Abstract:Implementation of evidence-based guidelines of Ventilator Associated Pneumonia prevention affirmed a significant reduction in the incidence and prevalence of Ventilator Associated Pneumonia.
Objective: This study aims to assess nurses’ application of evidence-based guidelines on prevention of ventilator associated pneumonia in neonates.
Settings: The study was carried out in NICUs at El-Raml Pediatric Hospital in Alexandria and Kafrelsheikh General Hospital in Kafrelsheikh.
Subjects: All nurses who are responsible for providing care for mechanically ventilated neonates in previously mentioned settings comprised the subjects (n= 100 nurses).
Tool: Nurses' Application of Evidence Based Guidelines on Prevention of Ventilator Associated Pneumonia Observational Checklist was used in the study. It included aseptic practices, aspiration prevention, oral care, endotracheal tube suctioning and respiratory equipment care guidelines.
Results: The main results revealed that 39% and 38% of the nurses had “Good” and “Satisfactory” practices scores respectively compared to only 23% of those who had “Unsatisfactory” scores regarding application of evidence-based guidelines of VAP prevention.
Conclusion: It can be concluded that more than two thirds of the nurses had either “Good” or “Satisfactory” total scores of practices in their application of evidenced based guidelines of VAP prevention.
Recommendation: The findings of the study recommended that proper in-service training programs should be provided for nurses about the most recent VAP preventive guidelines to update their knowledge and improve their practices about VAP prevention.
Keywords:Evidence-Based Guidelines, Ventilator Associated Pneumonia, Neonates.
Title:Nurses' Application of Evidence-Based Guidelines on Prevention of Ventilator Associated Pneumonia in Neonates

Abstract:Effective handling of telephone orders by staff nurses is essential for maintaining continuity of care and improving quality of sevice. Any unintentional error during handling of telephone orders can endanger patient safety.
Aim: the current study aimed to improve staff nurses’ handling of telephone orders and investigate its’reflection on staff nurses’safety behavior.
Design: quasi-experimental design was used.
Setting: The study was conducted at Ain Shams University hospital.
Subjects: 65 staff nurses were participated in the study.
Tools of data collection: it included knowledge questionnaire, an observation checklist, audit sheet, and safety attitude questionnaire.
Results: 44.6% of staff nurses had satisfactory knowledge in the pre-intervention phase and reached to 93.8% at post intervention phase, less than one third of them had adequate performance when receiving telephone order before the intervention which increased significantly after the intervention to 96.2% , less than one quarter of staff nurses had adequate performance regarding documentationof telephone order in patient medical file before the  intervention compared to 98.5%of them after the intervention slight more than two thirds of staff nurses had positive safety behavior before the intervention which increased significantly to 95.4% after the intervention.
Conclusion: the improvement of staff nurses’ handling of telephone orders was associated with enhancement of staff nurses’safety behavior.
Recommendations: Hospital on need to develop written policy about safe handling of telephone order and implement it and create a non-punitive work environment is required.

Abstract:Diabetic retinopathy DR is a complication of DM that affects the blood vessels of the retina and leads to blindness. Laser treatment is used to treat new blood vessels at the back of the eyes in the advanced stages of diabetic retinopathy. Staff education is an essential part of vitreoretinal VR   in the care of VR patients. 
Aim of the study: To evaluate the effect of educational health program for the nurses and the family caregivers about care of diabetic retinopathy patients with Laser Photocoagulation surgeries.
Subjects and Method A quasi-experimental design was utilized in this study, it was carried out in ophthalmology unit affiliated to Tanta University Hospital, a convenient sample consisted of all (30) available nursing staff working at above-mentioned setting. Two tools were used the structure questionnaire sheet and observational checklist.  
Results: There are highly significant differences in relation to the nurses' total practice level among preoperative immediate postoperative and after two months postoperatively, mean ± SD = 12.13±1.613, 43.00±0.00, 38.70±13. 121 respectively
Conclusion: the teaching program significantly improves nurses' knowledge and practice about Laser photocoagulation surgery for diabetic retinopathy patients with a sustained improvement in clinical outcomes and reduce complications.

Abstract:Breast engorgement is a physiological condition characterized by painful swelling of the breast because of increase in milk volume, application of educational program as warm compresses and reverse pressure softening is crucial either for alleviating breast engorgement or preventing nipple trauma. This study aimed to evaluate the effect of educational program on mothers' using for non-pharmacological therapies to alleviate breast engorgement after cesarean section. A research design was quasi experimental study conducted in patient postnatal units at Ain Shams Maternity University Hospital and postpartum women homes. A purposive sample technique was used to recruit two hundred seventeen postnatal mothers in the study. Four tools of data collection were used first was structure interviewing questionnaire, second tool was Visual Analogue Scale (VAS), third tool was six-point breast engorgement scale, and fourth tool was LATCH scale. The result of the study shows that there is no statistical significant difference between control, cabbage leaves with reverse pressure softening, and warm compresses with reverse pressure softening groups as regard degree of pain, breast engorgement, and latching scale before implementation of educational program. While, there is a highly statistical significant reduction on degree of pain & breast engorgement with highly statistical significant improvement on latching scale between groups especially for warm compresses with reverse pressure softening group. Conclusion and recommendations: the study concluded that educational program had positive effect on reducing degree of pain and breast engorgement after cesarean section adding to improve baby latch. Accordingly, the following recommendation is proposed: application of educational program for cesarean section mothers at immediate postpartum period regarding warm compresses with reverse pressure softening as an effective method for alleviating breast engorgement.
Keywords:Educational program, Non-pharmacological Therapies, Breast engorgement, Cesarean Section. 

Abstract:Older people are at risk for health decline and loss of independence. CAPABLE Intervention plays a central role in the maintenance of health, and the prevention of disease especially among older adults. The study aimed to assess the effect of CAPABLE Intervention plays on the activity of daily living and depression among institutionalized older adults.
Design: Quasi-experimental design (pre-post) test was utilized. Setting: The present study was conducted in the two geriatric home in Cairo, Egypt. It was opened on October, 2016. Sample: it was conducted on 60 elderly residents attending institutionalized elderly home at Cairo.
Instruments: three tools were used; Interviewing questionnaire, activity of daily living scale and The Geriatric mood Scale.
Results: The findings of the table showed that activity of daily living was highly significance effect on depression among elderly. Fifty seven percent of the study subjects had mild depression and about 28% of the subjects were dependent. The finding revealed that pre intervention the majority of elderly suffering depression mild suffering (77.8%). It revealed statistical significant relationship. The finding showed that ADL was highly significance effect on depression.
Conclusion: there are a significant effect to CAPABLE intervention on ADL and depression.
Recommendation: We need to better understand the linkage between disability and depressive symptoms and seek effective interventions to reduce caregiver strain and enhance care receivers’ well-being.

