Perceived Potential Barriers to Implementation of Nutritional Therapy Practice Guidelines in Critically Ill Adults in a District of KwaZulu-Natal, South Africa
Bibliographic record
Abstract
BACKGROUND: Transitional challenges in the disease profile and healthcare systems have revealed the need for the development of guidelines to assist healthcare practitioners in decision making regarding patient care. Implementing strong evidence‐based guideline recommendations into clinical practice is associated with improved clinical outcomes for patients, and integrated and collaborative nutritional services. PURPOSE: The purpose of this study was to identify perceived barriers to implementing national enteral nutritional therapy practice guidelines in critically ill adults in a district hospital and primary healthcare institutions in South Africa. METHODS: A quantitative descriptive research design was followed in this study. The district and institutions were selected using non-probability deliberate purposive and convenience sampling methods to select healthcare professionals (HCPs) for the study. Data were collected through a self-administered questionnaire and analysed with the IBM Statistical Package for the Social Sciences (SPSS) version 25. RESULTS: Ninety-six HCPs participated in the study which included nurses (76.0%, n = 73), doctors (10.4%, n = 10), pharmacists (7.3%, n = 7), nutrition specialists (5.2%, n = 5), and a speech-language therapist (1.0%, n = 1). Lack of awareness among HCPs and unavailability of enteral nutritional therapy practice guidelines ENTPGs in the institutions were identified as potential high priority barriers to implementation. CONCLUSION: The results of this study indicate the need for introducing guidelines to HCPs and institutions to create awareness of such guidelines and thus encourage adherence to recommendations. There is a strong need for further research on strategies to manage the identified barriers to facilitate adoption and implementation of the national enteral nutritional therapy practice guidelines for adults in a South African context.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.008 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.002 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".