Careful and regular assessment of pain improves the perception of nurses concerning the impact of pain on their patients' lives to enhance the quality of its management. Monitoring pain as the fifth vital sign is currently practiced in many developed countries. Therefore, the present study aimed to apply of a proposed graphic chart for pain as fifth vital sign in nursing practice in Assiut University Hospitals- Egypt. An exploratory descriptive research design was carried out in five units including (medical, surgical, burn, trauma & orthopedic units). The study subjects consisted of 60 nurses available at the time of the study. An interview questionnaire, nurses’ opinionnaire scale, nurses’ audit and proposed five vital signs graphic chart were used for data collection. Results revealed that nurse’s mean age ± SD was (27.85±7.82) years, years of experience mean ± SD was (7.40±3.94) years. The majority of nurses agreed upon chart feasibility (81.7%) & quality of pain care (83.3%). Overall 83.3% of the nurses agreed upon the proposed graphic chart. Auditing of patients files revealed full application of the new change by 93.3%, 63.3% of nurses for graphic part &70 % for pain assessment part. It is concluded that the majority of the nurses had full application of the proposed change & it is recommended to be implemented in nursing practice in different health settings. Nurses need to be accountable to improve their knowledge and skills in assessing pain, which necessitates implementing educational programs through in-service training and continuing nursing education. It is also necessary for hospitals to require nurses’ notes on their charts for pain assessment and management.

Careful and regular assessment of pain improves the perception of nurses concerning the impact of pain on their patients' lives to enhance the quality of its management. Monitoring pain as the fifth vital sign is currently practiced in many developed countries. Therefore, the present study aimed to apply of a proposed graphic chart for pain as fifth vital sign in nursing practice in Assiut University Hospitals- Egypt. An exploratory descriptive research design was carried out in five units including (medical, surgical, burn, trauma & orthopedic units). The study subjects consisted of 60 nurses available at the time of the study. An interview questionnaire, nurses’ opinionnaire scale, nurses’ audit and proposed five vital signs graphic chart were used for data collection. Results revealed that nurse’s mean age ± SD was (27.85±7.82) years, years of experience mean ± SD was (7.40±3.94) years. The majority of nurses agreed upon chart feasibility (81.7%) & quality of pain care (83.3%). Overall 83.3% of the nurses agreed upon the proposed graphic chart. Auditing of patients files revealed full application of the new change by 93.3%, 63.3% of nurses for graphic part &70 % for pain assessment part. It is concluded that the majority of the nurses had full application of the proposed change & it is recommended to be implemented in nursing practice in different health settings. Nurses need to be accountable to improve their knowledge and skills in assessing pain, which necessitates implementing educational programs through in-service training and continuing nursing education. It is also necessary for hospitals to require nurses’ notes on their charts for pain assessment and management.

Careful and regular assessment of pain improves the perception of nurses concerning the impact of pain on their patients' lives to enhance the quality of its management. Monitoring pain as the fifth vital sign is currently practiced in many developed countries. Therefore, the present study aimed to apply of a proposed graphic chart for pain as fifth vital sign in nursing practice in Assiut University Hospitals- Egypt. An exploratory descriptive research design was carried out in five units including (medical, surgical, burn, trauma & orthopedic units). The study subjects consisted of 60 nurses available at the time of the study. An interview questionnaire, nurses’ opinionnaire scale, nurses’ audit and proposed five vital signs graphic chart were used for data collection. Results revealed that nurse’s mean age ± SD was (27.85±7.82) years, years of experience mean ± SD was (7.40±3.94) years. The majority of nurses agreed upon chart feasibility (81.7%) & quality of pain care (83.3%). Overall 83.3% of the nurses agreed upon the proposed graphic chart. Auditing of patients files revealed full application of the new change by 93.3%, 63.3% of nurses for graphic part &70 % for pain assessment part. It is concluded that the majority of the nurses had full application of the proposed change & it is recommended to be implemented in nursing practice in different health settings. Nurses need to be accountable to improve their knowledge and skills in assessing pain, which necessitates implementing educational programs through in-service training and continuing nursing education. It is also necessary for hospitals to require nurses’ notes on their charts for pain assessment and management.

