Barriers to optimal nutritonal therapy for Critically ill patients admitted to jimma university Intensive care units

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. I