Background: Chronic Obstructive Pulmonary Disease (COPD) is a common respiratory disease interferes with basic function of breathing of elderly. Aim: To evaluate the impact of implementing nursing protocol on respiratory function of elderly patients' with COPD. Subjects & methods: Quasi-experimental research design was utilized to conduct this study in Chest Diseases Departments at the Main Assuit University Hospital. A purposive sample of 169 elderly patients with COPD (87 study& 82 control groups) was participated. Three tools were used includes: 1st tool: Elderly patients assessment sheet, it includes 2 parts (Socio-demographic& health history and Bristol COPD knowledge sheet). 2nd tool observational check lists: used to assess the practice of elderly includes (breathing & coughing exercise, inhaler technique and incentive spirometer).The 3rd tool respiratory function assessment sheet used to evaluate (dyspnea scale, SaO2, respiratory rate). Results: 75.9% were male, 63.1% were illiterate and vast majority were living in rural area. 97% of participant had poor knowledge & practice pre implementation. There were statistically significant differences between total score of elderly patients" knowledge& practice and respiratory function outcomes after application of nursing protocol (2 &6 months). Conclusion: Most of the studied elderly had poor knowledge &practice and sever dyspnea in pre-test after application the nursing protocol were significant improved respectively. Recommendations: Frequent patient education, home visit and telephone follow up is very essential to manage COPD patients.

Background: Chronic Obstructive Pulmonary Disease (COPD) is a common lung disease that interferes with basic functions of elderly breathing. Aim: to assess the respiratory functions among the elderly with COPD on the irk now ledge and practice. Subjects and methods: Descriptive cross sectional research design was used to conduct this study in Chest Departments at the Main Assuit University Hospital. Purposive sample of 169COPD elderly was participated. Three tools were used includes: 1 st tool: Elderly assessment sheet, it includes two parts (Socio-demographic& health history and Bristol COPD knowledge assessment sheet), 2 nd tool: Observational checklists used to assess the practice of elderly: (breathing & coughing exercise, inhaler technique) and 3 rd tool: Respiratory functions assessment sheet used to evaluate the (dyspnea grade, oxygen saturation, respiratory rate and peak flow meter). Results:The main age of studied sample 65.50±5.16 (60-78), 73.4% were male and 70.4% were smokers. The vast majority of studied sample had poor knowledge & practice with impaired in respiratory functions. Conclusion: Vast majority of the studied elderly had poor knowledge & practice which had negative impact on respiratory functions. Recommendations: Health education program for elderly with COPD to improve their knowledge & practice and respiratory functions is very essential to manage their disease.

Determining the quality of students learning is an ongoing challenge to all nursing students. Aim: The aim of this study was to assess students' perception, stress, and anxiety experienced by nursing students during OSCE, for the 1 st and 4 th year nursing students. Method:-A descriptive exploratory research design was used for this study. This study was conducted at Faculty of Nursing, Assiut University, Egypt. A total of 451 undergraduate nursing students were enrolled in this study. First year (n=312) and 4 th year (n=139). Three tools were used to collect data in this study: Tool one: OSCE questionnaire sheet to test perception of the nursing students during OSCE. Tool two: perceived stress scale (PSC) and Tool three: State and Trait Anxiety Inventory. Results: There was agreement among students that exam were fair, covered a wide area of knowledge, but needs more time each station. No significant differences between 1 st and 4 th year nursing students were found regarding the level of stress and anxiety. There was significant negative correlation between anxiety state, total anxiety, and stress with nearly most of OSCE attributes. Conclusion: nursing students viewed OSCE as an objective assessment for nursing practical courses. It covered a wide range of knowledge; the majority of the students viewed the examination as fair.

Background ICU scoring systems allowed an assessment of the severity of disease and death prediction. As ICU populations, investigations and management were changed, scoring systems should be updated. Aim The aim of this study was to evaluate three scoring systems in predicting outcome in Al-Abbassia Chest Hospital Respiratory ICU patients in 6 months. Patients and methods It was conducted on newly admitted cases in Al-Abbassia Respiratory ICU from July 2016 till January 2017. All patients were evaluated on admission and after 48 h by Acute Physiology and Chronic Health Evaluation IV (APACHE IV), Sequential Organ Failure Assessment (SOFA), and Simplified Acute Physiology Score II (SAPS II). Results APACHE IV and SAPS II scores were significantly higher between dead than alive patients on admission and after 48 h, but were not able to predict death in ICU. SOFA score was insignificantly higher on admission and after 48 h between nonsurvivors. None of the three scores could predict the length of stay in ICU. Conclusion APACHE IV and SAPS II scores were better than SOFA score as they were significantly higher between nonsurvivors but not to the extent to predict mortality or length of stay.

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