Abstract
BACKGROUND: Intensive care unit (ICU) patients frequently experience disruptions in their nutritional needs, and ICU nurses play a critical role in managing enteral nutrition. AIM: This study aimed to evaluate ICU nurses' knowledge, attitudes and practices (KAP) regarding enteral nutrition. STUDY DESIGN: A multicentre cross-sectional study was conducted from September to December 2024 across 15 hospitals in China. A self-developed questionnaire was used to collect socio-demographic data and assess KAP scores. The KAP levels were dichotomised using a threshold value of 80% of the maximum possible score. Differences in KAP scores based on demographic factors were analysed, and the relationships between KAP dimensions were explored using correlation analysis and structural equation modelling (SEM). RESULTS: A total of 420 valid questionnaires were analysed, with 80.0% of participants being female. The mean KAP scores were 17.87 ± 2.49 (range: 0-46), 48.74 ± 4.65 (range: 11-55) and 65.39 ± 7.36 (range: 15-75), respectively. Positive correlations were found between KAP scores (r = 0.243-0.450, all p < 0.001). Female gender (OR = 0.542, 95% CI: 0.324-0.907, p = 0.020), holding administrative positions (OR = 1.931, 95% CI: 1.014-3.681, p = 0.045), and attending enteral nutrition lectures (OR = 1.721, 95% CI: 1.096-2.702, p = 0.018) were independent factors associated with adequate knowledge. SEM revealed direct effects between knowledge and attitude (β = 0.275, p < 0.001) as well as between attitude and practice (β = 0.462, p < 0.001). Additionally, knowledge demonstrated both direct effect (β = 0.198, p < 0.001) and indirect effect (β = 0.127, p < 0.001) on practice. CONCLUSION: ICU nurses generally exhibited inadequate knowledge but demonstrated positive attitudes and proactive practices regarding enteral nutrition. Attitude showed a partial mediating effect between knowledge and practice. Educational interventions are necessary to enhance knowledge, which may further improve attitudes and practices. RELEVANCE TO CLINICAL PRACTICE: ICU nurses need better knowledge of enteral nutrition to enhance patient care and outcomes. Educational interventions are essential.