future vision of nursing - zagazig university

Zagazig University

Faculty of Nursing

1st

Medical Surgical Nursing Department Scientific Conference of

Faculty of Nursing Zagazig University

18th

April, 2016 – Zagazig, Egypt

Under the Patronage of

Prof. Dr. Khaled AbdEl-Bary

President of Zagazig University

Prof. Dr. Amal Mohamed El Dakhakhny Dean of Zagazig Faculty of Nursing

Conference's President

Prof. Dr. Nadia Mohamed Taha Head of Medical Surgical Nursing Department

Conference's Coordinator

Dr. Elham Hamad Mohamed

Conference's Secretary

Dr. Howida Kameel Zaiton

Future Vision of Nursing

Medical Surgical Nursing Department 1st Annual Scientific Conference Future Vision of Nursing

1

FUTURE VISION FOR NURSING

Nadia Mohamed Taha

Professor of Medical Surgical Nursing and the head of department

Introduction:

The nursing profession needs to begin to recognize new trends and patterns that are

emerging in health care. Change theory tells us that unsettled a time, a form of

unfreezing of old patterns, is also an era of opportunity. Changes are inevitable,

and both nursing and especially nursing education are in an excellent position to

lead rather than follow. But that is not easy. It takes energy, ideas and commitment.

This is our time of opportunity! It is crucial that nurses become involved in the

political process and that we teach our students and future leaders how to do that. It

is crucial that nurses learn to collect data to document health care needs and our

impact on the health of our societies. Nurses must learn how to identify those

health care needs of patients, families, communities and societies; to communicate

those needs to policy and decision makers and not allow those needs to be lost in

the frenzy of cost cutting options. It is crucial that nurses learn to generate new

ideas for care, utilizing the new medical and communication technologies that are

blossoming daily, but also keeping our high touch together with the high tech. It is

crucial that nurses learn the terminology of finance and business concepts that are

driving health care systems today and generate those new ideas for care with fiscal

responsibility, and seeking new ways to lower costs. It is crucial that nurses learn

about implementation strategies for those ideas. That we learn to deal with

opposition, and that we can present our arguments well; that we learn to develop

coalitions and a supportive constituency; that we learn to compromise in ways that

develop win-win situations and that we learn what we can give up and what we

cannot. These are major challenges for nurses and nurse educators today and in the

future. Nursing educators have a major responsibility in this arena and need to be

aware of and responsive to new trends and changes in the health care milieu. They

and the students they prepare should be a portal through which this information is

communicated to nurses in the field, who often don’t have sufficient resources or

time to keep abreast of new developments. Although strategic planning can be used

to develop nursing practice and educational programs of the future, in today’s

world change is coming rapidly, and those strategic plans cannot be static.

Practicing nurses, nurse administrators and nurse educators must respond to

changes quickly, as well as being proactive, based on recognition of trends and

external environmental dynamics.

Conference's President


2

Conferences' Objective

Conferences' Axes

Present New Innovation of Professional Nursing Care and Education

1. Nursing Technology.

2. Education for Professional Nursing Practice.

3. Dealing with chronic illness.

4. Qualities and patient outcomes.


3

Prof.Dr. Aml El Dkhakhny Prof.Dr. Sanaa Noor El Dien

Prof.Dr. Mohamed El-khashab Prof.Dr. Salwa Abbas

Prof.Dr. Nadia M Taha Prof. Dr. Amany Sobhy

Prof.Dr. Zeinab Hussein Ali Dr. Elham Hamad Mohamed

Dr. Eman Abd-El Aziz Dr. Howida Kameel

Dr. Eman El-Sayed Assist.Lect. Mona Abd-Allah

Assist.Lect. Mona Abd-Allah Assist.Lect. Magda Kamal

Assist. Lect. Mona Fathe Assist.Lect. Rehab Ragab

Dem. Mohamed Hebeshy Assist.Lect. Eman Ali

Ins. Doaa Sabry Assist.Lect. Fatma Mohamed

Dr. Aida Ahmed Dr. Maha Sakr

Dr. Gehan Hafez Dr. Naglaa Abd- Elkareem

Assist.Lect. Samah Mahmoud Assist.Lect. Aml Hamed

Dem. Amira Sabry Dem. Hala Abd- Elsaboor

Assist.Lect. Zienab El- Baramony Ins. Lamiaa Zaki

Dem. Mohamed Hebeshy Ins. Wafaa Amer

Ins. Ahmed Elmarakby Ins. Shefaa Abd el Naser

Ins. Samar Nabil Ins. Doaa Sabry

Ins. Salwa Hassan Ins. Taisir

Scientific Committee:

Advisory Committee:

Printing Committee:

