Hematuria is a life threating problem which lead to anemia and hypovolemic shock due to bleeding which affect patient life; so nurses must do great efforts to prevent complications by using urine color scale successfully to contribute a successful patients' outcomes. Aim: Evaluate the effect of teaching program about hematuria on nurses' performance at urology intensive care unit. Research design: This study was a quasi experimental design, conducted in urological intensive care unit and urological emergency unit at Assuit university hospital. Subject and method: This study was composed of 50 nurses caring patients with hematuria. Twotools were used for data collection, tool I is (knowledge assessment tool), tool II is (observational checklist). Results: The study revealed that more than half of nurses were in the age group from 20 to 25 years and held nursing technician institute, 92.0% of nurses had unsatisfactory knowledge about hematuria , but this knowledge improved after the implementation of the program. Conclusion and Recommendations: Nurses' had unsatisfactory knowledge about hematuria in pretest. The educational program was successful in achieving its goal of upgrading or improving nurse`s knowledge. A significant difference was found between scores of knowledge before and after implementing the program. The study recommends focused on establishing plans for periodical and scheduled training courses and educational programs for nurses to help in improving their knowledge.

Heat stroke is an acute, life-threatening emergency characterized clinically by elevated body temperature and central nervous system dysfunction. The nurse has an important role in critical care team. Therefore, the aim is to evaluate the effect of an educational program on the nurses' performance regarding heat stroke. Quasi-experimental research design was used to conduct this study. This study was carried out at Emergency department and isolation room at Assiut University Hospitals. The sample: A convenient sample included all nurses working at Assuit University Hospital ; 30 nurses in the emergency unit and 12 nurses in isolation room .Tools: Two tools were utilized in this study. Tool I: Nurses' knowledge assessment. Tool II: Nurses’ performance observational checklist questionnaire. Results: The present study revealed that total mean scores of the nurses' knowledge was 13.02±4.49 pre implementation, 27.57±2.38 post implementation of educational program and 26.33±4.06 at follow up. Total mean scores of the nurses’ performance was 112.64±8.84 pre implementation, 177.97±8.35 post implementation of the program and 160.67±14.44 at the follow up .So there is a significant difference between their knowledge before and after the educational program. Conclusion: The study concluded that the educational program led to improvement in nurses' knowledge and performance about heat stroke. Recommendation: The program should be utilized for all new graduated nurses to be orientated to all aspects of care provided for heat stroke patients.

Background: Radical nephrectomy is the standard treatment of choice for localized renal cell carcinoma. Ensuring that patients’ informational needs have been met before radical nephrectomy set the stage for successful management and improves recovery. Aims: Evaluate the effect of nursing teaching guideline on the level of anxiety before radical nephrectomy. Research design: True experimental research design (Pre-test and post-test). Setting: Assiut Urology and Nephrology Hospital. Patients: Sixty adult patients undergoing radical nephrectomy were distributed into two equal groups (study and control groups) 30 patients for each. Tools: (I) Patient assessment sheet, (II) State-Trait Anxiety Inventory for Adult, and (III) The designed nursing teaching guideline for patients undergoing radical nephrectomy. Results: Statistically significant differences were found between study and control groups regarding preoperative anxiety levels (P < 0.01). Conclusion: The levels of preoperative anxiety significantly reduce associated with preoperative nursing teaching guideline provision.

Proper nutrition found to be an essential in health maintenance and restoration in the critically ill patient. Aim of the study was to evaluate the effect of early enteral nutrition guidelines on occurrence of gastrointestinal complications among acute lung injury patients. Design A quasi-experimental research design was used to conduct this research. This study was carried out at Trauma Intensive Care Unit at Assiut University hospital. Sample: was consisted of 30 patients in each group. Tools: Tool I: Modified patient assessment questionnaire, Tool II: Gastrointestinal complications assessment related to enteral nutrition. Methods: data about 30 patients receiving enteral nutrition before enteral nutrition guidelines were retrospectively compared with data for 30 patients admitted after implementation of the guidelines. Results of the present study showed Patients in the after intervention group had a lower gastrointestinal complications than before intervention group. Conclusion: Implementing early enteral nutrition guidelines reduce occurrence of gastrointestinal complications among acute lung injury patient in ICU Recommendations: Provision an educational programs for nurses about enteral nutrition guideline.

Acute lung injury in trauma patient associated with pernicious values. Cardiopulmonary, neurological, gastrointestinal, and urinary, complications can be potentially avoidable. Therefore, implementing nursing protocol for this patient help prevent complications, promote faster recovery.

Aim:

Identify the effect of implementing nursing care protocol on acute lung injury patients' outcomes.

Method:

Quasi experimental research design was used on 80 patients (study and control groups). This study was carried out in trauma intensive care unit at Assiut university hospital.

Tools:

Modified patient assessment sheet, Systemic Assessment Observation Check List and patients’ outcomes Assessment sheet.

