Background: Rehabilitation is a cornerstone in management of mechanically ventilated patients in ICU concerned reducing impairments, preventing complications and reduce weaning time. Therefore, the aim was to identify the effect of early rehabilitation on mechanically ventilated patient's outcomes. Quasi experimental research design was used to conduct this research. This study was carried out at general intensive care unit at Sohag University Hospitals. The sample of this study was consisted of 60 patients, divided into study and control group equally. Tools used in this study; Tool I: Modified patient assessment sheet, Tool II: patients complications assessment sheet, Methods: Each patient of the study group subjects were exposed in addition to routine hospital care to two sessions/day of rehabilitation program until disconnection from mechanical ventilator. However control group subjects were exposed to routine hospital care only. The main results:- Finding of the present study revealed a significant statistical differences (P<0.05) found between both groups in relation to improvement on oxygenation, length of stay on mechanical ventilation, length of ICU stay, respiratory infection, and weaning in study group compared to control group. Conclusion: Applying early rehabilitation for mechanically ventilated patient help to reduce complications and improve the outcomes. Recommendation: Further researches are recommended to include information about the follow-up of these patients out of ICU.

Background: Cardiac surgery is the largest consumer of blood products in medicine; although believed lifesaving, transfusion carries substantial adverse risks. Aim of the study: evaluate the effect of blood transfusion precautions on patient’s outcomes undergoing open heart surgery. Patients and Methods: A quasi experimental design was adopted. A total of 60 adult patients post open heart operations divided equally into two groups (study group & control group). Tools: tool one; Patient Assessment Sheet; Part (I) Socio-demographic data, Part (II) Clinical Data, Part (III) Blood Transfusion observation Sheet. Tool two; Administering a Blood Transfusion Checklist. Results: The study group stayed less duration in the hospital and ICU than the control group with statistical significance difference as regard hospital stay in which p < .02 and statistical significance difference as regard ICU stay in which p < .000. As regards abnormal reaction during blood transfusion half of the control group had fever compared with one third of the study group. Recommendation & Conclusion: it can be concluded that, the applying of blood transfusion precautions on patients undergoing open heart surgery was successful in reducing hospital and ICU length of stay and complications of blood transfusion, and recommended that, hospital should provide ongoing quality programs for health care professionals.

Background: Acute angle closure glaucoma (AACG) is a true medical emergency. Glaucoma is the second leading cause of blindness worldwide. Aim: To assess the effect of immediate implementing standardized nursing care on outcomes of patients' with AACG. Methods: Quasi-experimental research design was used to conduct this study. The sample size calculated about 40 cases for each group include in the study. Data was collected using two tools Tool (1):- Patient assessment sheet. Tool (II):- Manifestations Assessment sheet. Results: There was a statistically significant difference before and immediately after implementing a standardized nursing care on patients outcomes with AACG regarding intra ocular pressure (P-value10.806, 0.124, 0.147), visual acuity and pain score among the studied groups p-value (0.002, 0.023, and 0.001) respectively. 65.0% of the studied groups had satisfactory level of knowledge regarding visual acuity, intra ocular pressure (IOP), and pain score characteristics. Conclusion Implementing a standardized nursing care had a positive effect on outcomes of patients' with AACG. Recommendations: Screening all people aged 40 years or more for symptoms &signs of glaucoma. Health education programs about standardized nursing care rules for patients' with AACG.

Background: Emergency hypertension is elevation of blood pressure (Systolic over 180 or diastolic over 120) associated with acute end organ damage .The critical care nurse assumes important role for the care and clinical stabilization of the patient with emergency hypertension Aim this study was carried out to evaluate the effect of nursing guideline on patient's outcomes with hypertension emergency. Setting This study was conducted at coronary care unit. Subjects A convenient sample of (60) patients that divided in to two groups (control 30 and study 30) collected over threeteen months. Tools Two tools were utilized to collect data pertinent to study Tool I Socio demographic and clinical data assessment sheet. Tool II Sequential Organ Failure Assessment scale "SOFA" score. Nursing guideline for patient with emergency hypertension Methods emergency hypertensive nursing guideline implemented by researcher using Tools I, II from the first day of admission and until discharge then the data were recorded in the developed tools. Results As regards to the emergency hypertensive patients suffering neurological manifestations, results revealed that there were statistically significant difference between studied groups in first day (P=0.046). As regards to the emergency hypertensive patients suffering renal manifestations, results revealed that there were statistically significant difference between studied groups in third and fourth day (P=0.048 and P=0.019) respectively. Conclusion Applying nursing care guideline for patients with emergency hypertension showed statistically significance difference in reduction incidence of complication regarding kidney function in third and fourth day and length of hospital stay.

