Bridging the Evidence–Practice Gap in Hyperglycemia Management During Enteral Nutrition: A Multidimensional Implementation Study in Critically Ill Patients

Long-term hyperglycemia poses an elevated risk of infection, organ dysfunction, and increased mortality. Despite the availability of strategies for managing hyperglycemia, implementation effectiveness remains suboptimal. Therefore, this study investigates the factors hindering successful implementation and identifies potential change strategies. This study established evidence-based questions and formulated quality indicators. A baseline survey assessed existing practices. Subsequently, obstacle factors were analyzed using the Ottawa Model of Research Use, considering three dimensions: innovation, potential adopters, and practice environment; change strategies were then developed. The study revealed a significant gap between evidence and practice in hyperglycemia management during enteral nutrition in critically ill patients; adherence to 20 of 25 quality indicators was below 60%. Key obstacle factors included inadequate medical staff knowledge, a lack of standardized management processes, and the complexity of the evidence base. To address these challenges, the research team proposed intervention strategies including strengthening standardized hyperglycemia management protocols, establishing multidisciplinary teams, and providing systematic training. This study offers a framework for improving the quality of hyperglycemia management during enteral nutrition in critically ill patients and promoting the translation of evidence-based practice. Trial Registration: Fudan University Center for Evidence-Based Nursing: ER20240865.