The Effect of Empowerment Program for Nurses Regarding Management of Children with Phenylketonuria

Context: Phenylketonuria (commonly known as PKU) is an inherited disorder that increases the levels of a substance called phenylalanine in the blood. If PKU did not diagnose early in life or the affected children with PKU do not be compliant with the treatment regimen (food), it leads to severe cognitive or behavioral problems, seizures, and autistic symptoms.Aim: The current study aimed to evaluate the effect of an empowerment program on nurses' management of children with phenylketonuria. Methods: Quasi-experimental research (one group pre/post-test) design was used to conduct this study. The study was carried out in the hereditary unit, and hereditary outpatient clinics at Ain Shams Specialized Hospital for children affiliated to Ain shams University. A convenient sample of all available nurses working in the previously mentioned study settings (80 male and female bedside nurses) from the beginning of May 2018 to the end of October 2018. Two tools were utilized for data collection for the current study. They are the structured interview questionnaire to assess the nurses' knowledge regarding the management of children with phenylketonuria and the nurses’ performance observation checklists regarding nursing care provided for children with phenylketonuria Results: nurses' knowledge regarding phenylketonuria was unsatisfactory before the empowerment program, while there is a statistically significant improvement between pre and post empowerment program implementation. Nurses' practice regarding phenylketonuria was incompetent before the empowerment program compared to post empowerment program. There is a positive statistical relationship between nurses' knowledge and practice post-program implementation. Conclusion: The study revealed that the empowerment program had a positive effect on the nurses' knowledge and practice towards the management of children with phenylketonuria. The current study recommended continuous education and training sessions about the management of children with phenylketonuria that should be provided to upgrade the knowledge and improve the practice of nurses caring for PKU children. Availability and accessibility of printed guidelines, posters, and simple handouts regarding the management of children with phenylketonuria

Effect of Supportive Educational Intervention for Mothers of Female Adolescents with Cerebral Palsy on Their Caring Practices

Context: Cerebral palsy is a major cause of poor physical, mental, and social health and one of the biggest risk factors for underachievement in later life. Mothers caring for children with disabilities experience several challenges. Parents of children with cerebral palsy (CP) must know about the disease and its management to improve the outcome.Aim: To assess the effect of a supportive educational intervention for mothers of female adolescents with cerebral palsy on their caring practices. Methods: A quasi-experimental (pre/post-test) design was employed at the neurology outpatient clinic at Pediatric Hospital, Ain Shams University, with a convenience sample of 50 mothers of female adolescents with cerebral palsy. The researcher used two tools: A predesigned questionnaire includes three parts to assess the demographic characteristics of the mothers and their daughters with cerebral palsy and their knowledge regarding the disease. The second tool is a mothers’ reported practice checklist regarding caring for a female adolescent with CP. Results: There was a highly significant difference between mothers' knowledge about normal physical and physiological needs of adolescents, physical needs and problems of handicaps, menstrual-related discomfort, and premenstrual manifestation between pre and post-intervention at a p-value <0.001 except for problems related to adolescent period. There was a highly significant difference between mothers' reported practice of routine care and routine perineal care during and after menstruation at a p-value <0.001. Conclusion: Implementing a supportive educational program for mothers regarding the care of their female adolescents with cerebral palsy had a positive effect on their knowledge and reported practice. The study recommended continuous training for mothers related to managing the child's physical needs and psychosocial ones. Future studies to examine the relationship between maternal psychological well-being and CP severity, using standard measures for CP severity. Further studies are needed to assess predictive factors affecting mothers' knowledge and practice regarding the care of an adolescent with cerebral palsy

Traditional Versus Objective Structured Clinical Examination on Pediatric Nursing Students’ Performance

