Effectiveness of Nursing Intervention Protocol on Nurses’ Performance and Patients’ Self-Care after Cataract Surgery

Context: Cataract is the leading cause of poor vision worldwide. Patients who are cared for by knowledgeable and skillful nurses are better prepared to engage in appropriate self-care activities post-cataract surgery.Aim: This study aimed to assess the effectiveness of nursing intervention protocol on nurses' performance and patients’ self-care after cataract surgery. Methods: The study followed a quasi-experimental, pretest-posttest design. The study was conducted in ophthalmology surgical inpatient units and the outpatient clinics at Benha University Hospital. The sample consisted of all available nurses (35) working in the ophthalmology surgical inpatient units, and the outpatient clinics who are willing and agreed to participate in the study, and a convenient sample consisting of 50 patients of both genders was also included in the current study before implementing nursing intervention protocol. Three tools were used to conduct the study: A structured interview questionnaire, a nurses' practice checklist, and a patients’ self-care activity checklist. Results: The results showed statistically significant improvements in nurses' performance (knowledge and practice) immediately post and after one-month follow-up post-nursing intervention protocol compared with pre-nursing intervention protocol implementation (p<0.001). General improvement in patients’ self-care activities (41.6±11.042) increased significantly to (64.2±13.65) after nursing intervention protocol implementation at p=0.001. However, after one month of implementing the nursing intervention protocol, a slight decline occurred after one month (52.46±10.97) compared to pre-intervention level. Highly statistically significant differences were observed at a p-value ≤0.001. Conclusion: Findings of this study conclude that the nursing intervention protocol was effective in improving nurses' performance, which was reflected in improving the practice of patients' self-care activities cared for by nurses exposed to nursing intervention protocol implementation. It is recommended that further studies are suggested to investigate the outcome of the implementation of nursing intervention protocol on decreasing the occurrence of complications post-cataract surgery

Impact of A Designed Skin Care Bundle Protocol on Nurse’s Knowledge, Practices and on Patients Outcomes at Intensive Care Unit

Pressure ulcers can affect patients in every healthcare setting and are seen in all age groups. Not only are they costly in terms of patients’ quality of life, but they also place a huge drain on health service resources.Presure ulcers represent a major problem both for affected patients and for the nurses who care for these patients. The present study aimed to examine the impact of a designed skin care bundle protocol on nurse’s knowledge, practices and on patients outcomes at both Benha university and Benha teaching hospital.Quasi experimental research design was adopted to conduct the study on (60) nurses working in the intensive care units at both Benha university and Benha teaching hospital, in addition to 60 patients admitted to these units  were included in the current study. The study subjects were randomly assigned into two equally homogeneous groups (control and study ) (30 subjects each).Three tools were used for data collection: knowledge questionnaire sheet, observational checklist and patient assessment sheet that  include Scio demographic data related to patients, Braden scale and designed skin care bundle sheet. Results: All research hypothesis were supported , the present study revealed that (a) The mean total and subtotal knowledge scores of  nurses were  increased immediately after implementation of a designed skin care bundle protocol with statistical significant difference compared to pre implementation. (b) The mean total and subtotal practice scores of nurses were higher immediately after a designed skin care bundle protocol with a high statistical significant difference compared to pre implementation.(c) There were a positive correlation between nurses knowledge and practices with a high statistical significant difference.(d)There were a positive patients outcomes as evidence by less incidence of pressure ulcers among study group compared by control group subjects. Conclusion: The designed skin care bundle protocol could be beneficial in improving the knowledge and the practices of the critical care nurses working in critical care unit as well on patient’s outcome in relation to prevention of pressure ulcer  at the intensive care unit. Recommendations: The present study emphasized on empowering staff nurses to provide skin care bundle protocol and identifying risk assessment. As well, planning staff development programs based on staff,organization,and patient needs. Key words: Impact, designed, skin care bundle, protocol, knowledge, practices, outcomes

Impact of A Designed Skin Care Bundle Protocol on Nurse’s Knowledge, Practices and on Patients Outcomes at Intensive Care Unit

