Nurses' Knowledge, Attitude, and Practice on Enteral Feeding of Critically ill Patients at Kenyatta National Hospital Critical Care Unit

  • Njuguna Joyce Wangari University of Nairobi
  • Lilian Omondi University of Nairobi
  • Dorcas Maina University of Nairobi
Keywords: Enteral Feeding, Critical Care Nurses, Critical Care Units, Knowledge, Attitudes, Practices
Share Article:


Enteral feeding/nutrition is the most efficient nutritional support strategy used by critical care nurses to feed patients in critical care units (CCUs) who are unable to meet their dietary demands orally. In developing countries, most critically ill patients continue to receive low amounts of their dietary needs in the CCUs. Therefore, it is necessary to carry out investigations on the levels of knowledge, attitudes, and practices of critical care nurses attending to extremely ill patients. This study's objective was to determine the levels of knowledge, attitudes, and practices of critical care nurses on enteral feeding of critically ill patients at Kenyatta National Hospital (KNH) CCUs. The study adopted a cross-sectional quantitative study design. Using a stratified sampling design and proportionate sampling technique, a sample size of 135 critical care nurses was recruited. Data was collected using a standardised questionnaire. Inferential statistics, Pearson Chi-square (χ2) or Fisher's exact tests were used to analyse the relationship between independent and dependent variables. A p-value of <0.05 was set as the significance criterion. Approximately 65.9% of the study participants noted adequate level of knowledge on enteral nutrition, followed by moderate (23.0%) and inadequate (11.1%) levels of knowledge. Most of the respondents (96.3%.) had positive attitudes toward enteral feeding. About 54.7% of the study subjects had competent enteral feeding practices. The gender, age group, terms of service, level of qualification and work experience were not significantly associated with the levels of knowledge, attitudes, and practices on enteral feeding among critical care nurses. This study concluded that the critical care nurses had adequate knowledge, positive attitudes, and competent practices on enteral nutrition. The study recommends that critical care nurses must be provided with regular, continuous medical training on enteral nutrition to maintain a high level of knowledge, positive attitudes, and competent practices on enteral nutrition


Download data is not yet available.


Abdullah, M., Mohammed, W., & Ismail, M. (2014). Nurses' knowledge and practices about administration of medications via nasogastric tube among critically ill patients. Journal of Education and Practice, 5(1), 147-159.

Ahmed, F. A. H. M., Ahmed, O. A. E., Abd, E., Albitar, E., & Ghoneim, S. E. S. (2018). Effect of educational nursing guidelines regarding enteral feeding on nurses' knowledge and practices at critical care units. IOSR Journal of Nursing and Health Science (IOSR-JNHS), 7(5), 69-75

Allen, K., & Hoffman, L. (2019). Enteral nutrition in the mechanically ventilated patient. Nutrition in Clinical Practice, 34(4), 540-557.

AlOtaibi, M. S., & Abdeldafie, S. Y. (2022). ICU Nurses' Knowledge About Enteral Nutrition at Buraidah Central Hospital in Qassim, Saudi Arabia. Journal of Pharmaceutical Negative Results, 13(9), 3096-3103.

Al-Qalah, T. A. H., & Alrubaiee, G. G. (2020). Intensive care nurses' knowledge of enteral nutrition at public hospitals in Sana'a, Yemen: a cross-sectional survey. Research, 9(759), 759.

Bloomer, M. J., Clarke, A. B., & Morphet, J. (2018). Nurses' prioritisation of enteral nutrition in intensive care units: a national survey. Nursing in Critical Care, 23(3), 152-158.

Compher, C., Bingham, A. L., McCall, M., Patel, J., Rice, T. W., Braunschweig, C., & McKeever, L. (2022). Guidelines for the provision of nutrition support therapy in the adult critically ill patient: The American Society for Parenteral and Enteral Nutrition. Journal of Parenteral and Enteral Nutrition, 46(1), 12-41.

Crossfield, C. L., Russo, P. L., & Bucknall, T. K. (2022). Enteral nutrition feeding practices by intensive care nurses: A retrospective evaluation. Nursing in Critical Care, 27(5), 676-681.

Darawad, M. W., Alfasfos, N., Zaki, I., Alnajar, M., Hammad, S., & Samarkandi, O. A. (2018). ICU nurses' perceived barriers to effective enteral nutrition practices: a multicenter survey study. The Open Nursing Journal, 12, 67-75.

De Lazzaro, F., Alessandri, F., Tarsitano, M. G., Bilotta, F., & Pugliese, F. (2022). Safety and efficacy of continuous or intermittent enteral nutrition in patients in the intensive care unit: Systematic review of clinical evidence. Journal of Parenteral and Enteral Nutrition, 46(3), 486-498.