Context: The Objective Structured Clinical Examination (OSCE) method is an effective tool for evaluating the clinical nursing skills of nursing students. OSCE is an assessment technique in which the student demonstrates their competence under a variety of simulated conditions Aim: This study aimed to compare objective structured clinical examinations versus traditional clinical examinations on pediatric nursing students' performance. Methods: A quasi-experimental research design (study and control group) was used to conduct this study. The study was conducted in the laboratory of pediatric nursing skills at the faculty of nursing, Benha University. All male and female pediatric nursing students in the 3rd year (n. =228), who were studying in the academic year 2018-2019, first semester, faculty of nursing, Benha University, was recruited. A simple random sample chose to achieve the aim of this study. The odd number was for the OSCE group and the even number for the traditional clinical examination (TCE) group. Four tools were utilized to collect data for the current study. A Structured Questionnaire Sheet, A modified Self-administered Questionnaire, Pediatric Nursing Students' Practice Observational Checklists, and Clinical Scenarios were designed to assess the pediatric nursing student OSCE exam and compare between the traditional method and OSCE method of exams. Results: The current study discovered statistically significant differences were found with a high percentage of agreement responses among pediatric nursing students for related items of OSCE method compared to those in TCE. Additionally, the results clarify a highly statistically significant difference between the studied pediatric nursing students' in TCE and OSCE total performance scores. Conclusion: Objective Structured Clinical Examination (OSCE) was opinioned as a tool for clinical evaluation. This finding appeared in pediatric nursing students' responses, which confirmed their acceptance of OSCE. The OSCE subsequently remains a more objective method of assessment than the traditional clinical forms of the exam that was previously used. OSCE can be used most effectively in undergraduate nursing curricula to assess fair practice. This type of exam provided an accurate measure of clinical skill competencies. Therefore, OSCE should be adopted as a strategy for examining clinical skills for students in all academic years. The current study recommended that Objective Structured Clinical Examination can be used as effective and meaningful assistance to fitness for practice, and OSCE should be adopted as a strategy f

Effect of Nursing Protocol Regarding Nasal Skin Breakdown for Preterm Infants Receiving Continuous Positive Airway Pressure

Context: Neonates, particularly those born premature, may require ventilation assistance immediately after birth since their lungs may not be fully developed. The use of nasal continuous positive airway pressure (CPAP) is increasing as a means of respiratory support in many premature infants. So, the presence of nasal skin breakdown may be seen as a complication.Aim: Evaluate the effect of nursing protocol regarding nasal skin breakdown for preterm infants receiving nasal continuous positive airway pressure (CPAP). Methods: A quasi-experimental research design was utilized to conduct the current study. The study was conducted at Neonatal Intensive Care Units (NICUs) and Surgical Neonatal Intensive Care Unit "SNICU" of Benha Specialized Pediatric Hospital at Benha city. A convenient sample of nurses (70) working in NICU and SNICU and a purposive random sample of (77) preterm infants were included from the settings mentioned above. Those premature infants were divided into two groups (study and control) (35) in the control group and (42) in the study group, who were selected according to the power analysis equation based on the total number of preterm infants admitted to the setting mentioned above during 2017. Three tools were used. A structured interviewing questionnaire was designed to assess nurses' sociodemographic characteristics, nurses' knowledge regarding CPAP, care provided to preterm infants undergoing CPAP, and nasal skin breakdown. The second tool was a nursing practice observation checklist to assess nurses' practice regarding nasal CPAP. The third tool was Preterm Medical Assessment Record. It is designed to assess the characteristics of preterm infants and medical data of preterm infants. The last tool was the Neonatal Skin Condition Score (NSCS) scale, designed to assess the neonates' skin condition. Results: Findings of the present study revealed a statistically significant difference (P<0.05) pre and post-nursing protocol implementation regarding CPAP, the role of the nurse caring for preterm infants undergoing nasal CPAP, and nasal skin breakdown. The results also revealed a highly statistically significant difference in nursing practice regarding care for preterm infants undergoing nasal CPAP pre and post-nursing protocol implementation at (p<0.001). Nasal Skin Breakdown in the study group was significantly less than in the control group at a different time of assessment at (p˂0.001). Conclusion: It can be concluded that the research hypothesis is accepted; the nursing protocol implemented for nurses improved their knowledge and practice as well as reduced nasal skin breakdown in the preterm newborns receiving NCPAP. The study recommended applying the nursing protocol for nurses caring for preterm infants to reduce nasal skin breakdown during CPAP ventilation, an effective and safe non-invasive intervention in all NICUs as a standard of care for all preterm infants

