| Enteral Feeding Barriers | Mean(SD) | % of Agreement |
|---|---|---|
| Guideline Recommendations and Implementation Strategies | 4.19(1.12) | |
| 1. I am not familiar with our current guidelines for nutrition in the ICU. | 4.16(1.81) | 47% |
| 2. Current scientific evidence supporting some nutrition interventions is inadequate to inform practice. | 4.39(1.64) | 4% |
| 3. The language of the recommendations of the current guidelines for nutrition is not easy to understand. | 3.86(1.82) | 37% |
| 4. The current guidelines for nutrition are not readily accessible when I want to refer to them. | 4.14 (1.76) | 40% |
| 5. No feeding protocol in place to guide the initiation and progression of enteral nutrition. | 4.28(1.79) | 45% |
| 6. Current feeding protocol is outdated. | 4.32(1.62) | 44% |
| ICU Resources | 4.33(1.49) | |
| 1. Not enough nursing staff to deliver adequate nutrition. | 4.80(1.81) | 60% |
| 2. Enteral formula not available on the unit. | 3.90(1.98) | 40% |
| 3. No or not enough feeding pumps on the unit. | 4.30(1.98) | 47% |
| Dietitian Support | 4.17(1.40) | |
| 1. Waiting for the dietitian to assess the patient. | 3.85(1.85) | 37% |
| 2. Not enough dietitian time dedicated to the ICU during regular weekday hours. | 4.12(1.78) | 44% |
| 3. No or not enough dietitian coverage during evenings, weekends and holidays. | 4.29(1.89) | 51% |
| 4. There is not enough time dedicated to education and training on how to optimally feed patients. | 4.42(1.62) | 53% |
| Delivery of Enteral Nutrition to the Patient | 4.04(1.23) | |
| 1. No feeding tube in place to start feeding. | 3.76(1.88) | 38% |
| 2. Delay in physicians ordering the initiation of EN. | 3.92(1.73) | 41% |
| 3. Waiting for physician/radiology to read x-ray and confirm tube placement. | 4.00(1.81) | 44% |
| 4. Delays in initiating motility agents in patients not tolerating enteral nutrition (i.e. high gastric residual volumes). | 4.08(1.49) | 37% |
| 5. Delays and difficulties in obtaining small bowel access in patients not tolerating enteral nutrition (i.e. high gastric residual volumes). | 4.15(1.60) | 40% |
| 6. In resuscitated, hemodynamically stable patients, other aspects of patient care still take priority over nutrition. | 4.09(1.70) | 44% |
| 7. Poor communication amongst the ICU team regarding the nutrition management resulting in delays in initiating or progression of EN. | 4.31(1.67) | 49% |
| Critical Care Provider Attitudes and Behaviors | 4.28(1.20) | |
| 1. Non-ICU physicians (i.e. surgeons, gastroenterologists) requesting patients not be fed enterally. | 3.63(1.76) | 34% |
| 2. Nurses failing to progress feeds as per the feeding protocol. | 4.05(1.51) | 30% |
| 3. Feeds being held due to diarrhea. | 4.58(1.65) | 57% |
| 4. Fear of adverse events due to aggressively feeding patients. | 4.59(1.50) | 56% |
| 5. Feeding being held too far in advance of procedures or operating room visits. | 4.34(1.59) | 50% |
| 6. General belief among ICU team that provision of adequate nutrition does not impact on patient outcome. | 4.48(1.71) | 53% |