Abstract:Background: Too much unprotected exposure to the sun's ultraviolet (UV) rays can cause skin damage and skin cancer. Even people in their twenties can develop skin cancer, so, effective education on the issue of sun safety is essential. The aim of this study was to examine sun safety educational awareness guidelines for prevention of skin cancer among college students. Design: A quasi-experimental research design was used. Setting: This study was carried out at 7 faculties in Helwan University, Egypt. Sample: A convenience sample of 550 students was selected. Tools: (I)A structured designed interviewing questionnaire which includes sociodemographic characteristics and student knowledge questionnaire. (II)Self–Report Practice Likert Scale toward Sun Protection Measures. (III) Self–Report attitude Likert Scale toward Protect from Sun Exposure. Results: The study sample had poor knowledge (61.5%), negative attitude (78.2%) as well as inadequate practice (71.3%) before conducting sun safety educational awareness guidelines. A highly statistically significant improvement was detected after educational guidelines in their total good knowledge (71.4%), positive attitude (89.5%), as well as their total adequate practices (91.6%). There was an increase in mean total scores of knowledge, attitude and practice regarding sun safety and skin cancer prevention at post educational guidelines than pre guidelines as (p<0.001). Conclusion: Overall improvement in the awareness of College students regarding skin cancer prevention after implementation of sun safety educational guidelines. Recommendation: Health promotion and young adult age education intervention focusing on sun-smart strategies are required.

Abstract:The clinical practice is a very important part of the nursing course. The nursing students report significant anxiety when anticipating their first clinical day, this leads to decreased self-confidence in clinical performance necessary to provide safe care for women. Nurse educators must be aware of anxiety levels and self-confidence to intervene appropriately to foster the best learning outcomes for students so the aim of the study is to evaluate the effect of role modeling as teaching method on maternity nursing students’ achievement, anxiety, and self-confidence at the labor area. Design: A comparative quasi-experimental posttest was used to conduct the study. Setting: The study was conducted at the Maternity lab at Faculty of Nursing, As well as the Maternity department at Fayoum University Hospital. Sample:  A Convenient sample of 240 nursing students in Maternal and Neonatal Health Nursing Department, enrolled in the academic year 2017/2018 were included. Tools used to collect the data were; I. A structured self-administered questionnaire, II. State-trait anxiety inventory, III. Confidence scale, IV. Practical achievement assessment tool and V. Attitude assessment tool. Results: The study findings revealed that there were significant differences between role modeling group and traditional group regarding students' clinical performance, self-confidence and anxiety level through the maternity skills at the labor area. As well as the student taught by role modeling exhibit a more positive attitude regarding the teaching method used in the clinical course more than whose in the traditional method. Conclusion: Role modeling significantly enhanced the students’ achievement, self-confidence and reduce the anxiety level in the labor area. Recommendation: Integrating the role modeling as a teaching method in all clinical nursing practice curriculums.

Abstract:Although, umbilical cord care practices for newborns vary widely between health facilities it can lead to disruption for both nurses and parents. Dry cord care is one of the essential gold standard nursing practices recommended by the World Health Organization to reduce morbidity and mortality amongst neonates. Purpose of this study is to examine the effect of gold standard dry cord practices versus 70% Alcohol application among neonates. Design: A Quasi-experimental comparative study was utilized at Obstetric and pediatric departments of the University hospital and the Teaching hospital in Shebein El-Kom, Menoufia Governorate, Egypt. Two hundred neonates and their mothers were included. Instruments: three instruments for data collection were used; 1: Socio- demographic characteristics structured questionnaire: it consisted of two parts. A: Socio- demographic characteristics of studied mothers and their neonates. B: Mothers' knowledge about umbilical cord care: 2- Mother's competency of skills observation check list...3: Newborns' Umbilical Cord Condition structured questionnaire from their Mothers' Perspectives. 4: Newborns' Umbilical Cord Condition Observation Check List. Results: the study results indicated that, 89% of the mothers reported that the dry cord care technique was very effective in the healing of the umbilical cord stump. 90% reported that this technique was very effective in decreasing risk for infection. 86% reported that this technique was very effective in decreasing the duration of cord separation time. The study concluded that dry cord care technique was very effective in healing of the umbilical cord stump, decreasing risk of cord infection and decreasing the time of cord separation compared with 70% Alcohol technique. Recommendation: Dry cord technique is importantly recommended as natural, safe and evidence based method for better healing and separation of neonatal umbilical cord.

Abstract:Clinical supervision is an opportunity for reflection and supportive learning of the personal for professional development. It is the responsibility of both supervisor and supervisee. Aim of the present study was to study effect of implementing clinical supervision program for head nurses at Tanta International Teaching Hospital. Method: Quasi experimental design was applied. The study was conducted at Tanta International Teaching Hospital, Tanta University in all inpatient departments: ICU and wards. Subject: All (31) head nurses working in all inpatient departments. Also, representative random sample of staff nurses (280) working in the same inpatient departments. Data were collected using three tools: (I) head nurses' knowledge about clinical supervision questionnaire, (II) observational checklist for head nurses' practice about clinical supervision, and (III) Manchester clinical supervision scale to assess staff nurses' perception about clinical supervision. Results: Majority (91.8%) of staff nurses had low perception about effectiveness of clinical supervision before program. Total knowledge of head nurses about clinical supervision improved statistically significant immediate post program and three months post program than before program. There was statistically significant improvement of head nurses level of total practice before and within three months post program. Conclusion: Staff nurses at Tanta International Teaching Hospital had low level of clinical supervision effectiveness. Immediately after implementation of a designed program on clinical supervision, a significant improvement in all head nurses' knowledge and practice about clinical supervision were found. Recommendations: Provide ongoing training for head nurses to ensure that clinical supervision is conducted in an appropriate and supportive manner. As well as provide adequate, regular and timely feedback to them concerning both strength and weakness points in their competencies.
Keywords:Head nurses, Clinical supervision, Supervisor, Supervisees.

Abstract:Vaginal laxity is a significant issue affect women, long-term physical and psychological consequences may occur, including loss of sensation and sexual dissatisfaction. An evidence-based nursing intervention as pelvic floor muscle exercises was effective in improving the quality of sexual function among women with vaginal laxity. This study aimed to evaluate the effect of the evidence-based nursing intervention on quality of sexual function among vaginal introitus laxity women. An intervention research design (time series) was adopted. A purposive sampling technique was used to recruit 60 women at gynecological outpatient and family planning clinics in Ain Shams Maternity Hospital. Four tools of data collection were used: Self-Administered Questionnaire, Female Sexual Function Index (FSFI), Female Sexual Distress (FSD-R), and Self-reported changing in sexuality post-intervention tool. Results: revealed that there were statistically significant improvements in the total (FSFI) mean score and the total (FSD-R) mean score after the intervention at (P < 0.001). In addition, women reported positive changing in their sexuality by the increase in the sexual activity, intercourse frequency, and satisfaction, and decreased the sexual difficulties. Conclusion: the Sexual function of women with vaginal introitus laxity was improved post 3 and 6 months of the intervention. This indicates that vaginal tightening with exercises had a positive effect on the sexual function in women. However, it will take a long period and need to give a good effect. Recommendation: Sexual relation counseling for the couples should be an integral part of the gynecological treatment in the hospitals especially for cases with sexual dysfunction.

