Questionnaire items | ICC (2,1) | Kappa* |
---|---|---|
Overall Barriers | 0.64 | 0.35 |
Guideline Recommendations and Implementation Strategies | 0.31 | 0.06 |
1. Current scientific evidence supporting some nutrition interventions is inadequate to inform practice. | 0.36 | 0.24 |
2. The language of the recommendations of the current guidelines for nutrition are not easy to understand. | 0.37 | 0.38 |
3. I am not familiar with our current guidelines for nutrition in the ICU. | 0.35 | 0.23 |
4. The current guidelines for nutrition are not readily accessible when I want to refer to them. | 0.51 | 0.30 |
5. No feeding protocol in place to guide the initiation and progression of enteral nutrition. | −0.13 | −0.03 |
Current feeding protocol is outdated. | 0.31 | 0.20 |
ICU Resources | 0.57 | 0.60 |
6. Not enough nursing staff to deliver adequate nutrition. | 0.70 | 0.60 |
7. Enteral formula not available on the unit. | 0.34 | 0.27 |
8. No or not enough feeding pumps on the unit. | 0.51 | 0.27 |
Dietitian Support | 0.39 | 0.34 |
9. Waiting for the dietitian to assess the patient. | 0.15 | 0.21 |
Not enough dietitian time dedicated to the ICU during regular weekday hours. | 0.43 | 0.34 |
10. No or not enough dietitian coverage during evenings,weekends and holidays. | 0.52 | 0.34 |
11. There is not enough time dedicated to education and training on how to optimally feed patients. | 0.32 | 0.20 |
Delivery of Enteral Nutrition to the Patient | 0.55 | 0.47 |
No feeding tube in place to start feeding. | 0.51 | 0.51 |
12. Delay in physicians ordering the initiation of EN. | 0.37 | 0.13 |
13. Waiting for physician/radiology to read x-ray and confirm tube placement. | 0.22 | 0.30 |
14. Delays in initiating motility agents in patients not tolerating enteral nutrition (i.e., high gastric residual volumes). | 0.43 | 0.16 |
15. Delays and difficulties in obtaining small bowel access in patients not tolerating enteral nutrition (i.e., high gastric residual volumes). | 0.52 | 0.65 |
16. In resuscitated, hemodynamically stable patients, other aspects of patient care still take priority over nutrition. | 0.59 | 0.52 |
17. Needles delays in relaying information regarding the initiation and progression of nutrition. | 0.36 | 0.32 |
Critical Care Provider Attitudes and Behavior | 0.62 | 0.35 |
18. Non-ICU physicians (i.e., surgeons, gastroenterologists) requesting patients not be fed enterally. | 0.57 | 0.43 |
19. Nurses failing to progress feeds as per the feeding protocol. | 0.09 | 0.19 |
20. Feeds being held due to diarrhea. | 0.46 | 0.50 |
21. Fear of adverse events due to aggressively feeding patients. | 0.53 | 0.33 |
22. Feeding being held too far in advance of procedures or operating room visits. | 0.69 | 0.65 |
23. General belief among ICU team that provision of adequate nutrition does not impact on patient outcome. | 0.60 | 0.87 |