Abstract Background: cancer pain has emerged as a leading stressor for patients with cancer in the intensive care unit (ICU).Unrelieved pain gives rise to negative physiologic and psychological events that can be detrimental to critically ill patients‟ health outcomes Aim of the study: evaluate the impact of an educational program about cancer pain management on nurses' knowledge, attitudes and practice at intensive care unit. Subject and methods: Quasi-experimental design was utilized in this study. A convenience sample of 55 ICU nurses 30 were nursing diploma, 17 were technical degree and 8 bachelor degree. The data were collected using the tool I Pre/post-test nurses' knowledge and attitudes assessment questionnaire sheet for assessment of nurses' knowledge and attitudes, tool II pre/post observation checklist to assess nurse practices. Results: The result reveals that the majority of nurses had unsatisfactory of knowledge and negative attitudes regarding cancer pain management pre-education program. The mean scores were improved significantly (P=0.001) post education program, also, the majority of nurse's practice were an inadequate pre-education program; they improved significantly (P=0.001) post education program. Conclusion: The study concluded that the education program leads to significant improvement in nurse's knowledge attitudes and practices about cancer pain management.

Abstract Nursing staff in the hospital are frequently the first to witness a cardiac arrest, they play a central role in the effective management of in-hospital cardiac arrest. Aim: Identifying the effect of a Basic life Support teaching Program on nurses’ Knowledge and skills at Emergency care unit. Research design: A quasi experimental research design. Setting: Emergency care medical department at Assuit University Hospitals. Sample: Nurses working in selected setting and having more than one year clinical experience. Methods: Two tools were used for data collection. Knowledge and skills assessment tools. The current study was carried out on assessment of baseline nurses’ level of knowledge and skills followed by implementation. The effect of teaching was carried out immediately after application of the program. Results: The study revealed that the majority of nurses had poor knowledge and skills related to CPR before teaching program which has been improved after teaching program. Conclusion, there was a significant improvement in the nurses' knowledge and skills related to CPR after teaching program. Recommendation annually assessment and refreshing courses to nursing staff with up- to- date guidelines to impart cognitive knowledge and psychomotor skills of CPR and to provide a standardized care to cardiac arrest patients

Abstract Background: Severe traumatic brain injury (STBI) is a serious medical condition that is associated with considerable disease burden and disability throughout the world. Clinical pathways provide the means to connect the best available evidence with clinical practice to improve patient outcomes. Objective: To measure the effectiveness of implementing a clinical pathway to usual care on the complications related to severe traumatic brain injury. Design: Quasi-experimental study.Methods: A convenience sampling of 60 adult patients with TBI were recruited, with 30 patients assigned to the control group and 30 to the pathway group. The study was conducted at the trauma ICU of Assiut Hospital, Egypt. The control group received 15 days of ICU routine care and intervention group received 15 day of care includes in the clinical pathway. Results: The study found fewer complications related to TBI in the clinical pathway group, with statistically significant differences found between groups. Patients in the clinical pathway group demonstrated significantly fewer cases of prolonged mechanical ventilation and reintubation. Conclusion: The current study suggests that the implementation of a clinical pathway for severe TBI may be effective in decreasing the frequency of complications related to severe TBI.

Abstract Background: Congestive heart failure patients at coronary care unit suffer from many problems, which might endanger their life as increased anxiety level which originated from disease process and the actual care they receive was complex. Modified Care pathway guidelines are tools that enhance the patient quality of care by decreasing level of anxiety which may lead to increasing patient satisfaction. Therefore, the aim of this study is to evaluate effect of modified clinical pathway guidelines on congestive heart failure patients' satisfaction at Coronary Care Unit. Design: Quasi-experimental research design. Setting: Coronary Care Unit at Assuit University Hospitals. Sample: sixty adult males and females' critically ill patients' who divided into two equal and matched groups (study and control). Tools:- Three tools; Tool I: Personal and medical datasheet, Tool II Assessment of patient anxiety using state-trait anxiety inventory, and Tool III Patients' Satisfaction Scale. Results: Finding of this study supported stated research hypotheses with statistical significant difference between study and control groups regarding total mean of anxiety score at 6th day of intervention were (39.6±6.7, 44.87±4.54) respectively as well as (50%) of study group patients were very satisfied as compared with (3.3%) of control group. Conclusion: Applying modified clinical pathway guidelines significantly reduce anxiety level in congestive heart failure critically ill patients and improve patient's satisfaction. Recommendation: Conducting training programs about importance of modified clinical pathway guidelines implementation for all health care providers.

Abstract: Back ground: intensive care unit nurses should be able to perform liver graft assessment post liver transplantation and learn principle of care to identify and manage any problem during ICU staying. Aim: this research was carried out to investigate the effect of implementing nursing care of patients post liver transplantation on nurses performance. Study design: Quasi-experimental research design was utilized in this study. Setting: intensive care unit at Alrajhey liver hospital at Assiut University hospitals. Sample: A convenience sample of all available nurses. The sample size was 30 nurses. Tools: Utilizing two tools, Nurse's knowledge questionnaire and Observational checklist. Results: Finding of the present study revealed that significant statistically correlation between total nurses’ knowledge and skills regarding assessment of liver graft function and intensive care post liver transplantation which indicated positive relation between knowledge and skills. Finding of the present study revealed that insignificant relationship between information and skills regarding assessment of liver graft function and intensive care post liver transplantation and their socio - demographic data. Conclusion: Nurses` knowledge and practice regarding assessment of liver graft function in ICU and becomes to the satisfactory level after the educational program. Recommendation: Nurses need for continuous training programs to increase their performance regarding assessment of liver graft function post liver transplantation.

Abstract Background: Immunoglobulin is an effective therapy in Guillain-Barre syndrome patients. Careful monitoring for side effects of immunoglobulin and reduction of complications remains mandatory for nursing care. Aim: To evaluate clinical outcomes post implementing nursing intervention for intravenous immunoglobulin recipient. Hypotheses: A significant reduction in complication incidence and length of hospital stay (ICU – department) among study group than control. Patients and Methods: Design: A quasi-experimental research design. Subjects: A convenience sample of sixty adult patients divided into study and control group diagnosed with Guillian Barre syndrome and had received intravenous immunoglobulin as a line of treatment. Setting: Neurological intensive care unit and department at Assiut University Hospital. Tools: I: patient assessment tool, II: four score assessment tool, and III: patient outcomes assessment tool. The control group subjected to routine hospital nursing intervention while study group received nursing intervention of IVIG administration. Results: Finding revealed a statistical significant decrease in disease complications, IVIG side effect, and hospital stay(ICU– department) in response to implemented nursing intervention between two groups p=0.003,0.004 respectively. Conclusion: Better clinical outcomes had been observed among intravenous immunoglobulin recipient with implemented nursing intervention Recommendation: Nursing intervention should be implement for all intravenous immunoglobulin recipient to achieve better clinical outcomes