Abstract:This study aimed to study the effect of guideline about endometriosis on enhancing young female knowledge and utilization of health services. Setting: This study was accomplished at Mansoura university hospital specific at gynecological outpatient clinic, Egypt. Design: Quazi experimental pre and post test design. Subjects: one hundred and sixty two young female from October 2017 to April 2018. Type of sample: purposive, Tools: An interviewing questionnaire schedule, self monitoring schedule & likert scale. Results: The present study results had revealed that the mean age among studied sample was (21.95 ± 2.02), also, there were significant improvement of total score of knowledge pre, post,& 3 months post intervention among studied sample  (8.12± 0. 59), (15.46 ±1.49)  and (13.97 ±2.89)respectively. In addition more than three quarter among studied sample had utilized health services regarding painful and heavy menstruation complains, while 39.9% complains from dysparunia, furthermore the majority of studied sample agreed to utilize the guideline. Conclusion: The majority among studied sample had incorrect knowledge about endometriosis pre intervention compared to highly significant improvement post and 3 months post intervention. While after implementing had significantly improvement and follow-up. In addition increase awareness regarding endometriosis and utilized health services. Additionally the majority of studied sample agreed to utilize of guideline in the future. Recommendation: Design guideline, purshor about endometriosis must be available at gynecological and obstetrics clinic to be distributed among young female.

Abstract:Oral health plays a key role in the overall health status and quality of life in children. Oral health intervention and promotion may be delivered at various setting such as hospitals, primary healthcare centers, private dental clinics, and schools. Aim of the study: The aim of this study was to investigate the effects of educational intervention program on oral health knowledge and practice among primary school pupils in Tanta city. Research design: Quasi experimental research design was used in this study. Setting: The study was conducted in 7 governmental primary schools in Tanta city which were selected based on stratified random sampling to constitute about 14% from a total number of 50 schools in both east and west educational zones. Tools: Two tools were used for data collection, Tool I: A structured interview sheet; it was composed of two main parts: Part (1): Socio-demographic data of the studied subjects, Part (2): Participants' knowledge of oral health such as number of milky and permanent teeth, its benefits and harmful habits for teeth. Tool II: Participants practice of dental care; it consisted of two parts: Part (1): Participants' reported practice of oral health care, Part (2): Observational check list sheet that contain steps of teeth brushing and flossing. Results: The result of this study revealed that, before implementation of the program, the studied pupils had low scores of knowledge and practice. There were statistically significant improvements in the pupils' total scores of knowledge and practice of oral health care immediately and three months after implementation of the program. Conclusion and Recommendation: The educational program was effective and enhanced pupils’ knowledge and practice of oral health care. So, school health nurses should conduct it regularly using simple attractive audiovisual aids.

Abstract:Breast cancer is the most common invasive cancer in women, and the second main cause of cancer death among them, after lung cancer. Chemotherapy is the cancer treatment most likely to weaken the immune system. The immune system helps to fight cancer and its activation strengthen the effect of chemotherapy.
The aim of study: is to evaluate the effect of educational immune enhancement guidelines on clinical outcomes of mastectomy patients undergoing chemotherapy.
Materials and methods: The study design used was a quasi experimental survey study. A purposive sample of 60 adult female patients, age ranged 20-60 years old, with cancer and scheduled to be treated with adjuvant chemotherapy for the first time after curative surgery who met the inclusion criteria it divided randomly 30 subjects in the study group and 30 subjects in control group, the study group received chemotherapy submitted to nursing management of chemotherapy side effects and immune enhancement through (diet, exercise, and life style modification as good night sleeping for 6-8 hours, relaxation technique for relieving worry and tension) in addition to the routine hospital care, while the control group received the routine hospital care.
Tool of data collection: five tools are used to collect the data including; Ι- knowledge assessment Structured interview questionnaire, ΙΙ- the Australia – modified Karnofsky performance status scale by Abernethy et al., (2005), III-The quality of life scale by brady et al., (1997), IV- Piper Fatigue scale by Piper et al., (1998) and V- Nutritional laboratory investigation assessment sheet.
The results of this study: revealed that after implementing the immune enhancement guidelines for the mastectomy patients undergoing chemotherapy, there was greatly improvement on the study sample quality of life, performance status of usual daily activities, fatigue level, nutritional status and lap investigations rather than the control group.
Conclusion: The immune enhancement through (diet, exercise, and life style modifications) is effective on the clinical outcomes of mastectomy patients undergoing adjuvant chemotherapy.

Abstract:Urinary tract infections are the most common healthcare-associated infections, and are especially common among patients in the intensive care unit. A majority of nosocomial urinary tract infections is related to insertion of urinary catheters. Aim: The aim of the present study is to determine the effect of nursing intervention protocol on the incidence of catheter associated urinary tract infection among critically ill patients. Design: Quasi-experimental research design was utilized in the study. Sample: A purposive sample of (70) adult patients from both genders were required for indwelling urinary catheter. Setting: Data were collected from General Intensive Care Units at Ain Shams University Hospitals. Tools: Two tools were used for data collection (I) A structured interview assessment questionnaire, which included (a) Socio Demographic and Medical Characteristics Assessment sheet, (b) Urinary Catheter Assessment Sheet, (II) Catheter Associated Urinary Tract Infection Checklist Tool, which included (a) Urinary Tract Infection Manifestations, (b) Mechanical problems, and (c) Diagnostic studies. Results: This study revealed that, there was a statistically significant difference in occurrence of Catheter associated urinary tract infections between study and control group in which study group showed lower incidence of Catheter associated urinary tract infections than control group. Conclusion: Applying of nursing intervention protocol by using sterile technique during catheter insertion and maintain daily care for the catheter after insertion decrease the incidence of Catheter associated urinary tract infections. Recommendation: The study recommended that; an educational guidelines and training on insertion of a urinary catheter by using sterile technique and maintain daily care for the catheter after insertion  should be held for Intensive Care Unit nurses to decrease the incidence of Catheter associated urinary tract infections.

Abstract:Cardiovascular disease (CVD) has emerged as the single most important cause of death worldwide. Coronary artery disease (CAD) is the most prevalent type of cardiovascular disease in adults. Cardiac catheterization is the gold standard diagnostic test for coronary heart diseases.  Aim: This study aimed to determine the effect of early ambulation on post diagnostic cardiac catheterization patient’s outcomes. Design: Quasi experimental research design was utilized in the study. Sample: A purposive sample of (70) adult male and female patients undergoing diagnostic cardiac catheterization, which will be divided into two equal groups study &control group 35 patients for each group. Setting: Data were collected from cardiology and cardiac catheterization departments at the National Heart Institute. Tools: Three tools were used for data collection (I) A structured interview questionnaire sheet, which included (a) socio-demographic characteristics, (b) Past and present Medical and Surgical history, (2) Pre/Post Cardiac Catheterization patient's Knowledge Questionnaire, (3) Patient's Physical Assessment Sheet. Results: This study revealed that, there was statistically significant difference between control and study group regarding incidence of back pain and no statistically significant difference regarding hematoma formation after the procedure, As well, there was statistically significant improvement in mean of knowledge regarding heart and cardiac catheterization among the control and study group. Conclusion: Early ambulation post the diagnostic cardiac catheterization is safe and has a positive effect on early complications among studied patient's regarding incidence of low back pain and increased patient's knowledge after educational session. Recommendation: The study recommended application of early ambulation on therapeutic cardiac catheterization with a larger sample.