Background: Acupressure decreases muscular tension, enhancing blood circulation, makes deep relaxation and improving sleep quality. Aim: to investigate effect of acupressure on sleep quality among patients with acute coronary syndrome (ACS). Design: a quasi-experimental design. Setting: Coronary Care Unit at Assiut University Heart Hospital. Subjects: Convenience sample of 60 male and female adult patients were assigned randomly to two equal groups (30 each). Tools: two tools were utilized to collect study data, Tool I Acute Coronary Syndrome patient assessment Tool II: Modified ST Mary’s Hospital Sleep Questionnaire (SMHSQ). Methods: Researcher assessed homodynamic status of both groups every four hours as base line data and for 3 consecutive days. Then, acupressure was applied for study group between 7:10 PM. On morning, sleep quality was assessed for both groups by using modified (SMHSQ) between 7:8 AM. Results: Finding of this study supported stated research hypotheses with statistical significant difference between study and control groups regarding sleep quality on 1st, 2nd and 3rd nights of intervention (P=0.000**, P= 0.000** and P=0.000**) respectively. Conclusion Acupressure can significantly improve sleep quality of ACS patients. Therefore, Utilization of acupressure as a basic part of care provided to all ACS patients is highly recommended.

Fatigue is frequently reported symptom influencing up to 90% of hepatocellular carcinoma patient .Aim: Evaluate the effectiveness of educational and physical intervention to reduce fatigue for hepatocellular carcinoma patient. Design: Quasi-experimental design. Setting: Viral Hepatitis Treatment Unit at Assuit Health Directorate. Subjects A purposive sample of 60 patients diagnosed with HCC and infected by hepatitis C, B virus or both. Methods Patients in the study group encourage to perform physical exercises in sessions for 6 months follow up and give information about this disease. Tools: two tools were applied Tool I: Patient assessment sheet Tool II: Functional Assessment of Chronic Illness Therapy (Fatigue Scale). Results: There were significant statistical differences existed between study and control groups regarding to patients' fatigue and patients' knowledge of p-value (0.001).There is very high statistical difference between groups regarding practice exercise &relaxation technique of p-value (0.0001). Conclusion: The nursing intervention had statistically significant beneficial effects on improving patient’s outcomes. It recommends replication of nursing intervention of this study on a larger probability sample.

Risk factor of cardiac arrest among ill patient has as a risk factors for sudden death, through cardiac arrhythmias, tension pneumothorax ,shock, hypoglycemia ,Myocardial infarction (MI), pulmonary embolism, or edema ,hypothermia and drug toxins, At Assuit University Hospital major risk factor of cardiac arrest as diabetic ketoacidosis Subjects and Method: Study was executed in the following: Coronary, Trauma, post, Elraghy ,and General intensive care units. The study sample consisted of all patients predisposing to cardiac arrest admitted to intensive care units within 6 months period. Three tools were utilized for data collection: tool (one):"Patient's characteristics and clinical data ”, tool (two): "cardiac arrest patient tool (three ) Risk factor of cardiac arrest . Results: Major risk factor for cardiac arrest patients among critically ill in the above mentioned setting at Assuit Hospital was 130 patients who predisposing for cardiac arrest. About (18.5%) with diabetic keto acidosis, and (17.7%) with chronic obstructive pulmonary disease .were expose to cardiac arrest Conclusion: Risk factors of cardiac arrest have been identified as(diabetic keto acidosis ,is most common certified in tables to help predict the cardiac arrest by alerting a clinical response Recommendations: Monitoring risk factors for cardiac arrest should be required to allow for the early detection and management.