Advertising Committee

Registration Committee Organizing Committee


4

Monday, 18 April, 2016

9:00 AM - 3:30 PM

9:00 - 10 AM Registration

10 - 11:00 AM Opening Ceremony

11:00 - 1:00 AM Session 1

1:00 - 1:30 PM Coffee Break & Noon prayer

1:30 - 2:30 PM Session 2

2:30 – 3:00PM Recommendations & Closure

3:00 - 3:30 PM Certification

Conference's program


5

Speaker Topic Time

Prof. Dr. Mohamed

El-khashab

Mode of transmission of viral hepatitis 11-12:00 AM

Dr. Misaa Abdella Zika Virus

12:00-12:30

AM

Dr. Atef Goda Palliative care of cancer patients 12:30-1:00 pM

Discussion 12:40-1:00 PM

Coffee Break

1:00-1:30 PM

Session (1) Monday, 18 April, 2016

(11:00 AM - 1:00 PM)

Chairpersons:

1- Prof. Amal El-Dakhakhny 2- Prof. Dr. Mohamed El-khashab

3. Prof. Dr. Nadia Mohamed Taha


6

Speaker Topic Time

Hend Salah eldin

Mohamed

Fast -Track Gynecological Oncologic Surgery: A suggest

Care Pathway Booklet 1:00- 1:15 PM

Dr.

Amany Hamed Gad

Mohamed

Risk Factors for Birth Related Perineal Truama among Low

Risk Parturient Women and Nursing Implications

1:15- 1:30 PM

Dr. Eman Elsayed

Hussein Mohammed Professional Nursing : bringing caring back to future

1:30 – 1:40 PM

Dr. Naglaa Abd-

Elkareem Maghazi Nursing Informatics: Current and future trends 1:40-1:55 PM

Dr.Aida Mohammed

Ahmed

Complementary Therpay

1:55 - 2:10 PM

Rehab Ragab

Bayomi, Magda

AbdElaziz Mohamed,

Nadia Mohammed

Taha, Hala Ibrahim

Zaiton

Nurses' Role Regarding Problems And Needs Encountered

Among Postoperative Cataract Patients

20:25 -2:40 PM

Eman Ali Metwaly,

Nadia Mohamed

Taha , Elham Hamad

Mohammed

Nurses' Performance Regarding Nasogastric Tube Feeding

in Intensive Care Units

2:40 -2:55 PM

Session (2) Monday, 18 April, 2016

(1PM - 3:30 PM)

Chairpersons:

1- Prof. Dr/ Nadia Mohammed Taha 2- Prof. DR/ Atef Goda

3- Prof.Dr/ Missa Abdella


7

Zeinab Mohamed

Ahmed, Howida

Kameel Zatton, Safaa

Hussein Mohamed &

Magda Abd Elaziz

Mohamed

Needs and Problems Encountered Among Post Mastectomy

Patients: Suggested Nursing Guidelines

2:55-3:5 PM

Samah Mahmoud

Mohamed, Nadia

Mohammed Taha, Impact of simulation training on second year nursing

students' clinical skills in faculty of nursing at Zagazig

University

3:5-3:15 PM

Suzan Mohammed

El-Sayed, Eman

Mohammed Abd -

Elaziz & Magda Abd

Elaziz Mohamed .

Prevalence and Influencing Factors of Unsafe Intravenous

Injection Practice among Nurses at Zagazig University

Hospitals

3:15-3:25 PM

Fatma Mohammed

Abdelhamied, Nadia

Mohammed

Taha)&Maha Dosoky

Sakr

Factors Affecting Wound Healing and Needs among Patients

with Diabetic Foot Ulcer: Suggested Nursing Guidelines

3:5-3:35 PM

Wafaa Mohamed

amer, Mohamed El-

khashab Nadia

Mohamed Taha

&

Howida Kameel

Zaton

Nurses Knowledge and Practice Regarding Gastrointestinal

Endoscopy and Suggested Nursing Guidelines

3:35-3:40 PM

Mona Mohammed

Fathy Rezk,Dr.Eman

Mohamed Abd El-

Aziz, Nadia

Mohamed Taha

Self-Care Practices for Patients on Chemotherapy at Zagazig

University

3:40 -3:50PM

Recommendation & Closure 3:50- 3:55 PM

Certification

3:55- 4:00 PM


8

Dr. Topic P

Nadia Mohamed Taha, Howida

Kameel, and Nahla Ahmed Abd Elaziz

Effect of A Health Educational Guidelines on

The Knowledge, Self-Management Practice And

Self-Efficacy of Patients With Type-2 Diabetes

1-

Asma Abood, Nadia Mohamed Taha

Maha Desokey Saleh

Impact of Training Education Program on

Improving of Nurses Knowledge and

Performance Regarding Infection Control In

Endoscopy Unit

2-

Samia Farouk Mahmoud Department of

community health nursing, Faculty of

Nursing , Zagazig University

Stem Cells and Diabetes

3-

Suzan Mohammed El-Sayed, Zeinab

Mohamed Ahmed, Fatma Mohammed

Abdelhamied What is Zika Virus?