Abstract:Breast cancer is the most common in female worldwide, which cause the highest death rate among female cancer patients. Breast cancer not only involves many aspects of individual health and quality of life but also impresses family health and social life. Aim: determine the impact of a designed supportive nursing program regarding psychosocial and physical complications among post mastectomy women. Design: quasi-experimental design was used. Setting: The study was conducted at the National Cancer Institute in Cairo, Egypt. Sampling: A convenient sample of 50 adult females was used for conduction of this study. Tools: the Data was collected by using four tools, structured interview questionnaire, Pre/ post/ follow up psychosocial and health changes questionnaire, Health survey short form-36(SF-36). and finally body image scale. Results: clarified that the supportive nursing program had a highly significant effect on decreasing the psychosocial and physical complications after mastectomy. Conclusion: in the light of the present study findings, it can be concluded that there was a positive effect of the designed supportive nursing program on improvement of the psychosocial and physical complications that encounter the women after mastectomy. Recommendations: The present study recommended that, replicate the programs that increase confidence and improve body image of women after mastectomy, include the husbands in this programs to help their wives to cope and adjust and establish a nursing training courses to guide them to help patients and their caregivers to acquire knowledge and skills of self-care.

Abstract:Stress among nursing students is familiar especially during their training as the students exposed to new areas with different types of patients, clinical, equipment’s and hospitals; these stressors could have significant consequences (positive or negative), on both thinking and learning.
The aim of the study: was to identify stressors and coping behaviors in different clinical practice areas among undergraduate nursing students in Faculty of Nursing Tanta University.
Subjects and method:
Study design: descriptive cross-sectional, study design was used in this study.
Study settings: The study had been conducted at three different academic years in Faculty of Nursing Tanta University, second year: (Medical- Surgical Nursing), third year: (Obstetrical and Gynecological and Pediatric Nursing) and fourth year: (Community, Psychiatric, and Administrative Nursing departments).
Study subjects: Stratified random sampling and simple random sample techniques were used. Tools of data collection: Three tools were used in this study. Tool I: Structured questionnaire sheet, tool II: -Stress levels and types of stressors and tool III: Coping behavior Inventory (CBI). 
Results: The studied subjects were 398 students with the mean age (20.721.072). Nearly three-quarters of studied students (73.9%) were female, more than half (59%) of them from urban and 67.8% were interesting in nursing .Nearly one quarter (22%) of them had the high level of stress and one quarter and more than half of them (26 & 52%) respectively had the moderate and low level of stress. More than two-thirds of them (74%) had low coping behaviors with stress. There was a statistically significant difference between all domains of stressors and all domains of coping behaviors (significant at the 0.01 level).
Conclusion:  The most common type of stressors perceived was related to working with various kinds of patients followed by stress related to the assignment. The most common coping behaviour utilized by the students was problem-solving followed by transference.
Recommendations: Nursing instructors should encourage students to discuss their feelings and their stressors in order to provide appropriate interventions

Abstract:Alzheimer’s disease (AD) has a major effect on Alzheimer’s patients by limiting the ability to live independently. Family members providing persistent care to Alzheimer’s patients suffer from extreme burden that alters their health, impairs their quality of life, and results in mental and physical exhaustion, which has a deteriorating effect on the care recipient.
The aim of the study: To evaluate the effect of psycho-educational program about Alzheimer’s disease on knowledge, healthy lifestyle, depression, and burden of caregivers of Alzheimer’s patients.
Subjects and Method: -Study design: Quasi experimental design (pre and posttest) study design was used to conduct this study.
Study settings: The study was conducted in Neuro and Psychiatric Outpatient Clinics of Tanta University Hospital, Health Insurance Hospital in Tanta city and Psychiatric Private Outpatient Clinics.
Study subjects: Convenient number of 45 caregivers of Alzheimer’s patient who had attended the previous settings.
Tools of data collection: Four tools were used to collect the necessary data from the study subjects. Tool (I): Structured interview schedule. It consisted of two parts: - Part (1): Socio-demographic characteristics of the caregivers of Alzheimer’s patient. Part (2): Bio- socio-demographic and clinical characteristics data of the cared Alzheimer’s patient. Tool II: The Alzheimer’s Disease Knowledge Scale (ADKS). Tool III: Health Promoting Lifestyle Profile II (HPLPII). Tool V I: - Beck Depression Inventory (BDI). Tool V: - The Zarit Burden Caregiver Scale.
Results: The result of this study revealed that there was an improvement of the mean of the total score of both Alzheimer’s Disease Knowledge Scale (ADKS) and healthy lifestyle profile II dimensions and there was a reduction of the mean of the total score of both scales of Beck Depression Inventory (BDI) and Zarit Burden Caregiver.
Conclusion and recommendations: - It can be concluded that psycho-educational program was effective at reducing caregivers' burden and depression and improved the caregivers’ level of knowledge and health promoting lifestyle profile of Alzheimer’s patient. Therefore, the generalization of the psycho-educational program must be provided to caregivers of Alzheimer’s patients to reduce their burden, depression, improve their healthy life style and strengthen the coping skill and thus improve their QOL.

Abstract:Triage in hospitals typically aim to categorize and prioritize pregnant women who present for emergent or urgent care before detailed evaluation and management. However, obstetric patients are best served if local emergency services develop protocols whereby they were taken to the most appropriate facility.
Aim of the study:  this study aimed to assess the effect of nurse’s application of structure obstetrics triage guideline on pregnant women outcomes.
Design: A prospective quasi-experimental design (pre and post intervention) was utilized.
Setting: at obstetrics department in Prince Hussein Bin Abdullah (Amman, Jordan).
Sample:  a convenience sample consists of all nurses (50) working in obstetric department at the time of data collection.
Instruments: included a structured interview questionnaire consisting of two parts; “personal characteristics, and knowledge about obstetric Triage” and the performance assessment checklist through Maternal Fetal Triage Index (MFTI) adopted from AWHONN’s, (2016).
Results: nurses were gain knowledge and practices for obstetric women triage as well as “Maternal Fetal Triage Index” after intervention than in before intervention with statistical significance difference p<0001 for all knowledge item about triage. In addition nurses after intervention increase their level of outcomes evaluation above the upper confidence level. An increases in nurses’ practicing in relation to improve maternal outcomes after intervention increase their level of outcomes evaluation “above the upper confidence levels”, than before intervention “below the confidence level”. 
Conclusion: Nurses application improved in their proficiency after conducting Structured Obstetrics Triage Guideline for pregnant women outcomes on post intervention than on pre intervention.
Recommendations: 1- theoretical and practical training of  obstetric triage for nurses in hospitals as well as undergraduate curriculum.2-Continous educational training programs about obstetric triage for health team should be provided to increase their knowledge and skills 3-Simple manual guidelines for Triage and MFTI should be available at every obstetric unit to guide nurses to priories newly admitted cases according to severity of obstetric symptoms 4-Establish an emergency simulation scenarios with staff from multiple areas to help everyone involved to be better prepared when an actual emergency occurred.

