Enhanced recovery after surgery is a standardized, multidisciplinary approach for caring patients with a goal of decreasing length of hospital stay and care without negatively affecting patient outcomes. Aim: to investigate the impact of enhanced recovery pathway application outcomes on nurses and women undergoing cesarean section. Design: A quasi experimental (pre-posttest for maternity nurses and study/control groups for women undergoing cesarean section) design was utilized in this study. Settings: This study was conducted at the obstetrics departments affiliated to University Hospital and Shebin El-Kom teaching hospital, Menoufia Governorate, Egypt. Sample: A convenient sample of 50 maternity nurses worked in the previous settings and a purposive sample of 250 cesarean delivery women were recruited in this study. Instruments: for collecting data; a structured interviewing questionnaire, knowledge assessment & an observational checklist for the nurses, knowledge assessment instrument, an observational checklist and numeric pain intensity scale for the mothers were used. Results: There was an increase in total knowledge and practice scores of the maternity nurses regarding the enhanced recovery pathway application. Also, its application following CS had an effect on relieving the women's postoperative problems especially pain than those who received the routine hospitals nursing care only.Conclusion: application of enhanced recovery pathway significantly reduces the postoperative complications especially pain, length of hospital stay, and improves the maternity nurses' knowledge and practice scores post caesarean . Recommendation: Enhanced recovery pathway should be applied during cesarean section operations to improve the patients' outcomes and reduce the postoperative complications.

Background: Breast engorgement is a common problem among postnatal women worldwide, some of whom use warm compresses to promote vasodilatation, improve circulation, and promote the amount of milk produced by the breasts. Conversely, the application of chilled cabbage leaves can reduce pain, the firmness of the engorged breasts, and prolong breastfeeding duration.Purpose: To examine the effect of warm compresses application as compared to chilled cabbage leaves for relieving breast engorgement and pain.Methods: Setting: The study was carried out at a postnatal ward and outpatient clinic at two hospitals in Menoufia Governorate, Egypt. Sampling: simple randomization technique was used to divide 100 post-natal women into two groups who received intervention with warm compresses (Group 1) and chilled cabbage leaves (Group 2). Instruments: Instrument I: interviewing questionnaire; Instrument II: six-points breast engorgement scale; and Instrument III: visual analog scale (VAS).Results: There was a highly statistically significant difference and improvement in terms of reduced engorgement and pain degree for both groups, with greater improvement was observed in Group 2 when compared to Group 1.Conclusions: Chilled cabbage leaves are effective in the treatment of breast engorgement and pain than warm compresses.Recommendations: The mothers should be advised to use chilled cabbage leaves as a home remedy to minimize breast engorment and promote comfort, further studies are recommended in this area in order to expand the evidence based approaches on management of breast engorgement.

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