# Challenges, Perceptions, Training and Needs of Primary Care Nurses in the Management of Patients with Percutaneous Endoscopic Gastrostomy: A Cross-Sectional Study in Southern Spain

## TL;DR

Primary care nurses in Spain manage PEG tubes but lack proper training and updated guidelines, highlighting the need for better education and resources.

## Contribution

This study identifies gaps in training and resources for primary care nurses managing PEG patients in Spain.

## Key findings

- Most nurses (92.4%) have cared for PEG patients, and 68.9% managed complications.
- Experienced nurses showed better knowledge, but only 38.5% had specialized training.
- 98.3% of nurses expressed a need for continuing professional development in PEG management.

## Abstract

Background/Objectives: The use of percutaneous endoscopic gastrostomy (PEG) offers numerous benefits but is also associated with complications that require specialised management. However, evidence regarding the management of these patients in primary care, both in Spain and internationally, remains limited. The aim of this study was to analyse primary care nurses’ perceptions of their level of knowledge and their needs related to the management of patients with PEG tubes. Methods: A descriptive cross-sectional study was conducted, using an online questionnaire addressed to primary care nurses in Andalusia, Spain. Demographic data, perceived level of knowledge, and perceptions regarding PEG management were collected. Statistical analysis included chi-square and Fisher’s exact tests, as well as a multivariable logistic regression model. Results: A total of 121 nurses participated, where 92.4% had cared for PEG patients and 68.9% had managed complications. Within the total group, older nurses and those with more years of professional experience demonstrated significantly greater knowledge in managing these complications (p < 0.05). However, only 38.5% had received specialised clinical training, and 98.3% expressed the need for continuing professional development. The lack of up-to-date protocols was a recurrent finding, with many nurses relying on referrals to specialist colleagues. Conclusions: Primary care nurses frequently manage PEG-related complications but lack systematic access to evidence-based guidelines and training. This gap underscores the need for structured educational programmes such as practical seminars, simulation-based online modules, regular clinical sessions led by specialist nurses, and clear visual protocols for identifying and managing common complications.