Background: anticoagulants are high-risk drugs so it is very important to monitor the patients receiving anti-coagulant therapy. Aim: assess the nurses' performance regarding caring of patients on anticoagulant therapy in Port Said Hospitals. Subjects and Method: a descriptive research design was used A convenient sample of 130 nurses at three hospitals affiliated to Ministry of Health (Port-Said General Hospital, Port-Fouad General Hospital and El-Zohor Central Hospital) at Port-Said governerate were recruited. Tools: data were collected using three tools, nurses' knowledge assessment questionnaire, nurses' attitude scale and observational checklist for practice. Results: the result of study indicated that 66.9% of studied nurses had got unsatisfactory knowledge and 69.2% of them had got unsatisfactory practice while 60.8% of them had positive attitude regarding anticoagulant therapy. Conclusion: the study concluded that more than two thirds of the studied nurses had unsatisfactory knowledge, practice and less two thirds of them had positive attitude regarding caring of patients on anticoagulant therapy and there were a highly statistically significant positive correlation between total nurses' knowledge, practice scores and their total attitude scores .In addition, there is no statistically significant relations between total score of nurses' knowledge, practice, and attitude and all items of personal characteristics and work related data. Recommendations: There are obvious needs for conducting educational and training programs to improve nurses' knowledge and practice regarding the care of patients undergoing anticoagulant therapy.

Background: Pulmonary embolism is the third commonest cause of cardiovascular death after coronary artery disease and stroke .Preventing thrombus formation is a major nursing role. Therefore, the best management of pulmonary embolism is through prevention of risk factors. Aim: Assess nurses' performance regarding preventive measures of pulmonary embolism. Subjects and Method: A descriptive research design was used. Setting: The study was conducted in surgical department, orthopedic department and intensive care unit at Port-Said general hospital, Port-Fouad general hospital, and Elzohour hospital. Subjects: A convenient sample of 90 nurses were participate in the study Tools: Data were collected using three tools, Nurses' Knowledge questionnaire, observational check list for nurses' practice and Nurses 'attitude scale. Results: The result of study indicated that 71.1% of studied nurses had unsatisfactory knowledge, 62.2% had unsatisfactory practice and 74.4% had positive attitude regarding preventive measures of pulmonary embolism Conclusion:. The studied nurses had unsatisfactory level of knowledge and practice, but, remarkable positive attitude was observed regard the preventative measures of pulmonary embolism. Also there was statistical significant correlation between nurses' knowledge and practice .Recommendations: There are obvious needs for conducted an in service educational and training programs to improve nurses' performance regarding preventive measures of pulmonary embolism.

Background: Amongst the quality initiatives adopted in healthcare, accreditation has increasingly been considered as the preferred method to promote healthcare quality at organizational and service levels. Nurses have key roles to play in the implementation of hospital accreditation process. This study aimed to identify factors affecting implementation of nursing services accreditation standards in Port Said general hospitals. A descriptive exploratory research design was utilized for the current study. A sample of 105 from different categories of nursing staff was i n c l u d e d in the study. Data were collected through utilizing Awareness about hospital accreditation standards questionnaire and factors affecting the implementation of nursing services accreditation standards questionnaire Results of the study showed that more than one third of studied nursing staff had high awareness score about hospital accreditation while less than half of them had moderate awareness score , in addition nursing staff awareness for such aspects of accreditation (Preparation-Outcomes-Prerequisites) was generally high. Continuous improvement was the highest factor affecting implementation of nursing services accreditation standards (NSAS) in Port Said general hospitals while financial incentives was the lowest from studied nursing staff point of view. It was concluded that : There was statistically significant relation between studied nurses' total awareness about hospital accreditation and their total opinion regarding factors affecting implementation of (NSAS).The current study recommended that establishing systems, protocols, policies and strategy to enhance nursing staff perception about quality and accreditation