Pressure ulcers can affect patients in every healthcare setting and are seen in all age groups. Not only are they costly in terms of patients’ quality of life, but they also place a huge drain on health service resources.Presure ulcers represent a major problem both for affected patients and for the nurses who care for these patients. The present study aimed to examine the impact of a designed skin care bundle protocol on nurse’s knowledge, practices and on patients outcomes at both Benha university and Benha teaching hospital.Quasi experimental research design was adopted to conduct the study on (60) nurses working in the intensive care units at both Benha university and Benha teaching hospital, in addition to 60 patients admitted to these units  were included in the current study. The study subjects were randomly assigned into two equally homogeneous groups (control and study ) (30 subjects each).Three tools were used for data collection: knowledge questionnaire sheet, observational checklist and patient assessment sheet that  include Scio demographic data related to patients, Braden scale and designed skin care bundle sheet. Results: All research hypothesis were supported , the present study revealed that (a) The mean total and subtotal knowledge scores of  nurses were  increased immediately after implementation of a designed skin care bundle protocol with statistical significant difference compared to pre implementation. (b) The mean total and subtotal practice scores of nurses were higher immediately after a designed skin care bundle protocol with a high statistical significant difference compared to pre implementation.(c) There were a positive correlation between nurses knowledge and practices with a high statistical significant difference.(d)There were a positive patients outcomes as evidence by less incidence of pressure ulcers among study group compared by control group subjects. Conclusion: The designed skin care bundle protocol could be beneficial in improving the knowledge and the practices of the critical care nurses working in critical care unit as well on patient’s outcome in relation to prevention of pressure ulcer  at the intensive care unit. Recommendations: The present study emphasized on empowering staff nurses to provide skin care bundle protocol and identifying risk assessment. As well, planning staff development programs based on staff,organization,and patient needs. Key words: Impact, designed, skin care bundle, protocol, knowledge, practices, outcomes

Effectiveness of Combined Exercise and Nutritional-Behavioral Intervention on Health Outcomes among Patients with Bariatric Surgery

Context: Many bariatric surgery patients experience suboptimal long-term weight outcomes, including weight regain. Weight regaining threatens the benefits initially achieved from surgery, including improved health outcomes, and patients still require hard work and lifelong behavioral change to lose and maintain weight successfully. Aim: This study aimed to evaluate the effectiveness of combined exercise and nutritional-behavioral intervention on health outcomes among patients with bariatric surgery. Methods: A quasi-experimental (study/control group) design was utilized in the present study that was conducted at surgical departments and outpatient clinics in the Benha University Hospital, Qualubia Governorate, from January 2021 until April 2022. A convenience sample of 85 patients ended with 60 patients who completed the study (Intervention group 30 & control group 30). They were recruited according to to sample size equation based on the patient admitted to the study setting in 2020. Two tools were utilized for data collection; the patient structured interviewing questionnaire and the patient’s health outcomes questionnaires that included anthropometric measures, eating behavior and food frequency questionnaire, international physical activity questionnaire, and the Moorehead-Ardelt quality of life questionnaire. Results: The findings revealed a mean sample age of 35.53±4.06 for the intervention group and 34.47±4.11 for the control group. The intervention and control groups revealed a highly statistically significant difference regarding all knowledge elements and the total knowledge score. Besides, a statistically significant improvement in the intervention group's knowledge throughout the study phases. A highly statistically significant difference was revealed in the percentage of weight loss (%wt L) among the intervention group throughout the following study periods (first month, six months, and one year of intervention), with statistically significant differences between the intervention and control group after one and six months, and after one year of intervention regarding their weight, % wt L, BMI, and excess BMI loss percentage. Eating habit scores revealed statistically significant differences between the intervention and control group regarding eating behaviors and food frequency at one and six months and one year of intervention. Residence (p=0.01), total patient knowledge (p=0.002), food frequency (p=0.000), and physical activity (p=0.001) level predicted weight loss in the intervention group, while age was the only predictor in the control group (p=0.02). Conclusion: Implementing the combined exercise and nutritional-behavioral intervention post bariatric surgery significantly improved patients' health outcomes in terms of improved patient knowledge, weight loss percentage, eating habits, physical activity, and quality of life levels among the intervention group compared to the control group. There is a need to raise knowledge of bariatric surgery patients regarding the value of living a healthy lifestyle for improving surgical outcomes and maintaining weight loss. &nbsp

