Prevalence and causes for enteral nutrition interruptions in inpatients: A mixed-methods study

Disease-related malnutrition is a prevalent condition among hospitalized patients and is closely linked to adverse clinical outcomes. Beyond malnutrition present at admission, various in-hospital factors can further deteriorate nutritional status. A particularly significant yet often underrecognized factor is the interruption of enteral nutrition, which may occur due to diagnostic or therapeutic procedures, gastrointestinal intolerance, or other clinical concerns. While this issue has been extensively studied in intensive care settings, its prevalence, underlying causes, and clinical impact in the general inpatient population remain poorly understood.

To investigate the prevalence and causes of enteral nutrition interruptions among inpatients in tertiary hospitals in China, and to explore the impact of enteral nutrition interruptions on inpatients.

A sequential explanatory mixed-methods design was adopted.

The study was conducted in two tertiary hospitals in Beijing and Qingdao, China. The cross-sectional survey included 2328 inpatients from nine departments, and qualitative interviews included 10 inpatients from seven departments.

Initially, a convenience sampling method was adopted to conduct cross-sectional surveys on two separate days in the two tertiary hospitals, aiming to investigate the prevalence and duration of enteral nutrition interruptions across various departments. Subsequently, an interpretative phenomenological analysis was conducted through one-on-one, semi-structured in-depth interviews with patients from different departments who had experienced enteral nutrition interruptions. The interviews aimed to explore patients' personal experiences, perceived causes of the interruptions, and their physical and psychological impacts.

A total of 2328 inpatients were surveyed, among whom 116 experienced enteral nutrition interruptions, with prevalence rates of 3.30 %, 7.01 %, and an overall prevalence of 4.98 %. We classified the causes of enteral nutrition interruptions into 11 categories, with surgery being the most common (73.28 %) and associated with a mean duration of 31.39 ± 24.74 h. Ten inpatients participated in qualitative interviews, which revealed that enteral nutrition interruptions resulted from various factors, some of which were avoidable, and had negative impacts on physical function, appetite, and psychological well-being.

Enteral nutrition interruptions were observed across different clinical departments in Chinese hospitals. Inpatients may experience multiple enteral nutrition interruptions during a single admission, caused by diverse factors, leading to adverse physical and psychological effects. Healthcare professionals could reduce the occurrence of enteral nutrition interruptions through process optimization and improved awareness.