Sleep disturbance among hospitalized patients has many factors especially at critical care units. Daily breathing exercises as pursed lip breathing (PLB) and diaphragmatic breathing improves sleep quality and reduces the occurrence of delirium. Aim of the study Evaluate the effectiveness of using breathing exercise on sleep quality among hospitalized patients. Design quasi experimental design. Sample A purposive sample including 152 patients were divided into four equal groups two from the Medical ward (study and control) 38 patients each group and two form the Medical Intensive Care Unit (MICU) (study and control) 38 each group at Minia university hospital. Results majority of the groups were male; all patients were in the middle age. (39% and 44.7%) of the medical ward groups (study and control) and (52.6% and 44.7%) respectively of the MICU groups had sever sleep problem. But after applying breathing exercise for 3 continuous days, the study groups (44.7%) of the medical ward and (50%) of the MICU had great sleep quality. Majority of study group's patients at the medical ward and MICU had no Confusion," with percentage (60.5% and 52.6%) respectively which mean no presence of delirium. Conclusion breathing exercise had significance effect on improving sleeping quality and reduce the occurrence of delirium among the study groups than the control groups.

Background: Meningitis is defining the patients as having inflammation of the meninges with a continuous fever. The triage nurse must be fully aware of the signs and symptoms of the disease and refer the patient immediately to the emergency room physician. The aim of this study was carried out to evaluate the effect of teaching program about nursing care of acute meningitis on nurse's performance at emergency units. Subjects and method, A quasiexperimental research design was used to conduct this study at the emergency unit at assiut university hospital Sample All available of nurses (30 nurses). Results: The results of the study present that the effectiveness of teaching program regarding nurses knowledge toward acute meningitis is a positive in post-test of teaching program.(knowledge at pre program is15.5%.However, knowledge at post program become 48.5%. Practice at pre program is8.6%.However, Practice at post program become 23.7%). Conclusion: The majority of nurses had satisfactory knowledge and skills toward acute meningitis after applying of teaching program more than before implementation of program with statistical significant differences between pre-post teaching program. Recommendation: The study recommended that the latest guidelines of acute meningitis should be available in written format in critical and emergency units.

Introduction: Application of nursing guideline of closed suction system had a positive affection critically patient's outcomes, took shorter time and is more economical. Aim of study: was to evaluate the effect of nursing guidelines on patient's outcomes regarding closed suction at intensive care unit. Design: Quasi-experimental research design. Setting, the study was conducted in pediatric intensive care unit at Assuit University hospital. Sample purpose sample 60 critically ill patient's were included in the study. There are categorized into two groups connected with mechanical ventilation who used closed suction from both sex study and control group (30 in each). Tools: three tools developed by the research after review of literatures to assess the patient condition to form baseline data these tool comprised Tool I-patient assessment, tool II-suction assessment, and tool III-outcomes patient tool. Results: The results of the study showed that the effectiveness of nursing guidelines of closed suction system is positive and clear. There was a good improvement of patient's status, the findings of the current study revealed there was significant difference between study and control group regarding to respiratory infection (10) Verus (20), the findings of the current study revealed there was significant difference between study and control group regarding to mortality rate in the study (66.7%) less than control group(93.3%). Conclusion: application of nursing guideline of closed suction system had a positive effect in critically patients out comes. Recommendation Keep the nursing guideline of closed suction system available in all the intensive care units.

Cardiogenic shock is a clinical syndrome characterized by end organ hypo perfusion. It's an irreversible condition may lead to cardiac arrest. Critical care nurses possess pivotal role in the assessment of patient with cardiac shock, providing treatment. Aim of the study: This study aimed to assess nurses' knowledge and practice regarding caring of patient with cardiogenic shock. Setting: the study was conducted in coronary care unit at Heart hospital Assiut University. Study design: A descriptive research design was utilized in the study. Subjects The study included 40 nurses working in the mentioned setting. Tools: two tools were used for data collection, Tool one: nurses' knowledge assessment tool. Tool two: observational checklist regarding caring of cardiogenic shock patients Results: revealed that total knowledge level of nurses were (72.5%) unsatisfactory level regarding care of cardiogenic shock patients and (27.5%) of nurses had a satisfactory level. While total nurses practice level were (82.5%) had an inadequate level regarding care for patient with cardiogenic shock and (17.5%) had an adequate level. Conclusion: Nurses showed inadequacy of their knowledge and practices regarding care of cardiogenic shock patients. Recommendations: The study recommends that an education program regarding care of cardiogenic shock patients be designed, conducted and monitored for nurses working in the ICU.

Introduction: Application and implementing standardized nursing care on patients with cardiogenic shock had a positive effect on critically patient outcomes, took a shorter time and is more economical. Aim: To evaluate the effect of implementing standardized nursing care on outcomes of patients with cardiogenic shock at the Coronary Care Unit. Design: Quasi-experimental research design. Setting: the study was conducted in the Coronary Care Unit at Assuit University Hospital. Sample: 60 critically ill patients were included in the study. They were categorized into two groups, study group who received standardized nursing care from both sex study and control group who received routine care (30 in each). Tools: Two tools developed by the researcher after reviewing the literature to assess the patient condition to form baseline data these tools were Tool I: patient demographic and medical data, tool II: patients outcomes assessment sheet. Results: the findings of the current study revealed there was a significant difference between study and control group regarding patients outcomes p.value<0.05. Conclusion: The application of standardized nursing care for a patient with cardiogenic shock had a statistically significant positive effect on their outcome. Recommendation: Application of standardized nursing care for the patient with cardiogenic shock in the Coronary Care Unit.