Abstract:Introduction: Enteral nutrition is the preferred feeding method for those patients with normal functioning gastrointestinal tracts (5)

Chronic disease management is the key target in many healthcare systems for adult patients. Patients' in-dependability is a crucial aspect to deal effectively with such diseases, especially, Congestive Heart Failure (CHF) as an epidemic chronic illness in Egypt. Zone tool as a health education strategy can be a magic self-care tool for such patients, which includes the necessary health care instructions and guidance for CHF. Thus, this study aims to investigate the effect of instructions by zone tool on self-care and quality of life among patients with congestive heart failure. An exploratory descriptive design followed by pre-post quasi-experimental design was employed, at the three medical sections of Gamal Abedel Nasser Health Insurance Hospital in Alexandria, Egypt. A convenient sample of 256 patients with CHF was recruited as a survey group and experimental group. Two tools were used: Heart Failure Self Care Management Questionnaire (HFSCMQ) and the Minnesota Living with Heart Failure Questionnaire. The findings of the survey group showed that there was insufficient self-care management as reported by CHF patients, including self-care' maintenance, management, and confidence elements. In addition to, they perceived lack in their quality of life (QOL). The findings of the experimental group denoted an improvement of CHF patients' perceptions about self-care management and its elements and their QOL before and after using of the developed zone tool, in the second and third assessments. This result proved that the instructional intervention using zone tool was an effective self-learning reference among Egyptian CHF patients. Conclusion and recommendations, health education tools as teaching strategies for CHF patients, are a crucial nursing activity to encourage CHF patient' self-care management and enhance their QOL at all. Zone tool is an effective strategy to be used with CHF patients in Egypt. Further studies are studies about; the relationship between CHF patients' health literacy and their adherence with their treatment, and, the effect of electronic health education material on CHF patients' self-care management, satisfaction, QOL and self-efficacy.

Background: Simulation education is a bridge between classroom learning and real-life clinical experience. It helps in nursing competency before engaging in real situation with the patients to enhance patient safety. Methods: This study was quasi experimental design which utilized one group pretest posttest design. Results: the findings of current study showed better knowledge, practice, and satisfaction of nursing students after Simulated education than pre-education. Conclusion: Simulated education was effective in improving knowledge, satisfaction and enhancing competency of nursing students.