{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T07:01:19Z","timestamp":1790060479740,"version":"4.0.1"},"reference-count":21,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing in Critical Care"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Enteral nutrition intolerance (ENI) is common among critically ill patients and may interfere with the effective delivery of enteral nutrition. Identifying patients at increased risk and potentially modifiable care\u2010related factors may help inform more targeted nursing management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>This study aimed to identify independent risk factors for ENI in critically ill patients, evaluate nurse\u2010modifiable protective factors and develop risk\u2010stratified nursing optimization strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A single\u2010centre retrospective cohort study was conducted, including adults patients receiving EN for \u2265\u200972\u2009h in the ICU (January 2023 to December 2025). The primary outcome was a composite endpoint of ENI. Independent predictors were identified using multivariable logistic regression. Risk stratification was performed based on predicted probabilities. Population attributable fractions (PAFs) were calculated to estimate potential benefits from modifying modifiable factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      ENI incidence was 44.6%. Age, APACHE II score and mechanical ventilation were independent risk factors (OR\u2009=\u20091.037, 1.399, 3.432; all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Probiotic use, nasoenteric tube feeding, gastric residual volume (GRV) monitoring \u2265\u20093 times\/day and a head\u2010of\u2010bed elevation adherence rate &gt;\u200990% were independent protective factors (OR\u2009=\u20090.226, 0.297, 0.252, 0.180; all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). In the high\u2010risk group (predicted probability \u2265\u20090.66), the ENI incidence reached 86.9%, but coverage of protective measures was low (head\u2010of\u2010bed elevation 52.5%, GRV monitoring 27.9%, nasoenteric tube 11.5%, probiotics 24.6%). PAF analysis suggested that delayed nasoenteric tube placement, non\u2010use of probiotics and inadequate GRV monitoring could potentially avoid 55.3%, 53.7% and 48.9% of ENI events, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>ENI in ICU patients is influenced by age, disease severity and nurse\u2010modifiable factors. Incorporating standardized probiotics, graded GRV monitoring and high head\u2010of\u2010bed elevation adherence into core quality control measures, along with a bundled strategy for high\u2010risk patients, may substantially reduce ENI incidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance to Clinical Practice<\/jats:title>\n                    <jats:p>The identified nurse\u2010modifiable factors provide clinically relevant targets for risk\u2010informed enteral nutrition management. Risk stratification may help nurses identify patients requiring closer monitoring and more individualized nutritional care. For patients at high risk of ENI, attention to feeding\u2010route selection, appropriate GRV monitoring, head\u2010of\u2010bed elevation adherence, and probiotic use may help optimize enteral nutrition management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nicc.70672","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T08:57:13Z","timestamp":1789030633000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk Factors for Enteral Nutrition Intolerance in\n                    <scp>ICU<\/scp>\n                    Patients and Corresponding Optimized Nursing Strategies"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-2249-2048","authenticated-orcid":false,"given":"Yuxia","family":"Pan","sequence":"first","affiliation":[{"name":"Intensive Care Unit Taizhou Hospital of Traditional Chinese Medicine (Taizhou Affiliated Hospital of Nanjing University of Chinese Medicine)  Taizhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1760-0463","authenticated-orcid":false,"given":"Qingye","family":"Zhang","sequence":"additional","affiliation":[{"name":"Intensive Care Unit Taizhou Hospital of Traditional Chinese Medicine (Taizhou Affiliated Hospital of Nanjing University of Chinese Medicine)  Taizhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongyi","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Nursing Taizhou Hospital of Traditional Chinese Medicine (Taizhou Affiliated Hospital of Nanjing University of Chinese Medicine)  Taizhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-4772-8927","authenticated-orcid":false,"given":"Wenjuan","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Taizhou Hospital of Traditional Chinese Medicine (Taizhou Affiliated Hospital of Nanjing University of Chinese Medicine)  Taizhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ncp.10232"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.4103\/ajim.ajim_65_25"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCC.0000000000000504"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468\u20101253(18)30036\u20100"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134\u2010016\u20104665\u20100"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/0148607115621863"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/jpen.1817"},{"key":"e_1_2_13_9_1","first-page":"236","article-title":"Should We Stop Using Gastric Residual Volumes?","volume":"4","author":"Sarah J. 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