Barriers to delivery of enteral nutrition in pediatric intensive care : a world survey

Tume, LN; Eveleens, R; Verbruggen, S; Harrison, G; Latour, J; Valla, FV

Abstract

Objective
To explore the perceived barriers by pediatric intensive care healthcare professionals (nurses, dieticians and physicians) in delivering enteral nutrition (EN) to critically ill children across the world.
Design
Cross-sectional international online survey adapted for use in pediatric settings.
Setting and subjects
Pediatric Intensive Care physicians, nurses and dietitians across the world
Interventions
The 20-item adult intensive care ‘Barriers to delivery of enteral nutrition’ survey was modified for pediatric settings, tested and translated into ten languages. The survey was distributed online to pediatric intensive care nurses, physicians and dieticians via professional networks in March – June 2019. Professionals were asked to rate each item indicating the degree to which they perceived it hinders the provision of EN in their pediatric intensive care unit (PICUs) with a 7-point Likert scale from 0 ‘‘not at all a barrier’’ to 6 ‘‘an extreme amount’’.
Measurement and Main Results
920 pediatric intensive care professionals responded from 57 countries; 477/920 (52%) nurses, 407/920 (44%) physicians and 36/920 (4%) dieticians. Sixty-two percent had more than five years PICU experience and 49% worked in general PICUs, with 35% working in combined cardiac and general PICUs. The top three perceived barriers across all professional groups were: (1) enteral feeds being withheld in advance of procedures or operating department visits, (2) none or not enough dietitian coverage on weekends or evenings, (3) not enough time dedicated to education and training on how to optimally feed patients.
Conclusions
This is the largest survey that has explored perceived barriers to the delivery of enteral nutrition across the world by physicians, nurses and dietitians. There were some similarities with adult intensive care barriers. In all professional groups, the perception of barriers reduced with years PICU experience. This survey highlights implications for PICU practice around more focussed nutrition education for all PICU professional groups.

Citation

Tume, L., Eveleens, R., Verbruggen, S., Harrison, G., Latour, J., & Valla, F. (2020). Barriers to delivery of enteral nutrition in pediatric intensive care : a world survey. Pediatric Critical Care Medicine, 21(9), e661-e671. https://doi.org/10.1097/PCC.0000000000002382

• Journal Article Type: Article
• Acceptance Date: Feb 13, 2020
• Online Publication Date: Jun 11, 2020
• Publication Date: Sep 1, 2020
• Deposit Date: Feb 13, 2020
• Publicly Available Date: Jun 11, 2021
• Journal: Pediatric Critical Care Medicine
• Print ISSN: 1529-7535
• Electronic ISSN: 1947-3893
• Publisher: Lippincott, Williams & Wilkins
• Volume: 21
• Issue: 9
• Pages: e661-e671
• DOI: https://doi.org/10.1097/PCC.0000000000002382
• Publisher URL: https://doi.org/10.1097/PCC.0000000000002382
• Related Public URLs: https://journals.lww.com/pccmjournal/pages/default.aspx