Nosocomial respiratory tract infections (NRTI) are the most common nosocomial infections in intensive care units (ICUs).. So the education and awareness among nurses as well as adherence to standard nursing guidelines for prevention of nosocomial respiratory tract infection should be used to reduce frequency of nosocomial infection in ICUs.Aim :the current study was carried out to evaluate the effect of implementing nursing guidelines in reducing (NRTI) in mechanically ventilated patients in ICUs .Methods : The study was conducted at the (ICU) of Minia university hospital. The sample of this study comprised 60 adult patients including both sex, their age ranged from 18-60 years old,. They were selected by convenience randomly assigned two equal groups control (group1) and interventional group (group2) (30 in each). Three tools were used to collect the data in this study ,tool one : Patient assessment sheet,tool two : Preventive nursing guideline ,and tool three: Evaluation sheet .Results and conclusion: The result of the current study revealed that Mean age of the both groups around forty year,and more than fifty percent of the patients in both groups were male. The finding of the current study revealed that, the mean score of body temperature in the study group nearly between normal ranges in all the sevens days of the study.While body temperature of the control group most of patients had hyperthermia in all the days of the study,and There were statistical significance differences between both groups in most of days of the study. there were an improvement of the respiratory status of the study group than control group, and a significant differences was elicited between two group on the most of the days of the study in relation to respiratory assessment .Recommendations: based on the current study finding it can be recommended that hospitals should implement protocols for the prevention of NRTI in mechanically ventilated patients that include each of the practices recommended by the CDC. Training and educational program should be developed to the nursing staff about the standardized care that should be delivered to the mechanically ventilated patients

Oral hygiene is a basic task of nurses who caring for ICU patients . So, critical care nurses must be aware of the best method of oral care for the critically ill patient. There are many questions about oral care that need to be explored further. These include the best option for care, brushing versus swabbing. Hence, the present study aim to compare between tooth brushes and cotton swabs in their ability to remove dental plaque among patients receiving mechanical ventilation. Quasi-experimental research design was used to conduct this research .This study was carried out at the general intensive care unit in Assiut University Hospitals . A Convenient sample of sixty adults patients receiving mechanical ventilation constituted the study sample. They were divided into two equal groups 30 for each . group G1who received oral care by using tooth brush, Group G2 who received oral care by using the cotton swab .TOOLS, Two tools were used to collect the data in this study ,tool one "Patient’s assessment sheet ". Tool two: " evaluation sheet" . Results : finding of the current study revealed that The percent of Oral assessment guide score increase with belonged day until reached on the seventh day 93.33% of (G1) had mild compromise score (7-12 score) While, 80.00% of (G2) had compromise score (13-18 score) with highly statistical significant difference between two groups. the percent of Oral Hygiene Index score increase with belonged day until reached on the seventh day 46.67% of (G1) had score (1) While 93.33% of (G2) had score 3 , with highly statistical significant difference between two groups , regarding the result of oropharyngeal swab on the seventh day, it was noticed that 46.67% of (G1) had growth swab. While 100% of the control group (G2) had growth swab. Conclusion ,the current study concluded that the toothbrushes are more effective in plaque removal than cotton swabs. Recommendations:based on the current study finding it can be recommended the use of a soft pediatric brush to remove debris and subsequent plaque to assist in decreasing microbial colonization. Moreover, training program should be established to update critical care nurses' knowledge and skills about oral hygienic care .

Oral hygiene is a basic task of nurses who caring for ICU patients . So, critical care nurses must be aware of the best method of oral care for the critically ill patient. There are many questions about oral care that need to be explored further. These include the best option for care, brushing versus swabbing. Hence, the present study aim to compare between tooth brushes and cotton swabs in their ability to remove dental plaque among patients receiving mechanical ventilation. Quasi-experimental research design was used to conduct this research .This study was carried out at the general intensive care unit in Assiut University Hospitals . A Convenient sample of sixty adults patients receiving mechanical ventilation constituted the study sample. They were divided into two equal groups 30 for each . group G1who received oral care by using tooth brush, Group G2 who received oral care by using the cotton swab .TOOLS, Two tools were used to collect the data in this study ,tool one "Patient’s assessment sheet ". Tool two: " evaluation sheet" . Results : finding of the current study revealed that The percent of Oral assessment guide score increase with belonged day until reached on the seventh day 93.33% of (G1) had mild compromise score (7-12 score) While, 80.00% of (G2) had compromise score (13-18 score) with highly statistical significant difference between two groups. the percent of Oral Hygiene Index score increase with belonged day until reached on the seventh day 46.67% of (G1) had score (1) While 93.33% of (G2) had score 3 , with highly statistical significant difference between two groups , regarding the result of oropharyngeal swab on the seventh day, it was noticed that 46.67% of (G1) had growth swab. While 100% of the control group (G2) had growth swab. Conclusion ,the current study concluded that the toothbrushes are more effective in plaque removal than cotton swabs. Recommendations:based on the current study finding it can be recommended the use of a soft pediatric brush to remove debris and subsequent plaque to assist in decreasing microbial colonization. Moreover, training program should be established to update critical care nurses' knowledge and skills about oral hygienic care .