Abstract:The process of aging is related to biological, mental, and social changes which cause susceptible conditions to get physical, psychological, and social health problems. The aim of the study: - to assess physical and psycho-social health problems among elderly people in rural area and its effects on their quality of life. Subjects and Method: -Study design: - In this study, a descriptive cross-sectional study design was used. Study settings: - The study was carried out in Ceberbay village as a rural area in Tanta City. Study subjects: - A convenient sample was utilized in the current study. The study sample consisted of (278) of the elderly people in the study setting equal and above 60 years.  Tools of data collection: - Two tools were used by the researchers to collect the necessary data Tool I: A structured interview schedule: - it consisted of the following parts: - Part 1- Socio-demographic characteristics, Part 2:- Physical health problems, and Part 3:- Psycho- social health problems. Tool II: World Health Organization Quality of Life-BREF (WHOQOL- BREF). Results: - The result of this study showed that there was a highly significant positive correlation between quality of life and activities of daily living, cognitive impairment and level of education but there was highly significant negative correlation with depression, abuse vulnerability and family income (p = 0.000**). Conclusion and recommendations: - It can be concluded that more than two- thirds of elderly people in the rural area had low QOL and the rest of them had mild QOL. Therefore, a pressing need for health education intervention to the elderly regarding their social and physical recreational activities group that will assist in building elderly self-confidence as well as it improved their QOL.

Abstract:Background: All children have the right to a safe, supportive and healthy school environment. After the students' home, school represents the second most influential environment in a child's life. The school considers an important setting for promoting health. The school is since long acknowledged as an important setting in public health because it has a unique opportunity to increase the knowledge and awareness of health from an early age. The school health visitors have a crucial role in the seamless provision of comprehensive health services to children and youth. The aim of the study: Evaluate the role of the school health visitors and students opinion regarding implementing of the school health program. Design and Setting: cross sectional descriptive study design was used in this study. It was conducted in different preparatory schools at Al-Gharbiya Governorate from January to June 2017. Subject: all available school health visitors (62) working at Tanta city and 500 students from four preparatory schools. Tools: three tools were used for data collection, Tool (1) Structure questionnaire sheet for nurses to evaluate the role of the school health visitors  regarding comprehensive health examination, preventive services, school medical treatment services and the school health environment, Tool (2) Opinions of the school health visitors regarding; applications of school health services, obstacles facing the health visitors activities, training needs for them and suggestion to improve their health care activities, and Tool (3) Opinions of the students regarding comprehensive health examination, preventive services, school medical treatment services and the school health environment ;  Results: It was reported that about half of both nurses and students had good opinion regarding pre, during and after health examination services and all of the nurses agree that present of certain obstacles to performing their tasks as little advanced resources, little workers or cleaner in the schools Conclusion and Recommendation: Based on the findings of the present study, the nurses need in-service training and the school needs effective materials and human resources to perform their activities.

Abstract:Nursing staff considered the main probable users to EMR. They play a vital role in planning and implementation of EMRs. So the aim of study was to evaluate the effect of an educational program on nursing staff knowledge and attitude toward electronic medical record at Tanta International Teaching Hospital. Subjects and method: quasi-experimental (pretest-posttest control group) design was used and the study was carried out in medical and surgical units at Tanta International Teaching Hospital. The subject consisted of all (130) available nursing staff working at previous mentioned setting, and randomly assigned into study and comparison groups. Tool of the study was questionnaire sheet which consisted of five parts; nursing staff characteristics, computer experience assessment questions, attitude toward electronic medical record questions and questions on nursing staff electronic medical record knowledge. Results: There were statistically significant differences between study and comparison groups' EMR knowledge and attitude pre than post the program. Post program study group's knowledge levels and attitude significantly improved while, no changed in comparison group. Conclusion: An improvement was noted in studied nursing staff levels of knowledge and attitudes about EMR after implementing an educational program as indicated by upgrading their EMR knowledge scores and positively changed related attitude subscales. Recommendations: providing initial and ongoing staff education on EMR through the use of simulation training can increase the potential for its success. Also, nursing faculties need to integrate IT into their undergraduate and graduate curriculum. 

Abstract:Electronic medical record system has a large impact on the day-to-day work. It will save a lot of effort and time and thus affect the quality of service offered positively which lead to organizational development. .Aim: The present study aimed to determine perception of nursing staff about electronic medical record, Assess organizational development categories, and explore the relation between using electronic medical record and organizational development. The present study aims to determine perception of nursing staff about electronic medical record, Assess organizational development categories, and to explore the relation between using electronic medical record and organizational development. Methods: Cross sectional descriptive study was used and conducted on 170 of staff nurses working at Mansoura Health Insurance Hospital, using two Tools: Nurse’s perception of electronic medical record questionnaire and organizational diagnosis questionnaire .Results: The findings of the study showed that nurses will be satisfied when using electronic medical record and this will lead to organizational development. Conclusion: The study concluded that there is statistical significant correlation between nurses perception toward using electronic medical record and total assessment score of organizational categories at Mansoura Health Insurance Hospital.

Abstract: The aim of this study was to evaluat the effect of utilizing guideline on sleep pattern in third trimester pregnant women. A Quasi-Experimentaldesign wasutilaized. This study was conducted at the Antenatal clinic at the Obstetrics and Gynecology center in Mansura city over a period of eight months from the beginning of July 2016 to the end of Feb 2016. A purposive sample was used to select the study (n=80). Two tools were used for data collection; the first tool wasa Structured Interview schedule. It consisted of four parts to measure the following items; general characteristics, the past and present reproductive history, the minor discomforts during third trimester and daily lifestyle of the subject. Tool two was Pittsburgh Sleep Quality Index (PSQI). The PSQI is composed of 19 items that are used to assessthe sleep quality. Findings:  According to Pittsburgh Sleep Quality Index (PSQI) there was a highly statistically significant difference in subjects' sleep patterns between pre and post-interventionscors. However, their utilization of sleep medication was almost the same before and after the intervention. The findings of this study suggested a statistically significant improvement in the subjects sleep pattern after implementation of the guideline in comparison to before. Recommendations: Simple handouts as booklets and brochures about sleeping pattern and its importance should be prepared and distributed at antenatal clinics. Sleep guidelines should be integrated into maternity courses curriculum for nursing students. Sleep enhancing educational session should be applied at the maternity hospitals and centers.

