The effects on the gastric intolerance and diarrhea from the outcome of patient care of the decision support system designed on enteral nutrition and identification of nurses' experiences WHO using the system

Objective: The aim of this study, by testing the reliability and validity of King?s Stool Chart Turkish (KSCTr) in enteral nutrition, to evaluate the effectiveness of Decision Support Systems (DSS) on gastric intolerance and diarrhea and to defined toto experiences of nurses who is using DSS.Method: This study was composed of three phases with methodological, quasi-experimental and qualitative designs. At the methodologic phase, the reliability-validity test of KSCTrwas conducted methodologically on 212 stool sample. Data was analyzed by Kendall W Test and Cohen's kappa coefficient. Quasi-experimental phase was carried out on 144 intensive care patients receiving enteral nutrition. Data was collected by Data Collection Formfor Intensive Care Patients with Enteral Nutrition, Daily Enteral Nutrition Follow-up Form, Gastric Intolarance Follow-up Form for Intensive Care Patients Patient with Enteral Nutrition and KSCTr form and analyzed by Mann-Whitney U and chi-square tests. Qualitative phase was carried out with 19 nurses who using to DSS, by in-depth individual interviews. Data was analyzed by thematic analysis.Results: At the methodologic phase, it was found that to be ascertain the agreement among the experts on KSCTr form (W= 0.101, p=0.09). At inter-observer adaptation, stool consistency characteristics (? = 0.76) and stool weight (? = 0.75) were consistent with good degree (p=0.00). At Quasi-experimental phase, reaching the target calorie levels at the experimental group who was be using the DSS on was higher than the control group (p=0.01). Gasrtik residual volume (GRV) amounts and the duration of diarrhea seen measured to 1stand 2nd day of the enteral nutrition at the experimental group were lower than the control group (p=0.04). The experimental and control group patients were be determined the gastric4intolerance on the 2nd and 7th days, but there was no difference between groups. There was no statistically significant difference in per day frequency in the case of diarrhea (p> 0.005), except to 15th days (p = 0.02) and 22th days (p = 0.03). In the qualitative phase, three categories and six themes become apparent.Conclusion: The study was found that KSCTr form is a reliable and valid instrument for evaluation of stool in patients receiving enteral nutrition, and DSS is not effective in gastric intolerance and diarrheaand effective in duration of diarrhea seen and GRVamounts and nurses have positive and negative attitudes towards the use of DSS.Key Words: Intensive Care, Enteral Nutrition, Decision Support System, Stool Assessment Chart, Diarrhea, Gastric Intolerance