Abstract In Minimally invasive heart surgery the patient experiences less pain and quicker recovery Aim: the study aimed to assess nursing care on patient’s outcomes after minimally invasive and conventional cardiac surgery Patient and method. Design: descriptive research design was utilized in the study. Setting: this study was conducted in the postoperative ICU, Heart Assuit University Hospital. Sample: a convenience sample of 60 patients 30 minimally and 30 conventional. Four tools have been to utilized to gather the data, ToolI: patient's assessment sheet, Tool II: Intraoperative assessment sheet, Tool III: postoperative assessment sheet and Tool IV: patient outcome assessment sheet. Results: A number of clinical outcomes were significantly improved with minimally than conventional including pain assessment30.8%, quality of life91.27±3.03,blood transfusion35.1% and length of stay in intensive care unit.was3.04±0.74.Conclusions:assessment of nursing care founded that patients with minimally invasive associated with decreased bleeding, blood product transfusion, ventilation time, intensive care unit stay and less pain than conventional group. Recommendation: Establishing a standardized protocol for nursing care after cardiac surgery. Repeat this research on a large probability sample acquired from different geographical areas in Egypt.

Abstract Diabetic coma is a dangerous condition that can lead to unconsciousness and even death. There are three main causes of diabetic coma: diabetic ketoacidosis, severe hypoglycemia and hyperglycemic hyperosmolar state. Aim of the study: This study aimed to assess nurse`s knowledge and practice regarding patients with diabetic coma. Research design: A descriptive research design was utilized in this study. Sitting: This study was conducted in emergency Care Unit at Assuit University Hospital. Subject and Method: This study was carried out on a convenience 35 nurses who are working in emergency care unit. Tools: Tool 1: Nurses’ knowledge assessment tool.Tool 2: Observational checklist regarding care for patient with diabetic coma. Results: The results showed that (68.6%) of nurses had unsatisfactory level of knowledge regarding care of patient with diabetic coma and (94.3%) of nurses had unsatisfactory level of practices regarding care for patient with diabetic coma. Conclusion: Nurses showed inadequacy of their knowledge regarding care of patients with diabetic coma. Recommendation: The study recommends that there is a need for an education program regarding care for patients with diabetic coma.

Abstract Background: Respiratory acid-base disorders are commonly seen in the critical care setting and can occur independently or coexist with metabolic acid-base disorders. Aim of the study: To explore the pattern of respiratory acid-base disorders and related risk factors in critically ill patients. Design: the descriptive design was utilized in this study. Setting: This study was carried out in the Trauma and general Intensive Care Unit at Assiut university hospital. Sample: fifty patients admitted to trauma and general Intensive Care Unit. Tools: Four tools were used in this study, patient assessment tool, APACHE II tool, Acid-base parameters assessment tool, and Risk factors assessment tool. Result: A total of 50 patients most of them were male with a mean age of 40.37 ± 13.86 in the survivors versus 47.75 ± 11.86 in non-survivor. APACHE II score was significant in non-survivor group confirmed by (P = 0.000), (P = 0.003) respectively.The incidences of respiratory alkalosis (52%), respiratory acidosis (24%) were higher in the survivor group. The significant risk factor was iatrogenic(drugs, mechanical ventillation). Conclusion: Respiratory acid-base disorders are common in critically ill patients mainly respiratory alkalosis and the major related risk factor was an iatrogenic.

Background: Patients on mechanical ventilation have a greater risk of acquiring infections; however, this problem is greatest in critical care units. Aim: Evaluate effect of educational program for nurses Performance regarding to infection control standard precautions, for patients on mechanical ventilation. Study design: Quasi-experimental research design was utilized in this study. Setting: The study was conducted in trauma ICU and emergency ICU at Assiut University hospital. Sample: A convenience sample of all available nurses. The sample size was 60 nurses. Tools: Utilizing two tools, Nurse's knowledge questionnaire and Observational checklist. Results: The majority of the studied Sample statistical significant difference between before and after educational program as regard to total nurses' knowledge and practice with P-value <0.001** .observed nurses' knowledge scores improved from 21.7% before the educational program to 75%after the educational program. In addition, the observed nurses' practice scores improved from 21.7%before the educational program to71.7%after educational program. Conclusion: Nurses` knowledge and practice regarding mechanical ventilation infection Control Standard Precautions in the trauma ICU and emergency ICU becomes to the satisfactory level after the educational program. Recommendation: Nurses need for continuous training programs to increase their performance regarding mechanical ventilation infection control standard Precautions.

Abstract Background: Educational program today is very important for the nurses to increase knowledge and practice for immediate care of cystectomy.Aim to: evaluate the effect of educational program on nurses` knowledge and practice for immediate care of post cystectomy patients at intensive care unit. Research design : A quasi experimental design was conducted to achieve the aim of the study. Subjects: All available nurses' were 40 nurses caring for patients with cystectomy. Two tools were used for data collection, tool one, knowledge assessment structured interviewing questionnaire and tool two, an observational checklist. Results: Nurses` knowledge scores improved after implementation of the educational program from (15% to 97.5%), also the observed nurses` practice scores were improved from (20%) before the educational program to (100%) after the educational program .Conclusion: Nurses` knowledge and practice regarding the immediate care of patients with cystectomy becomes satisfactory level after the educational program. Recommendations: The study recommends focused on establishing plans by periodical educational programs for nurses to help them in improving their knowledge and practice.

Abstract Background: Sepsis is considered to induce immune suppression, leading to increased susceptibility to secondary infections with associated late mortality. Aim: To assess the risk factors of patients with septic shock in the intensive care unit. Study design: a descriptive research design was utilized in this study. Setting: The study was conducted in the general intensive care unit and trauma intensive care unit at Assuit University Hospital. Sample: A purposive 60 patients with septic shock patients. Tools: two tools used for data collection, tool (1), Patient assessment sheet, and tool (2), risk factors assessment sheet. Results: The main risk factors were dysfunction of one or more of the major body systems, tracheostomy (65.0%), diabetes mellitus (65.0%) and respiratory disease, in addition, more than half of them stay more than 20 days in the ICU and half of them suffered from respiratory failure as a complication of septic shock. Conclusion: major factors that were associated with in-hospital mortality among ICU patients with severe sepsis or septic shock were multi-organ failure and DM which despite treatment with early resuscitation. Recommendation: Applied Nursing guidelines and standard precautions infection control of patients with septic shock at the onset of intensive care unit admission