Knowledge, Attitude and Practices Among Health Care Providers on Nutrition in Intensive Care Unit in Selected Tertiary Hospitals In Addis Ababa, Ethiopia.

Abstract

Abstract Background: Proper nutrition support in critically ill patients is essential for maintaining optimal nutritional status, preventing malnutrition, and supporting overall recovery. Adequate and timely enteral feeding in the ICU helps preserve lean body mass, promote immune function, enhance wound healing, and support organ function. It’s essential for providers in ICU to be well-informed, have positive attitudes and able to apply state of art practices to feeding critically ill patients for better outcomes. This study is conducted to assess knowledge, attitude and practice of first line health care providers in ICU, nurses and resident physicians. Methods: this study was designed multicenter cross-sectional survey by using structured self administered close ended questions. Four ICU settings of teaching hospitals were conveniently selected and all nurses, ECCM, ACCPM and IM resident physicians working in these ICU during study period were included in the study. Simple The sample size was 230 with response rate 100%. The study was conducted from December 01, 2023 to May 30, 2024. Data were entered in to EpiData and SPSS 26. The correlation between independent variables and dependent variables was estimated using bivariate and multivariate logistic regression at a 95% confidence level. Results: The level of good knowledge and practice among respondents were 58% and 68.8% respectively. Respondents who worked in ICU for 1 – 5 years are 3.2 times likely to have better knowledge better knowledge (p = 0.002 AOR 5.112, 95% CI 2.156 – 12.116) than those who worked in ICU for less than one year. Likewise, those respondents who worked in ICU for above 5 years have 7.89 odds of having better knowledge when compared with those less than one year (AOR 7.890, 95% CI 1.695 – 36.722). ECCM residents are 13.354 times better in having adequate knowledge when compared to nurses (AOR 13.354, 95% CI 4.222 – 42.235). Likewise, IM residents are found to have 2.93 times adequate knowledge when compared to nurses (AOR 2.936 95% CI 1.091 – 7.900). Females are 10.68 times likely to have good practice when compared to males (AOR 3.323 95% CI 1.613 - 6.844). Besides, ECCM residents are 61.871 times better practice when compared with nurses on feeding in critically ill (AOR 61.871, 95% CI, 15.338 - 249.577). Likewise, IM residents are 7.188 times better in their practice when compared to nurses (AOR 7.188, 95% CI 2.235 - 23.118) and ACCP residents are 5.556 times likely to have better practice when compared with nurses (AOR 5.556, 95% CI 1.736 - 17.783). Most of respondents 159(66%) still routinely check for gastric residual regardless of whether the patient is tolerating feeding or not. Conclusion: This study underscores the critical need for comprehensive education and consistent practices among ICU health care providers regarding enteral feeding. With over half of the respondents demonstrating adequate knowledge and higher percentage exhibiting good practice, it is evident targeted training can significantly, enhance health care. Despite these advancements, routine practices like gastric residual checking indicates the need for adherence to ongoing updates