4-

Mona Abdallah Chronic Care Management Model: Interactions

to promote the patient as the expert in managing

chronic conditions

5-

Samah Mahmoude Mohamed,Nadia

Mohamed Taha,HanaaHamdey Ali,

&Shaimaa Mohamed Nageeb

Fatigue, Depression And Sleep Disturbance

Among Hemodialysis Patients

6-

Samah Ebrahim Eldsouky, Nadia

Mohammed Taha, & Maha Desoky

Saleh

Nurses’ knowledge and practice in maintaining

adequate fluid and electrolyte balance among

patients with congestive heart failure

7-

Posters Monday, 18 April, 2016


9

Abstracts


10

Fast -Track Gynecological Oncologic Surgery: A suggest Care Pathway

Booklet Hend Salah Eldin Mohamed

Assist prof Obstetrics and Gynecology Nursing ,Faculty of Nursing ,Zagazig University

ABSTRACT

Background: Fast Track Surgery (FTS) programs have been adopted by many specialties with

documented improved patient outcomes and reduced length of stay (LOS). The aim of this study

was to design care path way booklet of patients following a fast-track (FTS) program, after major

gynecological/gynecological oncologic surgery and analyses elements that may have aided in

their early discharge. Sample: Purposive sample Design: prospective, intervention study design.

Setting: Gynecology department, Zagazig University. Tools of data collection:

tool1:.demographic data. Tool 2: The principles adopted for care of elective gynecological

patients, preoperative, intraoperative, and postoperative data. Results: ongoing research.

Key words: fast –track. Gynecological oncologic surgery, care pathway


11

Impact of a health educational guidelines on the knowledge, self-management

practice and self-efficacy of patients with type-2 diabetes

1Nadia Mohamed Taha, Howida Kameel, and

2Nahla Ahmed Abd Elaziz

1Medical-Surgical Nursing Faculty of Nursing at Zagazig University and

2Community Health Nursing at Ain Shams University

Diabetes is a common costly condition associated with significant morbidity and mortality.

The process of teaching individuals to manage their diabetes had been considered an important

part of the clinical management of individuals with diabetes. The goals of self-management

education are to optimize metabolic control, prevent acute and chronic complications, and

optimize quality of life; Aim: The aim of this study was to evaluate the impact of a health

educational intervention guidelines for T2DM on Patients' knowledge, self-efficacy, and self-

management practices. Design: quasi-experimental uncontrolled design with pre-post assessment

on 50 patients evaluated at three time intervals: before the intervention, at its completion, and 6

months after completion. Setting: The study was carried out in the outpatient clinics of

Endocrinology and Metabolism at Zagazig University Hospital. Tools: three tools were used, 1st

tool was an interview questionnaire, self-efficacy scale and patients’ self-reported self-

management behaviors concerning self-care practices. Results: There were statistically

significant improvements in patients’ knowledge (p<0.001), self-efficacy (p<0.001), and self-

management (p<0.001), which continued through follow-up. Multivariate analysis showed that

the knowledge and self-efficacy scores positively predicted the scores of self-management.

Conclusion: The study demonstrates the effectiveness of health educational intervention

guidelines in improving T2DM patients’ self-management behaviors and self-care practices

through provision of sound information and fostering their self-efficacy. The slight decline at the

follow-up phase indicates the need for periodic booster doses of the intervention. Therefore, the

study recommends generalization of such educational guidelines in all health care settings

providing services to T2DM patients. Such guidelines should particularly address the patients

with low educational attainments, long history of T2DM, and those residing in rural areas. More

research is needed to investigate the long-term effect of such educational interventions.

Key Words: type 2 diabetes, self-efficacy, self- management behaviors and self-care


12

Impact of Training Education Program on Improving of Nurses

Knowledge and Performance Regarding Infection Control In

Endoscopy Unit Asmaa A. Abd-Elhamid

1, Mohamed N. El-khashab

2, Nadia M. Taha

3, and Maha Desokey Saleh

4.

1 Assis. Lecturer of Medical Surgical Nursing, Faculty of Nursing, Fayoum university.

2 Professor of Tropical medicine, Faculty of medicine, Zagazig University.

3 Professor of Medical Surgical Nursing, Faculty of Nursing, Zagazig University. 4 Lecturer of Medical Surgical Nursing, Faculty of Nursing, Zagazig University.

\

Background: Endoscopes are complex and reusable devices. Understanding infection control in

the context of endoscopy is important in reducing the transmission of infection. This study aim

was to evaluate effect of an educational program on improving nurse's knowledge and practice

regarding infection control in endoscopy unit at Zagzig University Hospital. Research design: A

quiz experimental research design was used. Setting: The study was conducted in the endoscopy

unit at Zagazig University Hospitals. The study sample All available endoscopy nursing staff

Tools: First tool was Questionnaire sheet, to assess nurses' knowledge. The second tool was

observational checklist to assess nurses' practice. Results revealed that, than tow third of nurses

ware in the age group of more than 40 years with mean age 42.2 ± 8.4 years, while majority of

the sample had more than 10 years of experience. There was improvement in total level of

nurses' knowledge, and practice regarding infection control with highly statistically significant

difference between pre-post and pre-follow up program phase as regarding to infection control.

