A descriptive study of nurses' knowledge and practice about adult enteral nutrition in special care units of a referral hospital in Malawi.

Abstract

The purpose of this study was to describe current tube feeding knowledge and practices to target appropriate quality improvement interventions. This study was important because literature has demonstrated gaps in nurses' knowledge and practice in this area. The Synergy model of patient care was used as a conceptual basis for this study. Two data collection methods were used. A quantitative descriptive survey of nurses, using a questionnaire to collect information about knowledge and practice was undertaken concurrently with a retrospective review of case files between June and July, 2010. Ethical approval was sought from the relevant authorities. The whole population of nurses available was used, and a sample of 51 nurses that met the inclusion criteria responded to the questionnaire (100% response rate). A total of 78 eligible case files were reviewed using a checklist. SPSS Version 15 was used to analyse the data. The findings revealed that most nurses (98%) had received tube feeding training while at college. However, nearly the same number of nurses (96%) reported having received no in-service training on tube feeding. The findings showed variability in the levels of knowledge. Furthermore, the use of outdated method, to confirm proper tube placement was reported. The majority of respondents reported that they document the care given, but this was not evident in the review of the case files. Environmental aspects such as tube/feed shortage, lack of guidelines and patients/ guardian refusal of tube feeding were reported as common problems affecting nurses' practice. The standards for tube feeding suggested from literature are not attained. The characteristics of a nurse and the environment of care have an implication in tube feeding practices and can ultimately help to eliminate the gap in practice. The nurses' current knowledge and practice is a cause for concern. Recommendations include education, evidence based protocols and other efforts to improve tube feeding practice.