Role and knowledge of critical care nurses in the assessment and management of hypophosphataemia and refeeding syndrome. A descriptive exploratory study

Objective: To assess the perceived and actual role of critical care nurses in nutritional care, and their knowledge regarding the identification and management of hypophosphataemia and refeeding syndrome. Design and methods: Data were collected in one intensive care unit in Israel, from a self-administered questionnaire completed by 42 critical care nurses. The questionnaire was designed to assess their perceived and actual roles in the administration of nutritional care, and knowledge regarding electrolyte monitoring, hypophosphataemia and refeeding syndrome, including risk factors, consequences, and treatment. Results: The majority participants that dieticians are solely responsible for nutrition care and follow-up. Most agreed that the measurement of phosphate levels was not important and that patients should receive full nutrition upon admission, while important risk factors for the development of refeeding syndrome were not recognised or considered. This informed their actual practice. A correlation was found between nurses' knowledge and their actual practice so that the greater the nurses' knowledge, the more they adhered to current nutrition guidelines (p < 0.05). Conclusions: This study revealed critical care nurses' lack of clarity of their role and lack of knowledge regarding nutrition care. We suggest that this complex task is best managed by a multidisciplinary team, including nurses and dieticians, with clear role definitions.