Conclusion: The implantation of health educational program had improved nurse's knowledge

and practice regarding endoscopy infection. Recommendations: Continuous educational

infection control training programs are recommended in endoscopy units. So incorporation of

such interventions apply in all endoscope unite all over Egypt

Keywords: Educational Training Program, Gastrointestinal Endoscopy, Infection control, Endoscopy Reprocessing.


13

Risk Factors for Birth Related Perineal Truama among Low Risk Parturient

Women and Nursing Implications

Amany Hamed Gad Mohamed

Lecturer of Obstetrics and Gynecological Nursing- Faculty of Nursing- Zagazig University

Abstract: Perineal trauma related to vaginal delivery may occur spontaneously during vaginal

birth or when a surgical incision (episiotomy) is intentionally made to enlarge the diameter of the

vagina outlet.

The aim of the study was to determine the incidence of perineal trauma among low risk

parturient women, find out the harmful and non harmful practices behind the occurrence of

perineal trauma, and conducting a work shop for nurses working in labor unit about measures

used to prevent perineal trauma.

Subjects and methods, a cross sectional design was used. The sample included 500 parturient

women admitted to labor room without obstetrical or medical complications. Data collection

lasted 7 months, by using interview questionnaire, maternal assessment record, summary of

labor sheet, and partograph.

Results the incidence of perineal trauma was 43.0% ( 27.0% perineal tear & 16.0% episiotomy),

57.0% had their perineum intact (32.4% had first degree tear with no suture, and 24.6% had

completely intact perineum). Women age, parity, short birth interval, previous perineal trauma

were significantly associated with perineal trauma (p=0.00). There was direct proportion with

increase the frequency and number of vaginal examination, applying fundal pressure during the

second stage of labor, no psychological support, not done correct pushing after complete cervical

dilatation, and not done panting and slow delivery of the head and the occurrence of perineal

trauma.

Conclusion almost three fifths of women had intact perineum "complete intact perineum and

first degree tear" and the rest were exposed to perineal tear and episiotomy. Risk factors

significantly shown to be associated with perineal trauma were; previous perineal trauma and

perineal management technique.

Recommendation more publication and follow up for nursing protocol for the prevention of

perineal trauma should be adopted based on the identified risk factors and taking into

consideration the importance of perineal management techniques and avoidance of unnecessary

vaginal examination and fundal pressure during the second stage of labor.

Key words: episiotomy, perineal tear, risk factors


14

Professional Nursing: bringing caring back to future Eman Elsayed Hussein Mohammed

Lecturer of medical surgical nursing, Faculty of nursing, Zagazig University

Leadership, whether it is nursing, medical or health care leadership, is about knowing how to

make visions become reality. The vision that many nurses hold dear to their hearts is one where

patients are treated with dignity and respect at all times; where systems are designed for the

benefit of individual needs; and where the work performed by nurses and other careers is valued

and respected. Achieving such a vision will required a paradigm shift in the philosophy, priorities

policies, and power relationships of the health service. Fundamentally, it will require the rhetoric

of patient centered care to become reality. The following scenario is describes a health service

that is on the pathway to achieve the vision of a patient centered health services: (1) development

of patient centered care measures as a part of performance management and the clinical

governance agenda; (2) leadership based on personal growth and development principles; (3)

new clinical career and competency framework for nursing. Key words: Centered care; Career framework


15

Nursing Informatics: Current and future trends Dr. Naglaa Abd-Elkareem Maghazi

lecturer of medical surgical nursing, Faculty of nursing, Zagazig University

Informatization and the need of knowledge in the medical field has significantly grown in this

century. The purpose of informatization aims to prepare nurses, as well as to benefit from

integrating computer technology into everyday practice. It is essential to include concepts related

to the role of computer technology in clinical practice into the future basic nurse training

curricula. The look into the future will be the use of telemedicine and telenursing, in order to

exchange information from one place to another with the purpose of improving the patient’s

health condition. Nurses can also access the patient's electronic health records, and provide the

patients with healthcare information and also with education materials. As such, nurses must be

supported by excellent electronic health record and other technologies. As a conclusion,

information technology is not a remedy, but it will offer this profession an unprecedented faster

capacity for the production and dissemination of new knowledge in the nursing domain. The

short presentation of the supporting terminologies in nursing practice has introduced more of the

information management tools, used by nurses in their work.

KEYWORDS: Nursing Informatics, Information Technology, Electronic Health Record.