Abstract: Safe sleep position for infant and neonate can play an important role for prevention of sudden infant death syndrome. Aim of the study was to assess nurses’ adherence to safe sleep position of preterm and term neonate. Setting this study was conducted at Neonatal Intensive Care Units (NICU) in menoufia university hospital, Shebin El-Kom Teaching Hospital and Elgameyaa Elshreyaa NICU center, in Shebin El-Kom- Menoufia Governorate. Design A descriptive design was used. Sampling: a convenience sample of 84 nurses was obtained from the selected Neonatal Intensive Care. Instrument: 1) A structured interview questionnaire to assess nurses adherence to recommended safe sleep position. Results. More than two third of nurses (70.9%) and (68%) in university and teaching hospitals select (supine and side) as recommended safe sleep position in neonatal intensive care unit, as well as, 73% of them disapproved cobedding of multiple in NICU, also there no discharge plane   for parent about appropriate safe sleep  position. Conclusions majority of nurses select (supine and side) as recommended safe sleep position for premature and full term infant. Also they disapproved cobedding of multiple in NICU, in addition, less than half of nurses didn’t advice parent about recommended safe sleep position after discharge. Recommendation: In-service training education programs are needed to upgrade nurses' knowledge and practices about recommended safe sleep position.

Abstract:  The aim of the study was to assess the effect of nursing education intervention on time management for nurses in dialysis unit. Hypothesis: After the nursing education intervention: 1- the knowledge of nurses about renal failure,  haemodialysis and time management will increase, 2- The perception of nurses about importance of time management in improving their performance and the perception about their ability to control time wasters will increase. 3- The performance of nurses will improve after receiving the educational intervention. Design: Quasi-experimental design used. Setting:  dialysis unit at Benha university hospitals and health insurance hospital used to conduct study. Tools: two tools were designed; I): Interview questionnaire sheet: It consists of four parts (I): It consisted of personal identification and demographic characteristics of the studied nurses. Part (II): to assess nurses' general knowledge about renal failure and haemodialysis. Part III: Time management perception questionnaire. Part IV: Time wasters' perception questionnaire. Tool (II): Observational Checklist for nurses' performance with workload at dialysis unit. Results: The results of the study revealed that (58.3%) of nurses were working at Benha University Hospital and having experience at dialysis unit more than 5 years. more than half (55%) their age above 30 years, The majority of them 76.7% were working as a bedside nurse, (60.6%) have not any training program in time management. The results showed that there are statistically significant improvement regarding to total level of general knowledge about renal failure and time management, total level of perception about importance of time management and perception about ability to control time wasters after 1 month and at follow up among studied nurses. Conclusion: the nursing educational intervention had a significant effect on improvement of  the nurses' knowledge related to renal failure, haemodialysis, time management and  performance. Also, it improved the perception of nurses about importance of time management in their performance and their ability to control time wasters. Recommendations: Orientation program for newly staff and continuous education for nurses in dialysis unit about time management and time waster with periodic evaluation of knowledge and practices for the nurses working at dialysis to assess what needs and appraisals. In addition to application of protocol or Schedule of care for patient with chronic renal failure CRF written in Arabic language to improve factor that reinforce time waster.

Abstract:Diabetic retinopathy (DR) is the most common microvascular complication of diabetes, which can lead even to blindness. Aim of study: The current study aimed to evaluate the effect of nursing guidelines for improving knowledge and relieve anxiety of diabetic patients with retinopathy. Design: A quasi-experimental study design was utilized. Setting: The study was carried out in outpatient clinic of ophthalmology at Ain Shams University Hospital. It is ‘the largest national referral hospital of teaching, Tools: 1) A Structured Interview Questionnaire (SIQ): it was included, the demographic data and clinical data of the studied patients. 2) Patient Knowledge Questionnaire It was used to assess patients' knowledge regarding, definition retinopathy, signs and symptoms, stages of retinopathy, causes, signs & symptoms, complications of diabetes on peripheral blood vessels, diagnosis, and treatment. 3) Taylor Anxiety Scale: It was designed to assess level of anxiety.4) Assessment barriers regarding diabetic retinopathy check up. Results: There were also, highly statistical significant differences between pre, post and follow up of implementing the nursing guidelines in most items of knowledge (at P<0.05). There were a highly statistically significant differences were found between pre, post and follow-up of implementing nursing guidelines among diabetic patients with retinopathy and relieve the severity of anxiety (X2 =20.430 P<0.05 and 66.719 P<0.01) respectively. There will be negative relationship between patients' level of anxiety and total knowledge of diabetic patients with retinopathy (r= 0.779 at P<0.01). Conclusion: The implementation of nursing guidelines had a positive effect on knowledge and relives level of anxiety among diabetic patients with retinopathy. Recommendation: - Develop more specialists in counselling services for patients with DR including an emphasis on psychosocial recovery and adaptation.

Abstract:The antenatal period in the life of the pregnant woman is very vital. It needs recognition of gestational diabetes mellitus information that can influence the promotion of their attitude & self-care, consequently, the disease control. The purpose of the study was to assess the effect of nursing intervention on knowledge, attitude and self-care activities among gestational diabetic women. Setting: it was conducted in two MCH centers from Shebin Elkom MCH centers follow Shebin Elkom district, Egypt after random selection using a multistage random technique. Design: a quasi-experimental (pre & post) research design was used. Sample: A purposive sample of 60 pregnant women with controlled gestational diabetes for three months duration were recruited. Study instruments: three instruments were used in this study. a structured interviewing questionnaire which consists of three parts; the second instrument was a Diabetic Attitude Scale-Version 3(DAS-3). The third instrument was a Summary of Self-Care Diabetes Activities (SDSCA) scale. Results: The higher percentage (56.7%) of age among GDW under the study was between 31 years and more. Three quarters (75.0%) of them were not working (households), while three quarters (75%) of them had enough incomes, while 78.3% had family history to diabetes & development of gestational diabetes. Higher percentage of GDW (60%) had polyhydramnios. The total mean score of knowledge pre educational intervention was 20.2±0.4, it improved to become 36.4±5.5 post intervention. There was a highly statistical significant difference between pre& post educational intervention regarding to all attitude scale factors among studied GD women. There was a highly statistical significant relationship between pre-post educational interventions regarding the total and all self-care activities subscales related to gestational diabetes. Conclusion: The educational nursing intervention played positive effect in improving the knowledge, attitude & self-care activities of controlled uncomplicated gestational diabetic women after three months of follow up by correction of their recognition about the disease consequences. Recommendation: awareness program for educating the pregnant women about GDM risk factors, self management activities & complications.

