RESEARCH ARTICLE
Bridging the Evidence–Practice Gap in Hyperglycemia Management During Enteral Nutrition: A Multidimensional Implementation Study in Critically Ill Patients
Wenjun Yan,
Yanxia Han,
Chenying Qian,
Yaxin Li,
Zhi Zhao,
Wenjun Yan
First Affiliated Hospital of Soochow University, Suzhou, China
Search for more papers by this authorYanxia Han
First Affiliated Hospital of Soochow University, Suzhou, China
Search for more papers by this authorChenying Qian
First Affiliated Hospital of Soochow University, Suzhou, China
Search for more papers by this authorYaxin Li
School of Nursing, Suzhou Medical College of Soochow University, Suzhou, China
Search for more papers by this authorCorresponding Author
Zhi Zhao
First Affiliated Hospital of Soochow University, Suzhou, China
Correspondence:
Zhi Zhao ([email protected])
Search for more papers by this authorWenjun Yan,
Yanxia Han,
Chenying Qian,
Yaxin Li,
Zhi Zhao,
Wenjun Yan
First Affiliated Hospital of Soochow University, Suzhou, China
Search for more papers by this authorYanxia Han
First Affiliated Hospital of Soochow University, Suzhou, China
Search for more papers by this authorChenying Qian
First Affiliated Hospital of Soochow University, Suzhou, China
Search for more papers by this authorYaxin Li
School of Nursing, Suzhou Medical College of Soochow University, Suzhou, China
Search for more papers by this authorCorresponding Author
Zhi Zhao
First Affiliated Hospital of Soochow University, Suzhou, China
Correspondence:
Zhi Zhao ([email protected])
Search for more papers by this authorFirst published: 05 July 2025
Funding: This work was supported by 2024 Nursing level research project of the First Affiliated Hospital of Soochow University (No. HLYJ-2024-10).
ABSTRACT
Long-term hyperglycemia poses an elevated risk of infection, organ dysfunction, and increased mortality. Despite the availability of strategies for managing hyperglycemia, implementation effectiveness remains suboptimal. Therefore, this study investigates the factors hindering successful implementation and identifies potential change strategies. This study established evidence-based questions and formulated quality indicators. A baseline survey assessed existing practices. Subsequently, obstacle factors were analyzed using the Ottawa Model of Research Use, considering three dimensions: innovation, potential adopters, and practice environment; change strategies were then developed. The study revealed a significant gap between evidence and practice in hyperglycemia management during enteral nutrition in critically ill patients; adherence to 20 of 25 quality indicators was below 60%. Key obstacle factors included inadequate medical staff knowledge, a lack of standardized management processes, and the complexity of the evidence base. To address these challenges, the research team proposed intervention strategies including strengthening standardized hyperglycemia management protocols, establishing multidisciplinary teams, and providing systematic training. This study offers a framework for improving the quality of hyperglycemia management during enteral nutrition in critically ill patients and promoting the translation of evidence-based practice.
Trial Registration: Fudan University Center for Evidence-Based Nursing: ER20240865
Conflicts of Interest
The authors declare no conflicts of interest.
Open Research
Data Availability Statement
The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.
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