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.
Background: The COVID-19 pandemic has a negative effect on critical care nurses' mental health. Aim: This study aimed to assess the level of post-traumatic stress disorder (PTSD) among the critical care nurses caring for patients with COVID 19 and evaluate the stress factors that affect them. Study design and Methods: A descriptive crosssectional study was conducted in the intensive care and emergency units at Assiut University Hospital from the period of August 2020 to November 2020; 118 critical care nurses completed the questionnaire via an online survey. Results: Among the participating nurses (47.5%) were reported moderate level of post-traumatic stress disorder symptoms, and (39.0%) were reported severe level of PTSD symptoms. At P=0.05, there was a positive significant correlation between PTSD and workload, COVID 19 patient death, conflict with physician, lack of competency, and fear of infection among participant nurses (r =.370**, r = .268**, r = 268**, r = .265**, r = r =.272**, r =.277**) respectively. Conclusion: The rate of post-traumatic stress disorder was higher among critical care nurses caring for patients with COVID-19. Recommendations: We recommended further study to investigate the impact of the COVID-19 on mental health of critical care nurses and educate them about PTSD.
Dyspnea and a higher volume of secretions are common complaints among chronic obstructive
pulmonary disease patients. As a result, there is a current tendency to adopt non-pharmacological
approaches to help clear secretions, improve lung function, and relieve dyspnea. So, the aim of this
research was to evaluate the effect of autogenic drainage and acupressure on the respiratory
outcomes of non-invasive mechanically ventilated COPD patients. A quasi-experimental design was
used. Setting: chest and general intensive care units at Assuit University Hospitals. Sixty noninvasive
mechanically ventilated COPD patients recently admitted were included. Data was
collected using two tools: tool I: patient assessment sheet, tool II respiratory outcome assessment
sheet. Results: There was a highly significant reduction in the respiratory rate in study group after
application of autogenic drainage and acupressure at 3rd and 7th day (p<0.001), significance
differences were found regarding PaO2, SaO2 before and after intervention between study and
control groups at 7th day with P. value (0.004, 0.029and 0.005&0.005)respectively. Moreover, there
was highly significance increase in the amount of sputum clearance at 7th day (p<0.001),
improvement with highly significance in dyspnea measures among study group patients 7th day
(p<0.005) after extubation and (p<0.001) before discharge. Conclusion: applying autogenic
drainage and acupressure had statistically significant positive effect on respiratory parameters
outcomes on non invasive mechanically ventilated COPD Recommendations: provide educational
program for nurses about AD and acupressure.
