RESUMO
BACKGROUND: Critically ill patients are hypermetabolic and have increased energy requirements, making nutritional support a vital intervention. In the Intensive Care Units, enteral nutrition is based on opinions rather than evidence-based practices. Therefore, there is a need to identify the barriers to evidence based practice protocols for enteral feeding of patients in Jordanian ICUs. AIMS: To explore Jordanian ICU nurses' perceived barriers for enteral nutrition that hinders them from utilizing the recommended EN guidelines. METHODS: A descriptive cross-sectional design was utilized using self-administered questionnaire. A total of 131 nurses participated from different hospitals representing different healthcare sectors in Jordan. RESULTS: The five barriers subscales' means were almost equal ranging from 4.04 (Delivery of EN to the Patient) to 4.33 (ICU Resources) (out of 7). The most important barrier was "Not enough nursing staff to deliver adequate nutrition" (M=4.80, SD=1.81, 60%), followed by "Fear of adverse events due to aggressively feeding patients" (M= 4.59, SD=1.50, 56%). Although no significant differences in the mean barrier score were revealed, minimal significant differences were revealed that were distributed among different barrier subscales. CONCLUSION: Participants moderately perceived barriers with more focus on insufficient resources in ICU and among healthcare providers. Such barriers are modifiable and manageable, making their identification and management crucial for optimal patient care. This study confirms that enteral nutrition is a multidisciplinary responsibility.
RESUMO
BACKGROUND: ACS management aims for early coronary reperfusion, which should be within one hour from symptoms onset. This time was found to be relatively long, and many patients died before hospital arrival. In Jordan, this phenomenon is not clearly understood with a discrepancy between the reported durations of delay time. AIMS: To evaluate Jordanian ACS patients' delay time in seeking medical care, along with predictors of delay. METHODS: A descriptive, cross-sectional design was utilized to conveniently recruit 160 Jordanian ACS patients. Data were collected using chart review and the Modified ACS Response Questionnaire. RESULTS: The mean delay time was 7.8 hours (SD =3.5), with none of participants presenting within one hour. Delay time correlated negatively with ACS history, knowledge, attitudes, beliefs, and perceived risk (r = -0.448, r = -0.400, r = -0.408, r = -0.261, r = -0.411, respectively) and positively with health perception (r = 0.469). A 4-predictor model (history, beliefs, health perception, STEMI diagnosis) was revealed explaining 40% of variance in delay time (R(2)=.400, F (14,145) = 6.908, P < .001). CONCLUSION: Improving ACS patients' health seeking behaviors can be achieved when all components of care are considered together.
