Healthcare professionals’ views on barriers to implementing evidence-based enteral nutrition management in ICU patients receiving prone position ventilation: a qualitative descriptive study

To explore healthcare professionals’ views on barriers to implementing evidence-based enteral nutrition management specifically in ICU patients receiving prone position ventilation, with particular focus on prone positioning-induced challenges distinct from general ICU enteral nutrition care. A qualitative descriptive study. The study was conducted in a general ICU of a tertiary comprehensive hospital in a city in Sichuan Province, China. In 2025, semi-structured interviews were conducted with 15 participants, including 12 nurses and 3 physicians, all of whom had worked in the ICU for more than one year and had experience in providing enteral nutrition care for patients undergoing prone positioning ventilation. Participants were recruited using purposive sampling until data saturation was achieved. Interview questions specifically targeted prone positioning-related challenges rather than general enteral nutrition barriers. All interview data were analyzed using thematic analysis. Four main themes emerged that were uniquely shaped by prone positioning context: (1) prone positioning-specific care prioritization conflicts (airway management during prone position competing with feeding schedules), (2) prone positioning-specific resource demands (specialized positioning equipment, temperature monitoring during restricted patient access), (3) lack of prone positioning-specific training protocols, and (4) communication barriers regarding prone positioning timing and feeding coordination. This study identifies four key barriers that are uniquely amplified or created by the prone positioning context: the conflict between prone positioning-specific airway management and feeding schedules, increased resource demands for specialized positioning care, absence of prone positioning-specific training curricula, and coordination challenges between positioning schedules and enteral nutrition timing.