Effect of Designed Bundle Protocol about Ventilator Associated Pneumonia on Nurses' Performance, Compliance, and Patient Outcomes

Context: Ventilator-associated pneumonia (VAP) is considered one of the leading causes of morbidity and mortality due to nosocomial infections among ventilated patients. Aim: To evaluate the effect of a designed bundle protocol about ventilator-associated pneumonia on nurses' performance, compliance, and patient outcomes. Methods: The study employed the quasi-experimental research (pre/post-test) (study/control) design. This study was conducted at the intensive care unit of Benha University Hospital. A convenience sample of 50 critical care nurses and a purposive sample of 66 patients were enrolled in the current study. Three tools were used to collect data. Nurses' knowledge assessment questionnaire; nurses' practice assessment checklist; The VAP bundle compliance checklist; and patient outcomes assessment record. Results: Statistically significant improvement in total knowledge and practice mean scores post implementing a designed bundle protocol compared to pre-implementing a designed bundle protocol at p <0.001. Also, there was a statistically significant improvement in nurses’ compliance with a highly statistically significant difference between nurses’ compliance with practices of VAP bundle pre-and post designed bundle protocol implementation. Immediately after a designed bundle protocol implementation, the study group patients exhibited a statistically significant difference between all clinical pulmonary infection scores items except for oxygenation status and radiographic findings. Conclusion: The study group nurses who received designed bundle protocol training would get improved knowledge, practices, and compliance scores than pre-designed bundle protocol training. Also, the study group of patients who were cared for by trained nurses on the designed bundle protocol would get better outcomes such as a better score of CPIS, shorter length of stay in the intensive care unit, less duration on mechanical ventilation compared to the control group who received routine hospital nursing care. The study recommended replication of the study using a large probability sample from a different geographical area to allow for greater generalization of the results

Effect of Multimodal Integrative Interventions on Pain-Related Outcomes among Critically Ill Patients

Context: Pain, a persistent problem in critically ill patients, adversely affects outcomes. Despite recommendations, no evidence-based non-pharmacological approaches for pain treatment in critically ill patients have been found. Aim: To evaluate the effect of multimodal integrative interventions on pain-related outcomes among critically ill patients. Methods: A quasi-experimental design (pre / post-test) was utilized to fulfill the aim of this study. A convenience sample of sixty adult critically ill patients was recruited from the intensive care unit at Benha University Hospital affiliated to Benha University at Qualyubia Governorate, Egypt. Three tools were used to conduct this study as follows: Critically ill patients' assessment record; The Critical-Care Pain Observation Tool (CCPOT); The Groningen Sleep Quality Scale. Results: The results show decreased frequency of pain occurrence in the post intervention periods (75%) immediately post to 50% after 48 hours of intervention compared with pre-intervention (100%). The results show a highly statistically significant differences at p ≤0.001 between pre and post of intervention periods regarding the intensity of the pain mean score among studied patients. It also shows statistically significant differences with p-value ≤0.05 regarding all items of sleep quality immediately after and after 48 hours of intervention compared to pre-intervention, except related to having a deep sleep last night, and feel like a slept poorly last night with a p-value ≥0.05. There was a highly positive statistically significant correlation at p-value ≤ 0.001 between pain intensity and other secondary outcomes, including quality of sleep, blood pressure, heart rate and respiratory rate. Conclusion: Multimodal integrative interventions effectively decrease pain and improve pain-related outcomes among critically ill patients. Appropriate pain assessment must be partnered with an adequate, multimodal, evidence-based management strategy that incorporates both pharmacologic and non-pharmacologic modalities of pain control

Critical Care Nurses’ Knowledge and Practice Regarding Administration of Total Parenteral Nutrition at Critical Care Areas in Egypt

