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.

Deep venous thrombosis (DVT) is a major health problem that results in significant morbidity and mortality. Critical care nurses are the key players in the prevention of DVT and its complications. They are in the ideal position to asses' patient risk factors early and ask for DVT prophylaxis. Therefore, the current study was carried out to evaluate the effect of implementing nursing guidelines on the occurrence of DVT in critically ill patients. This study was carried out in four critical care unites in Assuit University Hospitals. The sample of this study consisted of 60patiens divided into two groups G1 (control group) 30 patients and G2 (interventional group) 30 patients. Two tools were used in this study. Tool one "Patient’s assessment for DVT" it consisted of four parts, part I which included the patient’s Profile, Part II that included the risk factors, part III which consisted of special biological factors and therapeutic modalities in the ICU. Part IV that included "Preventive measures check lists for Prevention of DVT" done by the critical care nurses for the control group. Tool two: "DVT evaluation sheet" it consisted of three parts part I "DVT manifestations" and part II "laboratory tests" and part III "Doppler Ultrasound findings" Finding of the current study revealed that low incidence of DVT in the global sample, only two patients experienced DVT in the control group, and none of the interventional group experienced DVT. The preventive measures of DVT done by the critical care nurses for the control group using non pharmacological and mechanical methods were not adequately performed. It was observed that all the studied patients of control group did not were the elastic stocking, while small proportion of this group performed leg exercises, changed their position, did deep breathing, and coughing exercises, and transfer on the chair. It was observed that, most of the studied patients experienced low percent of DVT manifestations with no statistical significant difference between the both groups. The present study reveals also that nearly half of the studied patients were in moderate & high risk grad for DVT in the both groups it was recommended that provide training program to update critical care nurses' knowledge and skills about DVT preventive measures. Repeat this research on a large sample size and in multi centers for generalization.

Deep venous thrombosis (DVT) is a major health problem that results in significant morbidity and mortality. Critical care nurses are the key players in the prevention of DVT and its complications. They are in the ideal position to asses' patient risk factors early and ask for DVT prophylaxis. Therefore, the current study was carried out to evaluate the effect of implementing nursing guidelines on the occurrence of DVT in critically ill patients. This study was carried out in four critical care unites in Assuit University Hospitals. The sample of this study consisted of 60patiens divided into two groups G1 (control group) 30 patients and G2 (interventional group) 30 patients. Two tools were used in this study. Tool one "Patient’s assessment for DVT" it consisted of four parts, part I which included the patient’s Profile, Part II that included the risk factors, part III which consisted of special biological factors and therapeutic modalities in the ICU. Part IV that included "Preventive measures check lists for Prevention of DVT" done by the critical care nurses for the control group. Tool two: "DVT evaluation sheet" it consisted of three parts part I "DVT manifestations" and part II "laboratory tests" and part III "Doppler Ultrasound findings" Finding of the current study revealed that low incidence of DVT in the global sample, only two patients experienced DVT in the control group, and none of the interventional group experienced DVT. The preventive measures of DVT done by the critical care nurses for the control group using non pharmacological and mechanical methods were not adequately performed. It was observed that all the studied patients of control group did not were the elastic stocking, while small proportion of this group performed leg exercises, changed their position, did deep breathing, and coughing exercises, and transfer on the chair. It was observed that, most of the studied patients experienced low percent of DVT manifestations with no statistical significant difference between the both groups. The present study reveals also that nearly half of the studied patients were in moderate & high risk grad for DVT in the both groups it was recommended that provide training program to update critical care nurses' knowledge and skills about DVT preventive measures. Repeat this research on a large sample size and in multi centers for generalization.

Nutrition support can result in improved wound healing, a decreased catabolic response to injury, enhanced immune system function, improved gastrointestinal structure and function, and improved clinical outcomes). The appropriately and timely nutritional intervention can improve patient recovery and survival, decrease complication rates, and decrease costs. Gastrointestinal complications (vomiting, diarrhea, constipation, and abdominal distension) are most commonly associated with complications derived from enteral feeding. Aim: this study was carried out to investigate the effect of the intermittent enteral feeding schedule on the occurrence of gastrointestinal complications and the length of the hospital stay among critically ill patients at Assiut University Hospitals. Design: a quasi-experimental design. Setting: trauma ICU at Assiut University Hospitals and the study took approximately one year started from July 2010 till July 2011. Patients: A convenience sample of 80 adults' critically ill patients on enteral feeding constituted the study sample. The patients were assigned randomly into two equal groups (control group and study group, 40 patients each).. Methods: The only manipulation was in the rest period and time interval in which the study group subjects were rested 8hours at night as compared to 6hours for the control ones, as well study group subjects were having 4hours time interval between each two consecutive feeding as compared to 2hours for control group subjects. Results: There was a significant statistical difference between both groups (p=0.000)indicating lesser hospital stay among study group subjects (52.5 % of the study group subjects were hospitalized less than one month as compared to 35 % of the control group subjects were stayed between 30 to less than 45 days). It was also found that, 57.5% of control group patients developed gastrointestinal complications as compared to 45% of the study group patients (n.s). Conclusion: intermittent 4-hour enteral feeding schedule had lowered the incidence of gastrointestinal complication and length of the hospital stay.