Barriers to the Adherence of ICU Nurses to the Tube Feeding Protocol: A Qualitative Study

Background The heightened metabolic demands of critically ill patients on ventilators necessitate proper tube feeding for optimal recovery. Despite nurses being primarily responsible for administering tube feeding, evidence indicates a lack of adherence to evidence-based practices. This study aims to identify the barriers preventing ICU nurses from adhering to the tube feeding protocol. Methods This qualitative study utilized conventional content analysis. Participants included ICU nurses from Sina Hospital, Tabriz, Iran, in 2024. A combination of purposeful and snowball sampling was employed, achieving data saturation after 19 interviews. Data were collected through semi-structured interviews and analyzed using the Zhang & Wildemuth method. Results The analysis identified three primary barriers to adherence: the gap between theoretical knowledge and clinical practice, organizational and interpersonal challenges, and resistance to change. Conclusion The findings highlight that barriers to adherence are multifaceted, deeply rooted in organizational contexts. Policymakers and clinical educators can use these insights to develop targeted interventions. Future nurses can reflect on these findings to enhance their professional development and adjust protocols to bridge identified gaps. Additionally, organizational values and interventions for nursing staff should be revised to address these barriers effectively.