequencies and percentages. Inferential statistics, Pearson Chi-square (χ2) or Fisher's exact tests were used to analyze for relationship between independent (gender, age group, terms of service, level of qualification and work experience) and dependent (levels of knowledge, attitudes and practices of enteral feeding) variables. A p-value of <0.05 was set as the significance criterion. The statistical outputs were illustrated in tables. Results: Most of the critical care nurses were female with a proportion of 63.7%. Approximately 65.9% of the study participants noted adequate level of knowledge on enteral nutrition, followed by moderate (23.0%) and inadequate (11.1%) levels of knowledge. Most of the respondents had positive attitudes toward enteral feeding at 96.3%. About 55.6% of the study subjects had competent enteral feeding practices. The gender, age group, terms of service, level of qualification and work experience were not significantly associated with the levels of knowledge, attitudes and practices on enteral feeding among critical care nurses attending critically ill patients in Kenyatta National Hospital CCUs. Conclusions: This study concluded that the critical care nurses attending critically ill patients at the KNH CCUs had adequate knowledge, positive attitudes, and competent practices on enteral nutrition. Besides, there was insignificant association between gender, age group, terms of service, level of qualification and work experience with levels of knowledge, attitude, and practices on enteral nutrition. Recommendations: This study recommends that critical care nurses should be provided with regular continuous medical training on enteral nutrition to maintain the high level of knowledge, positive attitudes and competent practices of enteral nutrition