Effect of Educational Empowerment on Student Nurses’ Knowledge, Practice, and Attitude toward Genomic Counselling

Context: All over the world, the increased awareness of the importance of early diagnosis of genetic diseases has given them priority in primary health care. However, more recent surveys indicate that genetics content is still lacking in nursing curricula.Aim: Evaluate the effect of educational empowerment on student nurses' knowledge, practice, and attitude toward genomic counseling. Methods: Quasi-experimental (pre/post-test) design was utilized to collect the data for this study. The study was conducted at the Faculty of Nursing affiliated to Ain Shams University. The subjects were all available adolescent nursing students who enrolled in the pediatric and obstetric course in the third year. The study sample was composed of 340 nursing students. Researchers used a self-administered questionnaire that includes characteristics of subjects and the assessment of knowledge, attitude, and practice of students. Results: 47.65% of the studied students had poor knowledge at the pre-educational program phase, while 55.88% had good knowledge at the post educational program, with a highly significant difference at p-value <0.01. There was a highly significant difference between studied students' attitudes toward genetic disease, health history benefits, genetic examination benefits, genomic counseling, follow-up, and decision-making process domains in pre and post-educational program at p-value <0.001. Also, the results reveal that 79.41% of studied students had unsatisfactory practice in the pre-educational program, while 70.59% of them had satisfactory practice in post educational program. There was a highly positive correlation between knowledge, practice, and attitude of studied students about genomic counseling at the pre-educational program. Conclusion: Educational empowerment positively affected the knowledge, attitude, and practice of adolescent nursing students regarding genomic counseling. The study recommended continuous training for adolescent nursing students about genetic counseling to prepare them for their future roles. Future studies are needed to examine the relationship between knowledge, attitude, and practice of adolescent nursing students regarding genomic counseling

Effect of Designed Practice Guidelines on Nurses’ Performance and Outcome of Children with Head Injuries

Contexts Acute head injury resulting from a trauma to the head, leading to brain injury or bleeding within the brain, can cause edema and hypoxia. Head injury is the leading cause of death in the first four decades of life. Effective nursing management strategies for children with severe traumatic brain injury are still a remarkable issue and a difficult task for neurologists, neurosurgeons, and nurses. Aim: To evaluate the effect of designed practice guidelines on nurses' performance regarding the care of children with head injuries. Methods: A quasi-experimental research design was utilized to conduct the current study on pediatric neurosurgery departments of Benha University Hospital and Benha Teaching Hospital. A purposive sample of 72 children with head injuries and a convenient sample of all available nurses. They were 62 nurses who are working in the previously mentioned study settings. Four tools were used to collect data in this study. A structured interviewing questionnaire sheet was developed to assess the personal characteristic of the studied nurses and nurses' knowledge regarding head injuries. Child medical data records were developed to assess children's personal and head injuries characteristics for them. Glasgow coma scale was adopted to assess the child's conscious level. Observational checklists to assess the actual nurses' practices regarding the care of children with head injuries. Results: There was a statistically significant improvement in nurses' knowledge and practice regarding the care of children with head injuries before and after implementing designed practice guidelines (p˂0.001). There was a statistically significant improvement regarding the occurrence of convulsion after the implementation of the program.Conclusion: The study concluded that implementing designed practice guidelines for nurses improved their knowledge and practice and reduced the occurrence of frequency, duration, and timing of convulsion, which supports the current research hypotheses. The study emphasizes the importance of implementing designed practice guidelines for nurses caring for children with a head injury to reduce head injury complications, which is an effective and safe non-invasive intervention in neurosurgery and emergency departments as a standard of care for all head-injured children

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population