16

Complementary therapy and nursing responsibilities

Aida Ahmed Mohamed Ibrahim

Lecturer of Medical Surgical Nursing, Faculty of Nursing, Zagazig University, Egypt

Abstract

The use of complementary and alternative medicine (CAM) is increasing. (CAM) covers a

heterogeneous spectrum of ancient to new-age approaches that purport to prevent or treat disease.

At least 42% of the general population use some form of CAM on a regular basis. The growing is

evidenced by the increased sale of natural substances, such as herbs and vitamins, which has

become a multimillion dollar industry over the last few years. Nurses are encouraged to think

critically before recommending or implementing CAM approaches and to also be open to the

possibilities that are available to help people live to their fullest potential. Nurses are encouraged

to teach clients to use the best of all systems in order to promote positive health outcomes.

Key words: complementary and alternative medicine, heterogeneous, positive health outcomes.


17

Nurses' Role Regarding Problems and Needs Encountered Among

Postoperative Cataract Patients Rehab Ragab Bayomi

(1),Magda Abd Elaziz Mohamed

(2), Nadia Mohamed Taha

(3),Hala Ibrahim

Zaiton(4)

(1) Assis. Lecturer of medical surgical Nursing, Faculty of Nursing, Zagazig University,

(2) Professor of Medical Surgical Nursing, Faculty of Nursing, AinShams University, (3) Assistant Professor of Medical Surgical Nursing, Faculty of Nursing, Zagazig University,

(4) Lecturer of Medical Surgical Nursing, Faculty of Nursing, Zagazig University

Background: Cataract is considered as a significant global health problem and represents the

most important cause of visual impairment worldwide. Extraction of cataract is a highly effective

surgical procedure to improve quality of life. The nurse plays a major role through identifying

health needs and assessing care given after surgery. Aim: The present study aimed to assess

nurses' role regarding problems and needs encountered among postoperative cataract patients.

Methods: Descriptive exploratory design was utilized. The present study conducted in

Ophthalmology Department and Out Patient ophthalmology Clinics at Zagazig University

Hospitals. The study subject includes two groups: Group I: 100 patientswith cataract surgery

from both sexes and with age ranging between 30-80 years.Group II: 36 nurse who dealing with

postoperative cataract patients. Tools: Two tools used for data collection. First tool, Patient

interviewing sheet to assess patients' problems and needs after cataract surgery, the secondtool

was Nurse Questionnaire sheet to assess nurses' performance for post operative cataract patients.

Results:The result of the present study showed that, Most of the studied patients had serious

problems after the surgery, while postoperative needs for the majority of them weren't achieved.

In addition the majority of the studied nurses had unsatisfactory level of practices, and about

three quarters had satisfactory level of knowledge. Conclusion: The study findings concluded

that, No statistical significant difference between total patients' needs and serious problems

encountered studied patients. In addition, there was statistical significant between total level of

nurses' knowledge and their practices. Recommendations: The main study recommendation

included that, Pre-service and in-service training program for the purpose of refreshing and

updating the knowledge and practice of the nurses working with ophthalmic surgical patients,

and the proposed protocol of patients' needs management that's evidence – based should be

implemented and evaluated in relation to visual problems post cataract surgery. Key words: Cataract Surgery, Patients' Needs, Nurses' Role


18

Nurses' Performance Regarding Nasogastric Tube Feeding in Intensive Care

Units

Eman Ali Metwaly (1), Nadia Mohamed Taha (2) , Elham Hamad Mohammed (3)

(1) Assis. Lec., medical surgical nursing dep., Faculty of Nursing, Zagazig University,

(2) Assis. Prof. of medical surgical nursing dep., Faculty of Nursing, Zagazig University,

(3) Lecturer of medical surgical nursing dep., Faculty of Nursing, Zagazig University.

Background: Nasogastric tube (NGT) feeding is a common practice in Intensive care Units

(ICUs). The aim of study was to assess nurses' performance regarding nasogastric tube feeding

in Intensive Care Units. Subjects and methods: A descriptive correlation design was used in this

study. All nurses (100) in all ICUs at Zagazig University Hospitals were included. Two tools

were used for collecting data, 1) questionnaire sheet to collect knowledge about socio-

demographic characteristics of study nurses and questions to assess nurses' knowledge regarding

nasogastric tube and feeding administration. 2) Observational checklist to assess nurses' practice

regarding NGT insertion and feeding administration. Results: the study finding revealed that

there was a statistical significant relation between total knowledge and total practice concluded

that nurses had unsatisfactory level of knowledge about NGT insertion and feeding, and their

level of practice was unsatisfactory. It can be concluded that the majority of nurses in intended

ICUs did not apply the most recommended nursing practices regarding nasogastric tube insertion

and feeding administration. It is recommended to provide a training program for all nurses who

provide care to critically ill patients in ICUs, periodic evaluation of nurses' practice.

