Investigation On The Status Of Enteric Nutrition Tolerance In ICU Nurses And Construction Of Training Program

ObjectiveTo compile a questionnaire to evaluate the knowledge,belief and behavior of ICU nurses on the intestinal nutrition tolerance in patients with severe illness,to explore the current level and influencing factors of ICU nurses’ knowledge and belief in intestinal nutrition tolerance in patients with severe illness,to construct a training program for ICU nurses on the knowledge and belief of intestinal nutrition tolerance in patients with severe illness,and to provide reference for hospitals to establish a training system for nurses’ knowledge and training on intestinal nutrition tolerance.Method1.Based on the theoretical structure of knowledge,belief,practice and guided by the intestinal nutrition guidelines,the ICU nurse’s intestinal nutrition tolerance knowledge,belief,practice questionnaire is compiled,and the formal questionnaire is formed adopting Delphi expert inquiry and Reliability&Validity test.2.610 ICU nurses from 6 Level-3 hospitals and 4 Level-2 hospitals in Qingdao were selected to investigate the status of intestinal nutrition tolerance.SPSS20.0 software was used for statistical analysis,mean ± standard deviation and composition ratio were used for descriptive analysis,t test or analysis of variance,and multiple linear regression analysis were used to explore the influencing factors of ICU nurses’ enterotrophic tolerance knowledge and behavior.Pearson correlation analysis was carried out between knowledge and credit.3.Based on the findings of the ICU nurse’s intestinal nutritional tolerance,combined with relevant clinical guidelines and semi-structural interviews,the interview outline was developed.Through interviews with nurses and subject specialists on training needs and recommendations,the initial training programme for targeted ICU nurses’ intestinal nutrition tolerance was developed,and the final training programme was determined through Delphi expert inquiries.Result1.The final formal questionnaire included 39 entries in three dimensions of knowledge,attitude and behavior;the total scale Cronbach’s α coefficient is 0.0.793,and the split-half reliability is 0.701,and the retest reliability is 0.756;In the content validity analysis,the item level validity(I-CVI)of the total questionnaire is 0.850～1.000,and the scale level validity(S-CVI)is 0.859;in the structure validity analysis,the KMO value of each item is 0.906,Bartlett’s spherical test value is 9818.675,P <0.001,three common factors with eigenvalue greater than 1 are extracted,and the cumulative variance contribution rate is 73.53%;the correlation coefficient between each dimension and the total score of the scale is0.222 to 0.831,the correlation coefficient between each dimension is 0.696 ～ 0.856.2.The current situation of the ICU nurse’s intestinal nutritional tolerance in the level 2 and 3 hospitals in Qingdao City was investigated.The knowledge,belief and behavior scores of the questionnaire were 11.62± 18.94 points,11.67± 3.63 points and 47.37± 17.76 points respectively.Regression analysis showed that the influencing factors of knowledge score were hospital level(β=4.161,P<0.001),whether it was a member of enteral nutrition group(β=2.468,P<0.001),working years(β=-0.675,P <0.001),the degree of learning enteral nutrition knowledge(β=1.155,P<0.05);whether the influencing factor of attitude score is a member of enteral nutrition group(β= 1.966,P<0.001),degree of learning of enteral nutrition knowledge(β=1.693,P<0.001),hospital level(β=1.612,P<0.001),age(β=0.484,P<0.05),learning route(β=-0.442,P<0.05);factors affecting behavior scores hospital level(β=9.760,P<0.001),whether it is a member of the enteral nutrition group(β=6.960,P<0.001),gender(β=-7.141,P<0.001),working years(β=-1.863,P<0.05);correlation analysis showed that knowledge,attitude,and behavior were all positively correlated(r=0.677,0.841,0.567,P<0.05).3.After two rounds of expert correspondence,the final ICU Nurse’s Intestinal Nutrition Tolerance Training Program was established,which included three parts: training objectives,training content,training methods and evaluation,including 16 first-level entries and 66 second-level entries.The response rate of the two-round expert consultation questionnaire was 100%,the authoritative coefficient of the first round of experts was 0.87,the authoritative coefficient of the second round of experts was 0.87,and The Kendall coordination coefficients(w)of the two rounds of expert consultation were 0.193 and 0.218(P<0.001),which is of statistical significance,and the degree of coordination of experts is high,and the results of inquiry is reliable.ConclusionThe prepared "ICU Nurse Enteral Nutrition Tolerance Knowledge and Practice Questionnaire" can be used as a tool to evaluate the current status of ICU nurses enteral nutrition tolerance,and has good reliability and validity.The overall scores of enteral nutrition tolerance in ICU nurses in Qingdao are low,and their attitudes and behaviors also need to be improved.The hospital level and whether they are members of the enteral nutrition group are the influencing factors of knowledge,beliefs,and behavior scores.Working years and the degree of knowledge of enteral nutrition learned are influencing factors of knowledge;learning methods and age are influencing factors of belief scores;gender and working years are influencing factors of behavior scores.According to the results of the current situation investigation and the Delphi expert consultation method,the "ICU Nurse Enteral Nutrition Tolerance Training Program" is practical and feasible,which meets the needs of nurses and has certain practical significance.The training methods and evaluation are in line with the current status of domestic nursing development.Provide reference for ICU nurse enteral nutrition training.