El-sol, A. E. S. H., & Mohmmed, R. G. A. (2018). Assessment of nurse's knowledge, attitudes, and practice regarding physical restraints among critical ill patients. Assessment, 4(1), 15-22.

Hadera, T., Worku, T., & Tuli, W. (2022). Nurses Knowledge, Practice, and Associated Factors with Enteral Nutrition in Adult Intensive Care Units of Public Hospitals. Ethiopian Journal of Health Sciences, 32(2), 423-432.

Huang, J., Yang, L., Zhuang, Y., Qi, H., Chen, X., & Lv, K. (2019). Current status and influencing factors of barriers to enteral feeding of critically ill patients: A multicenter study. Journal of clinical nursing, 28(4), 677-685.

Jordan, E. A., & Moore, S. C. (2020). Enteral nutrition in critically ill adults: Literature review of protocols. Nursing in Critical Care, 25(1), 24-30.

Kim, H., & Chang, S. J. (2019). Implementing an educational program to improve critical care nurses' enteral nutritional support. Australian Critical Care, 32(3), 218-222.

Komen, D. (2020). Assessing Nursing Enteral Nutrition Practices and Perspectives in An Intensive Care Unit of A Level Six Hospital in Kenya. Asian Journal of Pharmacy, Nursing and Medical Sciences, 8(6), 84-91.

Kotrlik, J. W. K. J. W., & Higgins, C. C. H. C. C. (2001). Organisational research: Determining appropriate sample size in survey research appropriate sample size in survey research. Information Technology, Learning, and Performance Journal, 19(1), 43.

Lambell, K. J., Tatucu-Babet, O. A., Chapple, L. A., Gantner, D., & Ridley, E. J. (2020). Nutrition therapy in critical illness: a review of the literature for clinicians. Critical Care, 24, 1-11.

Limketkai, B. N., Shah, N. D., Sheikh, G. N., & Allen, K. (2019). Classifying enteral nutrition: tailored for clinical practice. Current Gastroenterology Reports, 21, 1-7.

Mahmoodpoor, A., Sanaie, S., Momen, F., Pourmoghaddam, M. A., & Saghaleini, S. H. (2021). Knowledge, attitudes, and practices of intensive care unit nurses towards nutritional care in critically ill patients: A descriptive cross-sectional study. Journal of Research in Clinical Medicine, 9(1), 35-35.

Margrate, M., Khan, S., Mukhtar, F., & Asmat, K. (2018). Knowledge and Practices among Nurses of Tertiary Care Hospitals, Lahore Regarding Nasogastric Tube Feeding in Adult Patients. Saudi Journal of Medical and Pharmaceutical Sciences, 4(7), 798-801.

Metin, Z. G., & Pars, H. (2020). Knowledge and Clinical Competence of Nurses Regarding Enteral Nutrition: A Descriptive, Cross-sectional, and Comparative Study. Topics in Clinical Nutrition, 35(2), 104-115.

Mohamed Abo Elezz, H., Mohamed Adly, R., & Refaat Tantawi, H. (2021). Assessment of Nursing Performance toward Enteral Feeding at Pediatric Critical Care Units. Egyptian Journal of Health Care, 12(4), 1159-1178.

Quiroz-Olguín, G., Gutiérrez-Salmeán, G., Posadas-Calleja, J. G., Padilla-Rubio, M. F., & Serralde-Zúñiga, A. E. (2021). The effect of enteral stimulation on the immune response of the intestinal mucosa and its application in nutritional support. European Journal of Clinical Nutrition, 75(11), 1533-1539.

Ramuada, L., Veldsman, L., Livhuwani, N., & Blaauw, R. (2022). Assessment of knowledge, attitude, and practice of nurses regarding Enteral Nutrition at a Military hospital. South African Journal of Clinical Nutrition, 1-7.

Ramuadaa, L., Veldsmana, L., Livhuwanic, N., & Blaauw, R. (2023). Assessment of knowledge, attitude, and practice of nurses regarding enteral nutrition at a military hospital. South African Journal of Clinical Nutrition, 36(2), 63-69.

Tatsumi, H. (2019). Enteral tolerance in critically ill patients. Journal of Intensive Care, 7(1), 1-10.

Zheng, C., Ge, Q., Luo, C., Hu, L., Shen, Y., & Xue, Q. (2022). Enteral nutrition improves the prognosis and immune nutritional status of patients in the cardiothoracic surgery recovery unit: A propensity score–matched analysis. Clinical Nutrition, 41(12), 2699-2705.

17 January, 2024
How to Cite
Wangari, N., Omondi, L., & Maina, D. (2024). Nurses’ Knowledge, Attitude, and Practice on Enteral Feeding of Critically ill Patients at Kenyatta National Hospital Critical Care Unit. East African Journal of Health and Science, 7(1), 22-33.