Oral hygiene is a basic task of nurses who caring for ICU patients . So, critical care nurses must be aware of the best method of oral care for the critically ill patient. There are many questions about oral care that need to be explored further. These include the best option for care, brushing versus swabbing. Hence, the present study aim to compare between tooth brushes and cotton swabs in their ability to remove dental plaque among patients receiving mechanical ventilation. Quasi-experimental research design was used to conduct this research .This study was carried out at the general intensive care unit in Assiut University Hospitals . A Convenient sample of sixty adults patients receiving mechanical ventilation constituted the study sample. They were divided into two equal groups 30 for each . group G1who received oral care by using tooth brush, Group G2 who received oral care by using the cotton swab .TOOLS, Two tools were used to collect the data in this study ,tool one "Patient’s assessment sheet ". Tool two: " evaluation sheet" . Results : finding of the current study revealed that The percent of Oral assessment guide score increase with belonged day until reached on the seventh day 93.33% of (G1) had mild compromise score (7-12 score) While, 80.00% of (G2) had compromise score (13-18 score) with highly statistical significant difference between two groups. the percent of Oral Hygiene Index score increase with belonged day until reached on the seventh day 46.67% of (G1) had score (1) While 93.33% of (G2) had score 3 , with highly statistical significant difference between two groups , regarding the result of oropharyngeal swab on the seventh day, it was noticed that 46.67% of (G1) had growth swab. While 100% of the control group (G2) had growth swab. Conclusion ,the current study concluded that the toothbrushes are more effective in plaque removal than cotton swabs. Recommendations:based on the current study finding it can be recommended the use of a soft pediatric brush to remove debris and subsequent plaque to assist in decreasing microbial colonization. Moreover, training program should be established to update critical care nurses' knowledge and skills about oral hygienic care .

Oral hygiene is a basic task of nurses who caring for ICU patients . So, critical care nurses must be aware of the best method of oral care for the critically ill patient. There are many questions about oral care that need to be explored further. These include the best option for care, brushing versus swabbing. Hence, the present study aim to compare between tooth brushes and cotton swabs in their ability to remove dental plaque among patients receiving mechanical ventilation. Quasi-experimental research design was used to conduct this research .This study was carried out at the general intensive care unit in Assiut University Hospitals . A Convenient sample of sixty adults patients receiving mechanical ventilation constituted the study sample. They were divided into two equal groups 30 for each . group G1who received oral care by using tooth brush, Group G2 who received oral care by using the cotton swab .TOOLS, Two tools were used to collect the data in this study ,tool one "Patient’s assessment sheet ". Tool two: " evaluation sheet" . Results : finding of the current study revealed that The percent of Oral assessment guide score increase with belonged day until reached on the seventh day 93.33% of (G1) had mild compromise score (7-12 score) While, 80.00% of (G2) had compromise score (13-18 score) with highly statistical significant difference between two groups. the percent of Oral Hygiene Index score increase with belonged day until reached on the seventh day 46.67% of (G1) had score (1) While 93.33% of (G2) had score 3 , with highly statistical significant difference between two groups , regarding the result of oropharyngeal swab on the seventh day, it was noticed that 46.67% of (G1) had growth swab. While 100% of the control group (G2) had growth swab. Conclusion ,the current study concluded that the toothbrushes are more effective in plaque removal than cotton swabs. Recommendations:based on the current study finding it can be recommended the use of a soft pediatric brush to remove debris and subsequent plaque to assist in decreasing microbial colonization. Moreover, training program should be established to update critical care nurses' knowledge and skills about oral hygienic care .

Endotracheal suction is one of the most common procedure carried out in an intensive care unit. Although endotracheal suctioning for mechanical ventilated patient is routine nursing practice, however this practice is associated with serious complications including hypoxemia, atelectasis, bronchospasm, dysrhythmias, increased intracranial pressure, and airway trauma.

Endotracheal suction is one of the most common procedure carried out in an intensive care unit. Although endotracheal suctioning for mechanical ventilated patient is routine nursing practice, however this practice is associated with serious complications including hypoxemia, atelectasis, bronchospasm, dysrhythmias, increased intracranial pressure, and airway trauma.