Background: External skeletal fixator is an important aspect of fracture management. Patients with external fixation device have limited activity of daily livings and often have negative effects on their self-care abilities. The aim of the study: Was to evaluate the effectiveness of nursing guidelines regarding self-care strategies for patients with external skeletal fixation. Research design: Quasi experimental research design was used to conduct the aim of this study. Setting: The study was conducted in the orthopedic department and outpatient clinics for orthopedics affiliated to Benha University Hospital, Benha, Egypt. Sample: Convenience sample of all available patients were taken from both sexes , their age ranged from 20 to 60 years old during six months (n= 55). Tools: Three tools were used; (1) Patients' interviewing questionnaire (2) Barthel Index (3) Pain assessment scale. Results: There were high statistically significance regarding the overall knowledge about the skeletal system , fracture , orthopedic fixator and self-care at pre and post implementation of guidelines, there were highly statistical differences of patients' reported practice regarding external skeletal fixation, there was positive improvement regarding patients' independency in activities of daily living and also, self-care improved significantly after applying of guidelines. Finally there were statistically significant differences regarding all items of pain assessment between pre, immediate, and one moth post guidelines implementation. Conclusion: The mean patients' knowledge and practice scores after implementation of nursing guidelines were higher than as compared to before regarding self-care strategies for patients with external skeletal fixation. Recommendations: Ongoing educational and training programs are needed for patients with external fixation regarding self-care strategies to reduce and prevent complications and apply the program on large sample selected from orthopedic department

Back ground: Evidence based guidelines after bone marrow transplantation provides nurses with the scientific research to make well-founded decisions and reduce expected complications. Aim of the study: Was to evaluate the effect of evidence based guidelines on nurses' performance to reduce complications for patients after bone marrow transplantation. Research design: Quasi experimental design was utilized. Sample: Convenient sample of all nurses (60) from both sexes who had working in bone marrow transplantation units in Tanta Educational Hospital, and Dar El Salam Cancer Center in Masr Al-Qadimah (Harmel Specialized Hospital previously) and a purposive sample of 30 adult patients from both sexes post-transplant phase were included in the study during nine months. Tools: Three tools were used, I: Structured questionnaire for nurses, II: Nurse's performance observational checklist for BMT patient and III: Patient's assessment sheet. Results: There was positive correlation between knowledge and practice at pre, post and follow up implementation of the guidelines and there was a positive correlation between total nurses' knowledge, practice and patients' early and late complications at post implementation of evidence based guidelines. Conclusion: Implementation of evidence based guidelines has appositive effect in improving nurses' knowledge and practice regarding care of patients undergoing bone marrow transplantation and reducing patients' complications. Recommendations: Evidence based guidelines regarding bone marrow transplantation should be revised periodically and be available in all hospitals in both Arabic and English language.

Background: Tracheal intubation constitutes the most commonly performed procedure in the intensive care units and is often lifesaving. In contrast to the high incidence of life-threatening complications that can be avoided by nursing care. Evidence based practice help critical care nurses to apply procedures safely for critically ill patients. Aim: To evaluate the effect of evidence based program on critical care nurses' performance related to care for intubated patients. Method: A quasiexperimental, pre-test and post-test intervention research design was implemented to conduct the current study. The study was conducted in the general intensive care unit at

Background: Breast cancer related lymphedema is the most common serious complication resulting from breast cancer treatments that augment the incidence of lymphedema post mastectomy. Aim: To evaluate the effect of nursing program on patient's knowledge and selfcare strategies regarding lymphedema prevention post mastectomy. Design: A quasi-experimental, pretest and post-test intervention study design was implemented to achieve the aim of the current study. Setting: The study was conducted in general surgery department and oncology department affiliated to Benha University Hospital, Qalyubia Governorate, Egypt. Sample: A purposive sample consisting of 60 women post-mastectomy participated in the current study. Tools: Tool ( 1) Post mastectomy patients' assessment interview questionnaire: It includes three parts: Part (I) Patients' personal data, Part (II) Patients' medical and surgical data, and Part (III) Patients' knowledge assessment. Tool (II): Part (I) Patients' self-care strategies observational checklist (applied pre/post program implementation), Part (II) Self-reported instructions for arm lymphedema prevention. Tool (III): Patients' lymphedema assessment scale: It include three parts: Part (I) Assessment presence of lymphedema & numerical pain scale, Part (II) Arm girth measurement scale and Part (III) the upper extremity functional index.Results: One third of study patients had acute lymphedema immediately post mastectomy and there was positive correlation between patients' overall variables and their self-reported instructions for lymphedema prevention pre as well as post program implementation and before and after mastectomy also at follow-up of program in 2 weeks, 3 months, and 6 months. Conclusion: Overall, most of study patients didn't develop breast cancer related lymphedema by 3 months and 6 months follow up after implementation of self-care educational program. Moreover, there was a highly statistically significant difference of studied patients' total knowledge, learned exercises and self-reported instructions post implementation of educational program. Recommendations: The study should be replicated on a large sample size at different settings in Egypt to generalize the results.