Abstract:This study is being conducted to establish awareness of Renal Cell Carcinoma (RCC), Renal Cancer. For the purpose of this study the researcher used a Qualitative Autobiography Case Study approach to educate, advocate, provide resources and support based on a lived-experience; the researchers’ own experience. Presently, because of the prevalence of Sonography, Computed Tomography (CTs), and Magnetic Resonance Imaging (MRIs); RCC usually can be detected in the early stages (Kuang-Shun, Hsin-Chih, & Ching-Chia, 2013). The researcher’s intent is to educate individuals, by affording them with a description of what RCC is; the lived experience of the subject, kidney staging and grading information, symptoms and causes, and support resources.
Keywords:Renal Cell Carcinoma; Kidney Cancer; Kidney Staging and Grading; Support Resources.
Title:Renal Cell Carcinoma: Raising Awareness through Experience a Survivor’s Autobiography Case Study
Author:Dr. Giselle A. Castillo, PhD, MBA, BSBM
ISSN 2394-7330
International Journal of Novel Research in Healthcare and Nursing
Novelty Journals

Abstract:Nurse's managers who committed to actions that promote their staff autonomy helping them to participate in decisions related to their nursing care activities and providing them with chance to manipulate their right of autonomy. The autonomous nurses are expected to posses higher job satisfaction this in turn leads to good quality of work life. Aim of the study: The study aimed to measure nurse manager' actions conducive to staff nurses' autonomy as experienced by staff nurses and its relation to their quality of nursing work life in critical units at teaching and university hospitals. Design: A descriptive correlation design was used. Subjects: A convinces sample of 122 nurses was recruited from two hospitals (65 from teaching hospital and 57 from university hospital). Setting: The study was conducted at two hospitals in Menofia governorate: teaching and university hospital. Tool: Two tools were used in this study: (1): Nurse Manager’s Actions Scale, (2): The Quality of Nursing Work Life Scale. Results: The highest percentage of the study sample (68.9%) felt that the nurse managers do many actions that encourage their autonomy. The results revealed that the staff nurses in the study sample reported a low quality of nursing work life overall. There was a positive correlation between nurse manager' actions promoting autonomy and staff nurses' quality of nursing work life. Conclusion: From the study findings, nurse managers do actions that promote staff nurses' autonomy which in turn increase their quality of nursing work life. Recommendation: Staff nurses and their managers need to engage in dialogue to determine which manager’ actions are likely to enhance staff nurse autonomy and In-service education programs should do for nurse managers to learn how to apply actions that conductive to autonomy.

Abstract: Adolescents are high risk for the development of problem behaviors that are distressing and socially disruptive that increases the morbidity and mortality rates during adolescence.
The aim of this study was to determine the implementing teaching program for student adolescent about health problems and its effect on academic performance.
Subjects and Method: A quasi experimental research design was used in the study. The study was conducted at Technical Nursing Institute of Tanta University which affiliated to the Ministry of Higher Education and Police Technical Nursing Institute affiliated to the Ministry of Interior at Cairo city.  100 adolescent students who were selected by: a convenience sampling 50 students by simple randomization from the other sitting.
Three tools were used for data collection: structure questionnaire schedule to assess adolescents' demographic data, and knowledge about their risk behaviors, Main Integrated Adolescents Health Problems to assess adolescents' health risk and Grade Point Average to identify the factors that influence the academic performance.
Results showed that there were statistical significant differences among adolescent' sex, residence and BMI and their total health risk behaviors, there was highly statistically significant difference among adolescents' characteristics: age, child rank and body mass index regarding their grade point average.
The study concluded There was highly significant improvement among adolescents regarding to their total health risk behaviors after program implementation and there was highly statistically significant difference among adolescent health risk regarding their academic grades. Programs of multiple health risk behaviors for adolescents by community.
Recommendation: application of health education  program for school health visitor  teachers, family, must be taught the importance of healthy eating, benefits of engaging in physical activity, prevention of violence and tobacco use, ways to manage anger, and how to handle stress

Abstract:Children are at risk from conditions affecting both dental and soft-tissues, dental caries are the commonest in childhood; therefore, these standards considered the guidelines for prevention of dental caries. Prevention requires a multifactorial approach including dietary factors and eating habits, the use of appropriate fluoride therapy, the application of fissure sealants and the implementation of effective oral hygiene.
The aim of this study was to determine nurses' performance related to standards of care for children undergoing dental anesthesia.
Subjects and Method: The study was conducted at Pedodontic Unit, Pediatric Dentistry, Surgery, Oral Medicine and Orthodontics departments at Faculty of Dentistry-Tanta University: A Quasi experimental research design was used. All nurses who working at previous mentioned units were included in this study (35 nurses).
Tools of data collection three tools were used to collect data ; Experts opinion schedule of children undergoing dental anesthesia. Structured questionnaire schedule related to children undergoing dental anesthesia and Nurse's practice observation checklist for implementation the standers of care.
Results showed that, before standard total nurses knowledge scores were poor while as almost of them had good scores immediately after standard application. The total practice scores of the studied nurses related to care provided to children under dental anesthesia before standard were fair. While immediately after standards application, the total practice scores for nurses were good(91.4).
Conclusion: There was statistical significant difference before and after program implementation regarding nurse's knowledge and practice.
Recommendation: were suggested that, Dental nurses should be provided with periodic training to be familiar with the new information about dental anesthesia which used for children through providing them with handout and posters. A manual of nursing care standards for children under dental anesthesia should be available for pediatric dental nurses as guidance for them in deal with children under dental anesthesia and their families.

Abstract: Gait is a fundamental, but complicated activity of everyday life that requires the functional integration of skeletal, muscular, nervous, circulatory, and respiratory systems. The multiple characteristics of age-related variation in age-related performance in elderly adults and this decline are linked with a wide range of health outcomes, making gait health a key target for therapeutic interventions. There are some inconsequent findings in clinical trials about the effects of exercise on the gait of speed. The aim of the current meta-analysis is aimed towards understanding the influence of moderate exercise effects on gait speed in elderly Europeans. Three studies have been selected and included in the present work. A total number of 472 participants were examined. All three articles described the mean difference (MD) for overall effect of exercise interventions on participation. Random-effect mode was used, and increased heterogeneity was estimated between the studies (pq= 0.022, I2= 74%). We found that there was no overall effect of the exercise interventions on participation (MD= -0.12, 95%CI: -1.25 to 1.00, Z= -0.48, p= 0.89). In summary, this review did not show an overall positive effect of exercise on participation in meaningful life roles in older adults. There is a need for development of novel interventions aimed at enhancing this critical aspect of health for older adults.   

Abstract:Child's hospitalization for imperforate anus surgery considered a source of anxiety for the children and the parents that persists for a long time after discharge. Therefore, involving mothers in treatment of their children are extremely required to decrease their anxiety and children's postoperative complications. Aim: The present study aimed to investigate the effect of nursing interventions on reducing postoperative complications among children with imperforate anus and mothers' anxiety. Design: A quasi experimental design [study and control groups], pre / post-tests were used. Setting: This study was carried out at pediatric surgical department and surgery outpatient clinic affiliated to Mansoura University Children's Hospital, Egypt. Sample: A purposive sampling composed of 70 mothers of children with imperforate anus, who were admitted to the previous setting, after fulfilling inclusion criteria. They were divided into 2 equal groups (study and control). Tools: 5 tools were used.1. A structured Interview Questionnaire [Socio-demographic characteristics of mothers and children, surgical history and mothers' knowledge]. 2. Performance Observational Checklists. 3. Postoperative Complications Assessment Questionnaire. 4. State-Trait Anxiety Inventory. 5. Zarit Psychosocial Burden Interview Scale. Results: The present study revealed that, there were high statistical significant differences between both groups (p <0.001) after intervention regarding studied mother's knowledge and practice. In addition, the children in study group have less postoperative complications than those children in control group post intervention. Also, about two third (60.0%) and three quarter (74.3%) respectively of mothers in study group had mild anxiety level post one week and one month, compared to about one quarter (20.0% & 28.6% respectively) of mothers in control group. Also, more than one third (37.1%) and about half (48.5%) of mothers in study group have little or no psychosocial burden level after one week and one month, compared to less than one quarter (14.3% & 20.0% respectively) of mothers in control group. There were statistical significant differences between both groups after intervention. Conclusion: Nursing interventions affected positively on mothers' knowledge, practice, decrease children's postoperative complications and decrease mothers' anxiety, psychosocial burden level. Recommendation: It was suggested replication of this nursing interventions on a larger sample and future research to monitor the long-term postoperative complications.