Key words: Performance, Nasogastric tube, intensive care units


19

Needs and Problems Encountered Among Post Mastectomy Patients:

Suggested Nursing Guidelines

Zeinab Mohamed Ahmed

(1), Howida Kameel Zatton

(2), Safaa Hussein Mohamed

(3) &

Magda Abd Elaziz Mohamed(4)

(1)

Demonstrator, medical surgical nursing Dep., Faculty of Nursing, Zagazig University,

(2)

lecturer, medical surgical nursing Dep., Faculty of Nursing, Zagazig University,

(3)

lecturer, medical surgical nursing Dep., Faculty of Nursing, Zagazig University

,(4)

Prof. of medical surgical nursing, Faculty of Nursing, Ain Shams University

Abstract:

Background: Breast cancer is the most prevalent cancer worldwide with about one million

new cases annually. Breast cancer remains major health problem all over the world. The life-

threatening nature of breast cancer and the consequences of the aggressive treatment regimes can

result in a wide range of physical, emotional and social consequences may influence the patients'

needs. Aim of this study: assess problems and needs which encountered among breast cancer

patients following mastectomy and develop suggested nursing guidelines. Subjects and

methods: Descriptive design was conducted for sample of 60 adult female patients admitted to

oncology units, at Zagazig University hospitals through: using interview questionnaire sheet.

Results: This study revealed that, most patients suffered from pain, difficulty in hand movement

at surgical site, high costly treatment, chemotherapy and radiotherapy side effects following

mastectomy. There are significant relations between patients’ ages and needs for helping in

eating, clothing and bathing, between level of education and needs for economic help and

between constipation and patients’ needs for nursing guidelines. Conclusion: Patients’

substantial needs and problems require professional support even after completion of the

patients’ treatment. Continued assessment of the patients’ needs and symptoms provide the basis

for purposeful counseling and education. Recommendations: Rehabilitation programs for

patients should be developed and implemented in clinical practice.

Key wards: Mastectomy- Problems- Needs-Nursing Guidelines


20

Impact of simulation training on second year nursing students' clinical skills

in faculty of nursing at Zagazig University Samah Mahmoud Mohamed

(1), Nadia Mohamed Taha

(2),

(1) Assis. Lecturer of medical surgical nursing Faculty of Nursing, Zagazig University.

(2)

Assistant Professor of Medical Surgical Nursing, Faculty of Nursing, Zagazig University.

Simulation offers a fresh approach to psychomotor skills education which allows to nursing

students to integrate knowledge from all three learning domains during practicing psychomotor

skills. Aim: This study aimed to assess the impact of simulation training on second year nursing

students' clinical skills in Faculty of Nursing at Zagazig University. Methods: A quasi

experimental design was used. The study conducted in Medical Surgical Nursing skills labs and

classrooms of Faculty of Nursing at Zagazig University and Medical and Surgical Departments

of AL-Ahrar Hospital. Sample: A purposive sample of 100 second year nursing students were

included, 50 in the study group and 50 in the control group. Tools: Two tools were used for

collection of data; first tool was a knowledge questionnaire sheet to collect data about personal

characteristics of studied nursing students as well as knowledge regarding IM injection and

peripheral intravenous cannulation. Second tool was observational checklists to assess nursing

students' practice regarding IM injection and peripheral IV cannulation. According to nursing

students' assessment (pre-program), the researcher detected needed knowledge and practice, then

developed training program and implemented it through sessions. Results: The study results

revealed statistically significant differences between nursing students in the study group

compared to those in the control group related to knowledge and practice concerning IM

injection and peripheral IV cannulation immediately post program implementation and two

months later. Also, statistical significant relations between nursing students' knowledge and

practice mean scores and their personal characteristics throughout the program phases.

Conclusion: It can be concluded that simulation training program had a positive effect in

improving nursing students' knowledge and practice. Recommendations: It is recommended to

provide a continuous simulation training program for all undergraduate nursing students at

summer to refresh and update their knowledge and practice. In addition, Periodic evaluation of

nursing students' knowledge and practice as regards different nursing procedures at skills labs in

order to obtain data which determine level of knowledge and skills.

Key words: Simulation training, nursing students, skills.


21

Prevalence and Influencing Factors of Unsafe Intravenous Injection Practice

among Nurses at Zagazig University Hospitals

Suzan Mohammed El-Sayed (1)

, Eman Mohammed Abd - Elaziz (2)

& Magda Abd Elaziz

Mohamed (3)

. (1)

A demonstrator, Medical-surgical nursing dep.- Faculty of Nursing -Zagazig University,

(2)

lecturer of Medical surgical nursing dep.- Faculty of Nursing -Zagazig University, (3)

Prof. of Medical surgical nursing, Faculty of Nursing -Ain Shams University.

