Background: Careful monitoring for patient with hepatocellular carcinoma who receiving trans-arterial chemoembolization in adult intensive care units to reduce complications remains mandatory for nurses. The study aimed to evaluate the effect of implementing a nursing protocol on patients' outcomes undergoing trans-hepatic arterial chemoembolization. Quasi experimental research design was used in this study. Subjects: All adult patients who diagnosis with hepatocellular carcinoma and receiving trans-arterial chemoembolization at the liver intensive care unit and gastroenterology department at Al-Rajhi liver hospital were involved in this study. Two tools were used. Tool one: patient assessment questionnaire and includes 4 parts, tool two: patient outcomes assessment questionnaire. Methods: The nursing protocol on trans-arterial chemoembolization was implemented by the researcher from the day before procedure until discharge, the researcher assess site of insertion, post embolization syndrome after procedure and recorded it. Results: Findings of the present study revealed significant improvement in pain scores as it was 3.77±0.59 in the control group 4 hours after TACE while it was 3.19±0.63 in the Study group, and Mean ± SD was 3.95±0.58 in the control group 6 hours after TACE in comparison to 3.15±0.75 in the study group. Insertion site and ICU stay values of less than p=0.005, p=0.5 and p=0.05 respectively in response to implementing nursing protocol. Conclusion: implementing the nursing protocol on trans-hepatic arterial chemoembolization appear to be effective in terms of reducing incidence and consequences of post procedure complications. Recommendation: Patients and their caregivers need to be apprised of post embolization syndrome symptoms prior to TACE and provided with adequate nursing care for symptom control.
Background: Gastrointestinal (GI) dysfunction is a danger for critically sick patients who receive mechanical breathing. During the course of enteral feeding in the early stages of critical illness, gastric residual volume (GRV) is used as a surrogate metric for GI dysfunction. This study aimed to investigate the effect of high gastric residual volume on critically ill patient outcomes. Design: A prospective, observational research design. Methods: A purposive sample of 60 adult critically ill patients of both sex from the intensive care units )sUCI( at Assiut University Hospital, Egypt were included in the study from August 2020 to April 2021. According to the measurement of gastric residual volume, those patients were not randomly allocated in group 1[the normal limit of gastric residual volume (NGRV) 500]. Five tools were used to collect data included patient's assessment tool, APACHE 11 score, nutritional intervention assessment tool, gastric residual volume assessment tool, and Patient outcomes assessment tools. Results: there was a significant decrease in the Length of ICU stay, duration of mechanical ventilation, and mortality rate in NGRV group than the HGRV group (11.04±4.12 versus 13.91±5.88, 8.43± 4.5 versus 13.02 ±5.04, 30.4% versus 70.3%) respectively. Conclusion: HGRV had an adverse effect on critically ill patients' outcomes such as high ICU mortality, long duration of mechanical ventilation and long ICU stay. Recommendation: Frequent monitoring of gastric residual volume and gastric residual volume protocol and guidelines should be applied in ICU.