Abstract:Clinical performance assessment of nursing students represent challenge even for the experienced nursing educators because of subjectivity. Rubric assessmentprovide consistency in evaluation reduces subjectivity and enhances objectivity. Aim of the study: to evaluate the effect of rubric versus traditional clinical assessment on maternity nursing student's self-efficacy and satisfaction. A quasi-experimental research design was used. A purposive sample technique was used to recruit 206nursing students at Maternity and gynecology nursing department at academic year 2015-2016 and 2016-2017. The present study was conducted at antenatal clinical area at Maternity and gynecology nursing department at Faculty of Nursing at Ain Shams University. Three tools of data collection 1st tool was self-administrative questionnaire, 2nd tool was nursing competency self-efficacy scale, and 3rd tool was nursing students' academic satisfaction scale. Results: reveals that there is no statistical significant difference between control group and intervention group regarding their self-efficacy and satisfaction at first trial. While, there is a highly statistical significant difference between control group and intervention group regarding their self-efficacy and satisfaction at second trial. In addition, there is a highly statistical significant improvement on maternity students' self-efficacy and satisfaction after intervention.  Conclusion: Rubric clinical assessment has positive effect on maternity nursing students' self-efficacy, and satisfaction than traditional clinical assessment. Recommendation: application of rubric assessment tool as an integral part of undergraduate nursing students' clinical evaluation system.

Abstract:Ethical leadership and organizational identification are considered the cornerstone for success of any health care setting.  Most nurses look outside themselves to significant others for ethical guidance. Therefore, in the workplace, ethical leaders are considered the central source of ethical guidance. Yet, little empirical research focuses on studying ethical leadership and its relation to the organizational identification.  Aim: This study aims to assess the ethical leadership behavior and organizational identification as perceived by the Critical Care Nurses. Also, assess the relationship between ethical leadership behavior and organizational identification. Methods: A descriptive correlational research design was conducted at the University Hospital.  Results: the result of the present study revealed a positive significant correlation between ethical leadership behavior and organizational identification. Also, approximately 97% of the explained variance of organizational identification is related to ethical leadership behavior. 

Abstract:The aim of this study was to study the application of the four phase teaching method regarding care of the first stage of labour among nursing students and effect on their emotional intelligence. Design: An experimental study. Setting: This study was conducted at two settings; the first one was maternity nursing simulation lab at the faculty of nursing, Mansoura University, the second was labor and delivery unit at Mansoura University Hospital, Egypt. Subjects: One hundred and twenty male and female nursing students enrolled in the midwifery course during 2ndsemester of the academic year 2016-2017.Tools: An interviewing questionnaire schedule, Bar-On Emotional Intelligence Quotient Inventory, Student satisfaction and Self-Confidence in Learning Instrument. Results: The present study results revealed that, post intervention the mean scores of emotional intelligence had a highly statistically significant improvement among the intervention group compared to control group. Additionally, the students of the intervention group had a significant higher score of all items of satisfaction& self-confidence in learning compared to control group. It was observed that there was significant correlation between emotional intelligence and satisfaction and self-confidence scores among intervention group. Finally, there was a positive significant correlation between satisfaction and self-confidence scores in both groups. Conclusion: The present study results showed that the student's satisfaction and self-confidence were statistically significant higher among intervention group than the control group. It pointed out, our attention that four phase teaching method was highly significantly more effective than clinical training regarding student's emotional intelligence related to care of the first stage of labour. Recommendation: Integration a four phase teaching method in obstetrics and gynecology nursing curriculum.

Abstract:P53, also known as tumor suppressor is guard or gatekeeper of the cell and genome. It protects the cells from any type of stress by DNA repair or apoptosis or cell cycle arrest thus maintaining normal homeostasis. But in certain circumstances, there occurs overexpression or mutation of P53, resulting in disruption on normal cellular mechanism and disturbance of homeostasis causing the cells to grow unexpectedly. Overexpression of P53 is mostly encountered in advanced stage of tumors. Among the mutant verities, missense mutation is commonly encountered. Esophageal carcinoma is one of them which results from either overexpression or due to mutation of P53. Serum P53 antibody can be detected from patients with esophageal carcinoma. P53 directed therapy has shown good results in patients with esophageal carcinoma. So P53 represents an important biomarker and thus has clear association with esophageal carcinoma.

Abstract:Reflexology is basically a study of how one part of the human body relates to another part of the body. Reflexology practitioners rely on the reflexes map of the feet and hands to all the internal organs and other human body parts. They believe that by applying the appropriate pressure and massage certain spots on the feet and hands, all other body parts could be energized and rejuvenated. Due to its non-invasive, non-pharmacological complementary nature, reflexology is widely accepted and anecdotal evidence of positive effect reflexology in a variety of health conditions are available. Adequate training for practitioners is necessary to ensure the consistency of service provided.

Abstract:Sleep disturbances are distinctly more common in pregnant women. Sleep in the pregnant women progressively worsened for example, the risk of insomnia is estimated to be 2.03 times higher in later compared to earlier pregnancy as measured by the insomnia severity index. Aim of the study to identify the relationship between quality of sleep and pregnancy outcomes among primipara. Material: Research design: A descriptive research design was utilized in this study. Setting: The study was conducted at the labor unit of El-Shatby Maternity University hospital in Alexandria. Subjects: A Convenience sample of 300 pregnant women attending the previously mentioned setting was included in the study Tools: Three tools were used to collect the necessary data. Tool (I): pregnant woman Basic data interview schedule was included two main parts: first part: socio demographic characteristics (age, education, marital status, occupation, income, residence, age at marriage), second part: women’s profile of current pregnancy (whether it was planned or not, weeks of gestation, number of antenatal visit, accompanying pregnancy of symptoms). Tool (II): Pittsburgh Sleep Quality Index (PSQI) and Tool (III): Maternal & Fetal Outcome Observational Checklist. Results: about two thirds (67.7%) of study subjects reported no difficulty during sleep. As much as 31.3% of them had mild difficulty compared to only 1.3% who had severe sleep difficulty. Conclusion: It was concluded that a significant association between sleep difficulties some of socio-demographic, maternal and newborn related factors was evident. Such as low level of education, maternal distress, fetal distress, low APAGR as well as neonatal measurements. Recommendation(s): it was recommended that sleep quality during pregnancy and its associated factors are suggested to be included in maternity curricula at the related educational settings.