ORIGINAL RESEARCH article
Front. Nutr.
Sec. Clinical Nutrition
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1675530
Evaluation of the Dietitians adherence to nutrition support guidelines or protocols in Saudi hospitals and identifications of the barriers to compliance
Provisionally accepted
Sara Zaher*
Alhanouf Sameer AlhussainiRaneem Zuhair AbdulghaniRefal Eihab Azzouni
Seba Khalid AalouhShahd Majed AlharbiSondos Albukhari- Faculty of Applied Medical Sciences, Taibah University, Madinah, Saudi Arabia
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Background: Nutrition support (NS) is essential for patients who cannot meet their nutritional needs orally. To ensure the effective implementation of nutrition care, several NS guidelines have been established to standardise practices, enhance patient safety, and improve overall clinical outcomes. This study examined adherence to NS guidelines or protocols among dietitians in Saudi hospitals and identified key barriers to compliance. Methodology: All dietitians working in hospitals across Saudi Arabia were eligible to participate in this cross-sectional study. Convenience sampling was used initially, followed by chain referral sampling, to achieve an adequate sample size. Data were collected via an online questionnaire between January and March 2025 and analysed using both univariate and multivariate analyses. Results: A total of 133 participants were included in this study. The results showed that the American Society for Parenteral and Enteral Nutrition guidelines were the most commonly used, reported by 35.6% of respondents. Participants demonstrated equally strong adherence to protocols for both enteral nutrition and parenteral nutrition, with a median adherence score of 5.00. The most frequently reported challenges to adhering to NS protocols were resistance from healthcare practitioners (60.9%), limited resources (26.2%), and poor communication with the healthcare team (23.5%). Regression analysis revealed that both hospital size (β = 0.732, p = 0.001) and the dietitians' years of experience (β = −0.344, p = 0.007) were significant predictors of adherence level. Conclusion: This study identified several barriers and challenges to adherence to NS guidelines or protocols. To improve NS practices, strategic investments in the improvement of hospital infrastructure, the development of structured interprofessional communication frameworks, and the implementation of ongoing training programs are needed. Addressing these key areas will be essential for standardising and optimising the delivery of nutrition care in hospitals across Saudi Arabia.
Keywords: nutrition support, guidelines, adherence, Enteral Nutrition, Parenteral Nutrition
Received: 29 Jul 2025; Accepted: 30 Sep 2025.
Copyright: © 2025 Zaher, Alhussaini, Abdulghani, Azzouni, Aalouh, Alharbi and Albukhari. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Sara Zaher, sz332@cam.ac.uk
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