Results:

Lower complications, length of stay and mechanical ventilator days and better respiratory mechanics among studied group subjects than control group.

Conclusion:

Nursing care protocol help in reducing length of stay and improving patient outcomes.

Recommendations:

Planning educational programs for the critical care nurses with manual booklet about nursing care protocol for acute lung injury patient is required.

The importance of cuff pressure in endotracheal tube management cannot be overstated. Guidelines recommend that a cuff pressure should be in a range of 20 to 30 cm H2O. Low cuff pressure increase risk for micro-aspiration of subglottic secretions. This micro-aspiration is considered the major pathogenic mechanism for ventilator-associated pneumonia, complication with marked morbidity and mortality. Aim: This study was carried out to determine the relation between endotracheal tube cuff pressure and the incidence of ventilator-associated pneumonia. Design: Descriptive research design. Setting: In two critical care units at Assiut Main University Hospital: Trauma ICU and general ICU. Subjects: A convenience sample of 60 critically ill patients. Tools: Three tools were utilized to collect data of study, Tool I: Patient assessment sheet. Tool II: Endotracheal tube cuff pressure measurements. Tool III: Ventilator- associated pneumonia assessment sheet. Method: The researcher used preparatory, implementation and evaluation phases to implement this study. Results: Finding of the present study revealed that there was significant statistical relationship between endotracheal tube cuff pressure and incidence of ventilator associated pneumonia with (P value < 0.05). Conclusion: There is a significant statistical relation between endotracheal tube cuff pressure and incidence of ventilator-associated pneumonia. Recommendations: Endotracheal tube cuff pressure measurements should be standardized as a basic part of care provided to all critically ill patients in intensive care units. Keywords: Cuff pressure, Endotracheal tube & Ventilator associated pneumonia

Immediate care is an essential nursing function to identify early deterioration in mental status. The nurse monitors the patient's mental status closely .Oxygen is administered if oxygen de-saturation occurs. The nurse monitors for fever or abdominal pain. This may be a signal the onset of bacterial peritonitis or other infection. Aim of the study was to investigate the immediate nursing care for hepatic encephalopathy patients' to reduce gastrointestinal complication on patient's outcome. Subject and methods descriptive research design was used to conduct this research. The sample of this study was consisted of 60 patients. Tools used in this study comprised three main tools. Tool 1:- patients assessment sheet. Tool 11:-fluid intake and| output and nutrition assessment. Tool 111:- Evaluation sheet. The main result:- Regarding West- haven criteria there was a significant decrease for the studied group from 1 st day and 2nd day. There were statistical significance differences between the two days. Regarding complete blood picture; WBC in the studied group showed that significant decrease on 2nd day. Fluid intake & output in the studied group showed that significant increase on 2nd day. Conclusion:- Applied immediate nursing care significant to reduce gastrointestinal complication in hepatic encephalopathy patients and improve the patient's outcome. Therefore, it is recommended to providing nutritional counseling for all patients with hepatic encephalopathy, continuing Educational Nursing Programmes to access the high quality of care. Keywords: Hepatic encephalopathy, immediate nursing care, patient's outcome

Aims and objectives: To compare the effectiveness of clinical pathway-directed care to usual care on hospitalisation-related outcomes in patients with severe traumatic brain injury (STBI). Background: Severe traumatic brain injury is a major cause of disability and mortality in young adults. Clinical pathways endeavour to bring evidence and clinical practice closer together to foster the delivery of best practice and to improve patient outcomes. Design: Quasi-experimental study. Methods: The study was conducted in a trauma intensive care unit of a large teaching hospital in Egypt. Patients aged 18–60 years with a diagnosis of STBI, a Glasgow Coma Scale score between 3–8 and a nonpenetrating head injury were consecutively assigned to 15 days of care. The outcomes assessed were complications related to hospitalisation, clinical variances, length of intensive care unit (ICU) stay, ICU readmission rate and patient/family satisfaction. Results: Sixty participants completed the study (30 in each arm). Apart from age, there were no significant differences between groups in baseline characteristics. The clinical pathway group demonstrated statistically significantly fewer cases of hospitalisation-related complications on day 15, and a significantly shorter length of ICU stay, lower ICU readmission rate and a high level of patient/family satisfaction when compared with the usual care group. The effect of the intervention on fever, pressure ulceration, hyperglycaemia and readmission to the ICU was no longer statistically significant after controlling for age. Conclusions: The findings of the current study suggest that the implementation of a clinical pathway for patients with severe TBI may be helpful in improving the patient experience as well as some hospitalisation-related outcomes.Relevance to clinical practice: The provision of clinical pathway-directed care in a trauma ICU may offer benefits to the patient, family and institution beyond that provided by usual care. KEYWORDS care pathways, clinical effectiveness, evidence-based practice, outcomes, patient satisfaction, severe traumatic brain injury