Perceived Potential Barriers to Implementation of Nutritional Therapy Practice Guidelines in Critically Ill Adults in a District of KwaZulu-Natal, South Africa

BACKGROUND: Transitional challenges in the disease profile and healthcare systems have revealed the need for the development of guidelines to assist healthcare practitioners in decision making regarding patient care. Implementing strong evidence‐based guideline recommendations into clinical practice is associated with improved clinical outcomes for patients, and integrated and collaborative nutritional services.

PURPOSE: The purpose of this study was to identify perceived barriers to implementing national enteral nutritional therapy practice guidelines in critically ill adults in a district hospital and primary healthcare institutions in South Africa.

METHODS: A quantitative descriptive research design was followed in this study. The district and institutions were selected using non-probability deliberate purposive and convenience sampling methods to select healthcare professionals (HCPs) for the study. Data were collected through a self-administered questionnaire and analysed with the IBM Statistical Package for the Social Sciences (SPSS) version 25.

RESULTS: Ninety-six HCPs participated in the study which included nurses (76.0%, n = 73), doctors (10.4%, n = 10), pharmacists (7.3%, n = 7), nutrition specialists (5.2%, n = 5), and a speech-language therapist (1.0%, n = 1). Lack of awareness among HCPs and unavailability of enteral nutritional therapy practice guidelines ENTPGs in the institutions were identified as potential high priority barriers to implementation.

CONCLUSION: The results of this study indicate the need for introducing guidelines to HCPs and institutions to create awareness of such guidelines and thus encourage adherence to recommendations. There is a strong need for further research on strategies to manage the identified barriers to facilitate adoption and implementation of the national enteral nutritional therapy practice guidelines for adults in a South African context.