Background Unsafe injection practices put patients and healthcare providers at risk of infectious

adverse events and have been associated with a wide variety of procedures and settings. Aim of

this study: Was to measure the prevalence of unsafe intravenous injection practice among nurses

and identify the related influencing factors. Subject & methods: Research design: An analytical

cross- sectional design was used. Setting: The present study was conducted in general wards

(medical and surgical) of Zagazig University Hospitals. Subject: 240 of bedside nurses who are

give direct care and had more than one year of experience were selected. Tool of data

collection: A questionnaire sheet and an observational checklist were used. Results: Majority

(94.6%) of nurses had a series lack of safe injection practices. the majority (96.2%) of hospital

infection control activities were lacking except for the presence of incinerator (93.3%) similarly

low percentage of adequate training (3.8%) and working condition(6.3%)were reported . in

addition , only (8.8%) of nurses had satisfactory knowledge .there were a negative correlation

between practice and each item of age and experience . there were positive correlation between

practice and each item of qualification and supplies availability . Conclusion: The staff nurses in

general wards of Zagazig university hospitals had a series lack of safe intravenous injection

practice, the related influencing factors were inadequate hospital infection control activities,

training, work condition and unsatisfactory level of nurses' knowledge regarding safe injection.

Recommendations: Urgent program for staff development along with promotion of safety

culture in the study setting, provision of needed supplies for safe injection practice and further

research is proposed to test the effectiveness of these changes on nurses' practice of safe

intravenous injection.

Key words: Prevalence, Influencing Factors, Unsafe Intravenous Injection, Nurses, Zagazig University Hospital.


22

Factors Affecting Wound Healing and Needs among Patients with Diabetic

Foot Ulcer: Suggested Nursing Guidelines

Fatma Mohammed Abdelhamied

(1), Nadia Mohammed Taha

(2)&Maha Dosoky Sakr

(3)

(1)Demonstrator, medical surgical nursing dep, Faculty of Nursing, Zagazig University,

(2) Assistant Professor of Medical Surgical Nursing, Faculty of Nursing, Zagazig University,

(3)

Lecturer of Medical Surgical Nursing, Faculty of Nursing, Zagazig University

Background: Diabetic foot ulcer is one of the most frightened complications of diabetes and is

the leading cause of hospitalization among diabetic patients. Aim: The present study aimed to

assess factors affecting wound healing and needs among patients with diabetic foot ulcers.

Research design: Descriptive exploratory design was utilized. Setting: The present study

conducted in outpatient clinic at Zagazig University Hospitals Sample: The study subject

includes 70 patients with diabetic foot ulcer as result of diabetes(40 males and 30 females).

Tools: four tools were used for collection of data, first patient's assessment sheet, Thai stress test

(TST) questionnaire, questionnaire sheet about patient knowledge about diabetes mellitus and

foot care, questionnaire about needs of patient with diabetic foot ulcer. Results: The study

finding revealed that the mean age of the study sample was (53.4±10) years Also, there was

statistical significant strong positive relation between knowledge and patients practice about

diabetes. The factors that were significantly affect ulcer healing were age, wound grade, vascular

condition, infection, blood glucose, offloading devices, and mental stress .The psychological

needs and the total needs were significantly affect diabetic foot ulcer healing. Conclusion: The

study findings concluded that, the most factors which affect ulcer healing were age, wound

grade, vascular condition, infection, blood glucose, offloading devices, and mental stress. the

high needs for patient with diabetic foot ulcer were psychological needs followed by physical

and functional needs then socioeconomic needs and spiritual needs. Recommendations: Further

studies are recommended to identify effects of educational programs on improving patient

knowledge and practice regarding care for diabetic foot ulcer.

Key words: ( factors affecting wound healing; Diabetic foot ulcer; Thai stress test; Needs).


23

Nurses Knowledge and Practice Regarding Gastrointestinal Endoscopy and

Suggested Nursing Guidelines

Wafaa Mohamed amer(1),

Mohamed N. El-khashab2 Nadia Mohamed Taha

(3) & Howida

Kameel Zaton (4)

(1) Assis. lecturer of Medical Surgical Nursing, Faculty of Nursing, Zagazig University


(3) Lecturer of Medical Surgical Nursing, Faculty of Nursing, Zagazig University

Aim of the study: to assess knowledge and practice of nurses regarding to Gastrointestinal

