Background: Utilization of a multidisciplinary clinical pathway during care of women undergoing hysterectomy is considered to be more effective during women' management than routine hospital care.Aim: This study was conducted to investigate the effect of clinical pathway of postoperative nursing care on improving postoperative outcomesfor women undergoing hysterectomy. Design: A quasi experimental design (study and control group). Settings: The gynecology and obstetrics departments at two hospitals affiliated to University Hospital and Shebin El-Kom teaching hospital, Menoufia Governorate. Subjects: 100 women who are undergoing hysterectomywere selected. Tools: three instruments were used for data collection;a structured interviewing, numeric pain intensity scaleandpatient satisfaction record.Results: The current study shows that women underwent hysterectomy in the study group were significantly more likely to experience less mean pain score, lesser need for analgesiaand Significant differences in the length of stay were observed compared to those in the control group.Significant differences in the early oral intake, postoperative bowel mobility and need to antiemetic drugswere observed between the study and the control groups. Concerning women's satisfaction related to the care provided,the score given was mostly satisfied and neutral. Conclusion: application of clinical pathway improving postoperative pain successfully, short length of stay postoperative outcomes related to early ambulation, early oral intake, and bowel mobility, hours to remove catheters and drains and patient satisfaction. Recommendation: Sit is recommended to generalize application of clinical pathways in other clinical areas to improve patient outcomes and reduce postoperative complications.

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Background:The gynecological examination is an essential part and the most performed procedure in gynecological care, that the maternity nurses play a vital role during it. Aim: was to assess the effect of gynecological examination educational guidelines on maternity nurses' knowledge, practices and explore the women's satisfaction. Methodology: A quasi-experimental design was utilized for all nursemidwife working at Al-Azhar university hospital, and El Zarka Central Hospital in Damietta Governorate. A total of 40 nurses were recruited in the study and attended the educational program. A total of 120 women were recruited to explore their Satisfaction regarding gynecological examination care. Three tools were utilized for data collection first, structured interviewing questionnaire, observational checklist, and women's' satisfaction assessment tool. The Results revealed that: the nurses mean age was 30.7 ± 3.10 . post-intervention most of maternity nurses 87.5% had correct knowledge about gynecological examinations, 85% of them had satisfactory care about gynecological examinations. Almost all studied women 95% were satisfied with nursing care post-intervention Conclusion: The implemented educational guideline had a positive effect as it improves the nurses' knowledge and practice about gynecological examinations which inturn women were satisfied regarding care provided during gynecological examination. Recommendations: A training guideline regarding gynecological examination must be recommended for all nurses working at obstetric and gynecological units to improve the quality of care given to women. Also, further research to examine teaching vulvar self-examination and its implication for women at reproductive age.

Background: COVID 19 is a pandemic viral infection around the world. Starting in Wuhan citychina at December 2019.Egypt was affected by this viral infection at February 2020. Pregnant women are worried about infection during pregnancy and its outcome for morher and newborn. Study design: A quasi-experimental design one group pre/posttest, Setting: Obstetrics and Gynecologic Clinics in governmental hospitals and private clinics at Ismailia city. Four tools were used to collect data in the current study, as the following:1 st Tool: Self-Administered Online Questionnaire: included socio demographic data, past/ current obstetrical history and knowledge assessment,.2 nd Tool: Reported practice Check list, 3 rd Tool: Maternal and Neonatal Outcomes Record, 4 th Tool: Breast Feeding Record: assessed during 1 st , 5 days and 14 th days after delivery. Results: the mean age of the studied women 26.250 ± 4.817 years. 50% of the studied women had Bachelor education.76.9% of the studied women were housewives. Maternal Knowledge and practice were improved with highly statistical significant differences (p=0.000). maternal and neonatal outcomes were improved Limitation: restricted sample size because of 2 nd wave started with new manifestation. Conclusion: Pregnant women who received the guidelines regarding COVID-19 precautions had satisfactory knowledge & practice. They had a positive maternal& neonatal outcome. Recommendations: Application of guidelines at Maternal Child Health (MCH) Centers in early pregnancy to avoid other waves of COVID 19.

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