Individual and Organisational Factors Influencing Knowledge, Attitude and Practice Regarding Post-Extubation Dysphagia in ICU Nurses: A Cross-Sectional Multicentre Study.

BACKGROUND

Dysphagia is a prevalent and critical issue in critically ill patients who have undergone mechanical ventilation. The knowledge, attitude, and practice (KAP) of ICU nurses are determinants of the effectiveness of post-extubation dysphagia (PED) management. However, existing evidence regarding the current KAP status of PED among ICU nurses remains insufficient.

OBJECTIVES

This study aimed to assess the current status of ICU nurses' KAP regarding PED, along with associated individual and organisational factors.

METHODS

From August to September 2024, a cross-sectional, multicentre study was conducted on a convenience sample of 305 ICU nurses from 15 tertiary hospitals in 10 cities of Guangdong Province, China. An online self-reported structured questionnaire was used to collect data on the KAP of PED among ICU nurses.

RESULTS

A total of 305 valid questionnaires were analysed. The overall mean score was (70.08 ± 15.34). The mean scores of knowledge, attitude, and practice were (78.10 ± 28.98), (80.02 ± 13.27), and (52.13 ± 22.94), respectively. Multivariate analysis revealed that the individual factors related to the total score included confidence in PED management (β = 0.356, p < 0.001), and the organisational factors included leadership support (β = 0.210, p < 0.001), unit compliance with PED screening and treatment protocols (β = - 0.169, p = 0.001), and availability of PED educational resources (β = 0.156, p = 0.002).

CONCLUSIONS

ICU nurses possess a relatively extensive knowledge base and exhibit positive attitudes toward PED, but there is still room for practice improvement. Besides strengthening the training of ICU nurses on PED-related knowledge, formulating standardised protocols, establishing a multidisciplinary management team, creating a favourable improvement atmosphere, and providing sufficient training resources are indispensable measures for enhancing the quality of clinical PED management.

RELEVANCE TO CLINICAL PRACTICE: To enhance the quality of PED management, it is advisable to formulate a multi-aceted support strategy targeting both organisations and individuals, thereby facilitating the implementation of relevant practices.

REPORTING METHOD: The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement of cross-sectional studies was followed for reporting in the study.

PATIENT OR PUBLIC CONTRIBUTION: No patient or public involvement.