Background: Burn injury is often a devastating event with long-term physical and psychosocial effects. It can result in multiple psychological sequelae.Aim: The aim of the current study was to investigate the relationship between self-efficacy and psychological status among hospitalized burned patients.Subject and Methods :the research design A descriptive correlation design was adopted in the current study. Setting: The study was carried out in burn units at Port-Said general hospital, Port-Said, Egypt. Convenient sample of 92 adult burned patients were recruited to participate in this study. Two tools are used for data collection were: the Depression Anxiety Stress Scale (DASS) and General Self-Efficacy Scale (GSE),Result: The results of the current study revealed that Psychological impairment was found to be sever and more than half of studied patients at the anxiety, depression and stress. Self-Efficacy was low in about half of burned patients. There were negative correlation between Self-Efficacy and depression and stress but positive correlation with anxiety.Conclusion The study was concluded that there is a significant relation between stress as well as depression and anatomical site of burn, especially in the upper limb. As well as there was a significant relation found between General Self-Efficacy and patient's age. Recommendations: The importance of early psychological intervention to reduce the complications to recognize and treat pre-existing impairments to reduce the complications of long-term remedy.

Background Selective groups of patients, presenting with INTERMACS-1 cardiogenic shock due to acute ischaemic heart failure, may benefit from mechanical circulatory support (MCS). Patients with biventricular failure, severe septic shock or oxygenation problems should be selected for VA-ECMO, although the left Impella-CP heart pump can be considered as a less invasive alternative in supporting predominantly left ventricular failure. Bleeding issues are a major concern in patients on MCS, especially in this group where triple anticoagulation therapy (unfractionated heparin (UFH) for prevention of pump thrombosis and dual antiplatelet therapy (DAPT) after coronary stenting) is necessitated. We aim to investigate the bleeding and transfusion rate in DAPT-patients on VA-ECMO versus Impella. Methods We report single center data for 51 VA-ECMO and 8 Impella patients between 2011 and 2019. Indication for MCS was acute ischaemic cardiogenic shock. Patient demographics, transfusions and reported/radiographically diagnosed bleeding (BARC-classification) complications were analyzed. All patients received UFH and low dose aspirin plus clopidogrel or ticagrelor. Impella flow was at least 2.5 L/min. Transfusion targets were Hb >7 g/dl, fibrinogen >100 mg/dl (or >150 mg/dl when active bleeding) and platelet count >50/fL. Results Impella patients were significantly older (VA-ECMO 52.8 vs. Impella 62.4; p=0.02) as compared to the VA-ECMO group. Anti-Xa-levels and length of the MCS-run (mean 7.9 VA-ECMO vs. 6.4 days Impella) were comparable in both groups. Occurrences of minor bleeds was comparable between both groups (mainly oozing from the insertion site in the ImpellaTM group 63% vs. VA-ECMO 72%; p>0.05) but major bleedings with BARC score of 3 or more were significantly lower in the Impella group (13% vs. VA-ECMO 65%; p=0.005). Platelet and red blood cell transfusions were significantly lower in the Impella group (0.1 units of platelets per day vs. 1.1 units of platelets per day on VA-ECMO; p=0.002 and 0.8 units of RBCs per day vs. 2.6 units of RBCs per day on VA-ECMO; p=0.02). Bleeding/transfusion VA-ECMO vs Impella Conclusions Bleeding is a frequent complication of MCS. However, in our cohort, triple anticoagulation in acute cardiogenic shock due to ischaemic left ventricle failure resulted in a lower major bleeding rate when support was given by the left Impella device as compared with VA-ECMO therapy group. As a result, platelet and red blood cell transfusions were lower in the Impella group. These findings are likely to be partly explained by the increased number and size of cannulas in VA-ECMO, as well as the increased risk of haemolysis and consumptive coagulopathy due to the complexity and extensive foreign body surface of the ECMO-circuit. We conclude that Impella support should be considered as a safer option than VA-ECMO with regards to bleeding in patients with ischaemic left ventricular failure who require DAPT and MCS as a bridge to recovery or other definitive therapy.