Background: Critical care nurses are responsible for administering total parenteral nutrition that affects on critically ill patient general condition. Nurses must know proper constituents  of each solution and should be expert in calculating the dose of medication to prevent errors. Each nurse should be aware of indications, action, contraindications, adverse reactions  and  interactions of  each parenteral solution.  Moreover, nurses monitor  patients for  any negative signs of a change in condition, administer medication, and develop a plan of action for patients care. Aim of the study: to assess critical care nurses ' knowledge and practices regarding total parenteral nutrition. Research Design: A descriptive exploratory design was utilized in this study. Research questions: the following two research questions were formulated ;a)what the nurses know about the administration of total parenteral nutrition?, b) what are the practices the nurses perform while administering the total  parentral nutrition. Setting: The study was carried out at different Critical Care units at Menofiya and Benha University Hospitals, in Egypt. Sample: A sample of convenience of 80 nurses from different critical care units with a minimum one year of experience were included in the present study. Tools of data collection: Two tools were used to collect data; the first tool has two parts ;part one is background data sheet that included gender, age, years of experience, educational level and area of work. part two was total parenteral nutrition knowledge questionnaire that was designed by researcher to assess knowledge regarding indication, contraindication,   and nursing measures  towards total parenteral nutrition. The second tool was  total parenteral nutrition observational checklist that was designed to assess nurses practices while administering. Results:The current study findings revealed that critical care nurses have got low knowledge and practice scores with  significant correlations between years of experience and their level of knowledge and practice regarding total parenteral nutrition. Conclusion: it can be concluded that critical care nurses have inadequate knowledge and practice regarding total parenteral nutrition. Recommendations: Carrying out educational programs about nursing management of total parenteral nutrition complications and training on total parenteral nutrition administration. Key words: Critical Care Nurses ' knowledge , Nurses practice, Total parenteral nutrition

Investigation of The DGs Effect on The Coordination Between Protective Elements in Distribution Network

Addition of Distributed Generators (DGs) to the electric network have more advantages to the network. It improves the voltage profile and the power flow in the network. In the last decade, DGs is used in power system, especially the distribution system. Coordination study for protective devices must be performed on the distribution network with DGs to reach selectivity with minimum clearance time of fault. Due to DG insertion to the electric system, the short circuit level is changed and coordination between protective elements should be done. This paper presents a technique to avoid the miscoordination problem between protective devices due to the impact of DG units insertion without any additional costs. The proposed technique depend on activating and updating the setting of network relays to achieve correct coordination. Also, it doesn\u27t need any additional costs or any additional equipement to be installed in the electric network. This paper make studies on a real radial system of power transformer with its feeders of a 66kV utility substation before and after adding DGs. ETAP software is used to simulate the network under study

CHEMICAL INVESTIGATION OF BAUHINIA VAHLII WIGHT AND ARNOTT LEAVES GROWN IN EGYPT

Objective: Plants of genus Bauhinia are famous for their rich flavonoid content. Several phytochemical and biological investigations affirmed the role of flavonoids in the different biological impacts exerted by Bauhinia plants. The present study aims to investigate the major phytoconstituents of the leaves of B. vahlii Wight and Arnott.Methods: Powdered leaves were extracted with n-hexane (HE) and the defatted marc was extracted with 70% ethanol. The defatted ethanolic extract (DEE) was further partitioned with solvents of increasing polarities. The HE and polar fractions of DEE were purified using different chromatographic techniques and isolated compounds were identified through their melting points, 1D and 2D NMR, UV and MS spectral data.Results: A total of nine compounds were isolated and identified. Taraxerol (1), a pentacyclic triterpene, and β-sitosterol (2) were isolated from HE. Investigation of polar fractions of DEE yielded six flavonoids and a phenolic acid, namely luteolin (3), quercetin (4), gallic acid (5), avicularin (6), quercitrin (7), hyperoside (8) and quercetin-3-O-β-sophoroside (9).Conclusion: Flavonols of the quercetin nucleus were the major detected constituents in B. vahlii leaves. Taraxerol, avicularin and quercetin-3-O-β-sophoroside are isolated for the first time from the genus Bauhinia. Results of this study encourage future pharmacological investigation of B. vahlii due to the presence of biologically active flavonoids and phytosterols.Keywords: Bauhinia vahlii Wight, Arnott., Polar extractives, Flavonols, Quercetin, TaraxerolÂ