Background: Pressure ulcers remain a common problem in hospitals and the community. It is more common among immobilized patients and is often related to the high incidence of lifethreatening complications that can be avoided by nursing care. Aim of study: Was to evaluate effect of an educational program on nurses' performance regarding reducing pressure ulcer and safety of immobilized patients. Research design: A quasi-experimental, pre-test and post-test intervention study design was implemented to achieve the aim of the current study. Setting: The study was conducted at the orthopedic department in Benha University Hospital, Qalyubia Governorate, Egypt. Sample: A convenient sample consisting of 50 nurses of both gender who assigned caring the immobilized patients and a purposive sample consisting of 80 patients. Tools of data collection: Four tools were used to collect data; I: Interview questionnaire. II: Observational check list for nurses' practice. III: Braden Scale and IV: Patient's assessment questionnaire. Results: Total knowledge level and total practice level mean scores immediate post and after one month follow up of the program implementation were higher statistically significant than preprogram. There was a marked decreased (improved) in total Braden scale post implementation of program, implementation of educational program was very effective in reducing pressure ulcer which was best predicted by patients' age, weight, chronic disease, and length of hospital stay. Conclusion: Application of the educational program is highly effective in improving (knowledge and practice) regarding reducing of pressure ulcer and safety of immobilized orthopedic patient, which supported the study hypotheses. Recommendations: Provide continuous education and training sessions for nurses caring for immobilized patient to improve their knowledge and practice about pressure ulcer prevention.

Background: Nephrolithotripsy is a non-invasive kidney stone treatment procedure which breaks the stones into small fragments. Education about nephrolithotripsy helps patients gain best performance (knowledge, practice and behavior) to meet ongoing health care needs. Aim of study: Was to evaluate the effect of educational guidelines prior nephrolithotripsy on patients' performance and satisfaction. Research design: A quasi-experimental, pre-test and post-test intervention research design was implemented to conduct the current study. Setting: The study was conducted at

Background: Post thoracic surgery patients are often related to the high incidence of lifethreatening pulmonary complications that can be avoided by a variety of pulmonary care techniques. Aim: Was to evaluate the effect of evidence-based nursing program on post thoracic surgery patients' health outcomes regarding pulmonary care. Study design: A quasi-experimental, pre-test and post-test intervention study design was implemented to achieve the aim of the current study. Setting: The study was conducted in chest department and cardiothoracic surgery intensive care unit at Benha University Hospital affiliated to Qalyubia Governorate, Egypt. Subjects: A purposive sample of sixty patients with chest diseases planned for thoracic surgeries selected from the previously mentioned settings over a period of nine months of data collection. Tools: Data were collected using three tools, (I) Patient's interview schedule questionnaire, (II) Pulmonary care technique observational checklist pre/post pulmonary care intervention, (III) Patients' health outcomes assessment. Results: Total knowledge level and total practice level mean scores post evidence-based nursing program implementation were higher statistically significant than preprogram. There was highly significant difference between pre and post program implementation concerning patients' health outcomes including all pulmonary function test variables, respiratory rate, heart rate, systolic blood pressure, as well as PH, PaO2 and SO2. Conclusion: Patients' knowledge and practice had been significantly improved post program implementation which reflects that early post-operative pulmonary care following thoracic surgeries was effective in reducing the risk of post-operative pulmonary complications and had a positive impact on patients' health outcomes with high statistically significance differences as (p=<0.05). Recommendations: Upgrading cardiothoracic nurses' knowledge and practice regarding to chest physiotherapy through continuous attending in-service training programs and workshops to improve the standard of nursing care given to post thoracic surgery patients.

Background: Retinal detachment describes an emergency situation in which a thin layer of tissue (the retina) at the back of the eye pulls away from its normal position. Retinal detachment separates the retinal cells from the layer of blood vessels that provides oxygen and nourishment. The longer retinal detachment left untreated, the greater the risk of permanent vision loss in the affected eye. Aim: The study aimed to evaluate the effect of an educational program for patients after retinal detachment surgery on their performance and postoperative pain management. Methods: The following hypotheses were formulated to achieve the study aim. H1: Performance of the study group will be improved post program implementation than the control group. H2: The study group will be able to manage pain post program implementation than the control group. H3: There will be significant correlation between patients' performance and pain management post program implementation for the study group. A quasi-experimental research design was utilized to conduct the current study in the ophthalmology department at Benha University Hospital. A purposive sample of (100) adult patients post retinal detachment surgery were included in this study. Three tools were used, the patients' knowledge assessment questionnaire, the patients' practice observational checklist regarding eye care and visual pain analogue scale to assess pain severity. Results: This study shows that most patients had an unsatisfactory level of total knowledge and inadequate total practice regarding the postoperative pain management after retinal detachment surgery pre-program implementation (68% and 76%). This result improved significantly regarding all knowledge and practice elements post-program implementation, where the majority of the patients had a satisfactory level of their total knowledge and adequate total practice (78% and 75%). Conclusion: The majority of the studied patients had an unsatisfactory performance level (knowledge and practice) concerning postoperative pain management after retinal detachment surgery preprogram implementation. In contrast, most of the studied patients had statistically significant improvement in their performance post program implementation. Also, there was a significant positive correlation between patients' performance and pain management post program implementation that supports the research hypotheses. The study recommended continuous in-service training programs and repeating the study on a high probability sample to achieve generalization of the findings.