Abstract:
Background: Critically ill patients in Intensive Care Units are at high risk of
malnutrition which worsens morbidity and mortality by increasing the risk of infection,
prolonging mechanical ventilation and impairing wound healing. Despite the
importance of optimal nutritional therapy in improving outcomes, its delivery is
hindered by numerous barriers particularly in low-resource settings like Jimma
University Medical Center. This qualitative study explored these barriers faced by
healthcare professionals in providing optimal nutritional therapy to critically ill patients
in Jimma University Medical Center Intensive Care Units.
Methods: Semi-structured interviews were conducted with 13 healthcare professionals
(nurses, residents, and a consultant) from various Intensive care units departments at
Jimma University Medical Center. The interviews were audio-recorded and the data
were transcribed verbatim and translated into English. A thematic analysis was used to
analyze the data. Thematic analysis was used to identify key themes related to these
barriers.
Results: The study revealed multifaceted barriers to optimal nutritional therapy. Seven
key themes emerged from the analysis: clinical and patient-specific factors (e.g.,
cultural and religious practices, patient comorbidities); communication barriers (e.g.,
language differences between staff and patients); knowledge and training gaps among
healthcare professionals (compounded by the lack of standardized protocols for
nutritional assessment and administration); lack of interdisciplinary collaboration;
organizational and resource-based barriers (e.g., shortages of enteral feeding pumps and
specialized nutritional formulas); socioeconomic constraints; and workload and
personal attitudes.
Conclusion: This study underscores the complex interplay of barriers to optimal
nutritional therapy in Jimma University Medical Center Intensive Care Units.
Addressing these challenges requires a multifaceted approach including targeted
training programs for healthcare professionals, improved resource allocation (e.g.,
dedicated nutrition support teams), enhanced interdisciplinary collaboration, culturally
sensitive care and systemic reforms such as integrating nutrition support teams into ICU
care. Implementing these strategies can enhance nutritional therapy delivery and
improve patient outcomes in critical care settings.
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