Background Caring for critically ill patients with chest drain is an essential part of nursing practice, especially for those nurses who care for patients with complicated respiratory problems or undergo cardiothoracic surgery.Aim This study aims to assess the effect of an educational guideline on nurses' performance caring for critically ill patients with digital chest drainage system.Methods A quasi experimental design was utilized. At cardiac intensive care unit & chest intensive care unit which affiliated to Ain Shams University Hospital at Cairo - Egypt. A purposive sample of 50 nurses caring for patients with digital chest drainage system in the previously mentioned units were be recruited in the current study. Two tools were used to collect data related to achieve the aim of the present study as following I-Nurses’ knowledge self-administered questionnaire and II-nurses' practice observational checklist.Results Most of nurses had total unsatisfactory level of performance regarding caring for critically ill patients with digital chest drainage system pre the educational guideline implementation. Meanwhile the majority of the study sample had statistically significant improvement in their performance post the educational guideline implementation. While this improvement lowered slightly post 3 months at follow up.Conclusion The educational guideline for nurses was effective in improving their performance regarding caring for critically ill patients with digital chest drainage system. Recommendations: Conducting periodic in-service training advanced care programs for nurses help in improving their performance and quality of care that provided to critically ill patients with digital chest drainage system.
Background: Subcutaneous enoxaparin administration often causes problems such as pain; bruise and hematoma at the injection sites. In terms of these problems, cold application has been found to have various therapeutic benefits as relieve pain by produce localized anesthetic effect and controls bleeding by causing vasoconstriction. Aim of the study: To investigate the effect of cold application on local problems among patients receiving subcutaneous enoxaparin. Design: Selfcontrolled trial design was utilized. Setting: The study was carried out in general surgery department, orthopedic surgery department, and chest Intensive Care Unit at Beni-seuf University Hospital. Study subjects: A purposive sample of 60 patients was included in the study. Data collection tools: Data were obtained through Patient assessment tool, Bruising Category Scale, Visual Analogue Scale for pain and Hematoma Formation Scale. Results: All studied patients had pain and more than half developed bruise at injection site when they received enoxaparin without cold application but more than three quarter of studied patients had pain and less than one quarter developed bruise when they received injection with cold application. Meanwhile, the majority of the studied patient did not develop hematoma whether cold applied at injection site or not. Conclusion:The pre-injection cold application at enoxaparin injection site was effective in reducing the occurrence of pain and bruising. Moreover, there was statistically significant relation between the patients' pain intensity, the size of bruising and their demographic characteristics; age and gender. Recommendations: Cold application should be included in standard protocol for the administration of SC enoxaparin and providing on-going and regular in-service educational programs about it for nurses.
Context: Positioning is one of the most frequently performed nursing activities in the critical care unit. It is often providing a central pivotal focus for planning other nursing activities. Therapeutic positioning of the patient's head, different degrees of the head of the bed elevation has been suggested as a low-cost and simple approach to preventing secondary brain injury. Aim: determine the effect of body position on oxygenation and hemodynamic status among patients with traumatic brain injury. Methods: Quasi-experiments (single group pre/posttest design). The study was conducted in the Critical Care Units in El-Mansoura general hospital at El-Mansoura city. A purposive sample of (67) adult patients diagnosed with traumatic brain injuries was recruited in this study. A structured socio-demographic interview questionnaire, patients’ medical records to elicit clinical variables and record cardiorespiratory assessment findings, Glasgow Coma Scale, and Richmond Agitation Sedation Scale were used to either include or exclude the patient according to the study criteria. Results: There was a significant increase in oxygen saturation in post right lateral position from (94.93 ± 1.25 to 95.37 ± 1.17) and the semi fowler position from (95.37 ± 1.17 to 97.31 ± 11.13) compared to pre-positioning. The hemodynamic parameters (heart rate, respiratory rate, systolic blood pressure, diastolic blood pressure, and mean arterial pressure) were significantly decreased in the post-semi-fowler position and then right lateral position compared to pre. Besides, the CVP is significantly increased in the semi-fowler position. Conclusion: Oxygen saturation and all hemodynamic parameters were significantly improved compared to their normal range in post-semi-fowler position, then right lateral position. Develop nursing practice protocol for critical care nurses to position patients at the semi-fowler position after traumatic brain injury can improve oxygenation and hemodynamic parameters. Moreover, further studies should be carried out to assess the effect of other body positions in other medical conditions.
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