Racial and Ethnic Differences in Healthcare Access and Utilization Among Adults With Congenital Heart Defects in the Congenital Heart Survey to Recognize Outcomes, Needs and Well-Being (CH STRONG).

Enteral Nutrition (EN) is essential for preserving intestinal integrity, bolstering immune function, and preventing intestinal atrophy, rendering it the favored nutritional support approach for critically ill patients [, ]. Nonetheless, EN disruptions are prevalent in clinical settings due to factors like diagnostic procedures, surgeries, feeding intolerance, and inadequate healthcare staff awareness []. These interruptions can hinder the attainment of feeding objectives, potentially resulting in malnutrition and negatively impacting patient results []. Malnutrition significantly affects the prognosis of critically ill patients, influencing mortality, length of hospital stay, duration of mechanical ventilation, and infection rates []. Research indicates a prevalence of malnutrition among ICU patients ranging from 38% to 78% []. ICU nurses, being the primary implementers and overseers of EN protocols, significantly influence the frequency and handling of these interruptions. While some studies have delved into ICU nurses’ knowledge, attitudes, and practices concerning EN interruptions [, ], there is limited research on the circumstances and influencing factors among ICU nurses in Shandong Province. Hence, this study seeks to evaluate the knowledge, attitudes, and practices concerning enteral nutrition interruptions among ICU nurses in this area and to pinpoint the factors that affect these outcomes. This study used a cross-sectional, electronic survey design. In February and March 2025, Shandong Province was divided into five regions (eastern, central, western, southern, and northern) using stratified sampling methods. Various factors, including hospital size, medical technology level, and regional representation, were considered in each region through a combination of random and purposeful sampling techniques. Subsequently, ICU nurses from 18 tertiary hospitals in these regions were selected as the study participants. The sample size was determined using the formula for estimating population rate sample size, with an additional 20% to accommodate potential invalid questionnaire responses, resulting in a final minimum sample size of 300 participants [].