Endoscopy procedure and suggested nursing guideline. Research design: Descriptive

exploratory design was utilized. Setting: The present study conducted in gastrointestinal

endoscopy unit at Zagazig University Hospitals. Sample: The study subject includes all

available endoscopy 35 nurses. Tools: Three tools were used for collection of data, first

questionnaire sheet to collect knowledge about socio demographic characteristics of study nurses

and questions to assess nurses' knowledge regarding endoscopy as definition, structure,

complication, nursing role, guidelines and types of endoscopy and her role in the pre-

procedure, during procedure and post –procedure. Second tool was nursing attitude. Third tool

was an observational checklist to assess nurses' practice in the pre procedure, during procedure

and post procedure in endoscopy and Suggested nursing guideline. Results: The study revealed

that the more than half of the nurses , had their age equal 25 years or less and most of them had

diploma degree and that more than half of nurses had, their working experience range from 8

years to less than 28 years. Most of studied nurses had satisfactory level of nurses' knowledge

regarding Gastrointestinal Endoscopy. The majority of nurses had positive attitude. The majority

of nurses had unsatisfactory nurses' level of practice before, during and after GI endoscope,

discharge instructions and manual Disinfecting of endoscopy. Also, there were statistical

significant relationship between total nurses' knowledge regarding GI endoscopy and their age,

training and work duration and not significant with nurse qualification..Conclusion: we can

conclude that the nurse age, training and working duration are affecting the level of nurses'

knowledge regarding gastrointestinal endoscopy including; general precautions, basic steps to

clean and disinfection in endoscopy unit. The majority of nurses had positive attitude. While

training and qualification can affect dealing with patients in addition to nurses' level of practice

before, during and after GI endoscope, discharge instructions and manual Disinfection of

endoscopy. So, we recommend adequate education and training of all nurses working with

gastrointestinal endoscopy unit, with continuous evaluation of nurses' work practice. Periodic

evaluation may help to take decision regarding training programs to increase theoretical l and

practical experience. Further studies are necessary to identify effects of educational programs on

nurses' performance in gastrointestinal endoscopy unit.

Key words: Nurses, knowledge, practice, attitude, gastrointestinal endoscopy, training, education .


24

Self-Care Practices for Patients on Chemotherapy at Zagazig University

(1)

Mona Mohammed Fathy Rezk, (2)

Nadia Mohamed Taha , (2)

Eman Mohamed Abd El-

Aziz (1)

Demonstrator of Medical Surgical Nursing, Faculty of Nursing, Zagazig University (2)

Assistant Professor of Medical Surgical Nursing, Faculty of Nursing, Zagazig University,

(3)


Background: Self-care is fast becoming an important issue in relation to patients with cancer

because of the introduction of complex treatment regimens which frequently involve the use of

multiple combinations of chemotherapeutic drugs. The complexity of regimens makes it more

likely that patients will experience potentially toxic side effects, requiring prompt and effective

self-management to prevent adverse effects on their treatment and quality of life. Furthermore,

people with cancer have unique and experiential knowledge of living with cancer and its effects

and therefore can effectively contribute to their management. Aim of this study: was to assess

self-care practices for patients on chemotherapy at Zagazig University Hospitals. Setting: the

present study was conducted in the out-patient clinic of chemotherapy and the Oncology

Department at Zagazig University Hospitals. Design: a descriptive exploratory design was

utilized in the current study. Subjects: 159 adult patients receiving chemotherapy at above

mentioned setting selected randomly. Tools of data collection: Three tool were used. A

questionnaire sheet composed of three parts: personal information questionnaire, chemotherapy

side effects questionnaire, Patient knowledge questionnaire, 2nd

tool composed of two parts

general self-care practices questionnaire, specific self-care practices questionnaire, and third tool

factors affecting self-care practices questionnaire was used. Results: majority of studied patients

(93.1%) had unsatisfactory knowledge, Majority of studied patients (89%) had unsatisfactory

total self-care practices, and there were factors affecting 82% of studied patients regarding their

self-care during chemotherapy. there was significant positive correlation between factors

affecting self-care practice score, total knowledge score, and self-care practice score Conclusion:

it can be concluded that the majority the studied patients had unsatisfactory knowledge, and

practice level regarding their self-care during chemotherapy. Furthermore, most of the studied

patients reported that they had various factors (physical, psychological, social, financial, and

beliefs) that affect their self-care during chemotherapy. Recommendations: a manual Prospectus

of side effects of chemotherapy and how to manage it should write in simple words and use

attractive pictures given to the patients, encourage the patient to participate in health teaching and

counseling program about chemotherapy side effects and how to deal with these side effects.

Key words: Self-Care, practice, Chemotherapy


25

FATIGUE, DEPRESSION AND SLEEP DISTURBANCE AMONG HEMODIALYSIS

PATIENTS

Samah Mahmoud Mohamed(1)

, Nadia Mohamed Taha(2)

, Hanaa Hamdey Ali(3)

, & Shaimaa

Mohamed Nageeb(4)

(1)

Assis. lecturer of Medical Surgical Nursing, Faculty of Nursing, Zagazig University (2)

Assistant Professor of Medical Surgical Nursing, Faculty of Nursing, Zagazig University,

(3)

Lecturer of psychatric Nursing, Faculty of Nursing, Zagazig University (4)

Lecturer of psychatric Nursing, Faculty of Nursing, Zagazig University

Abstract

Chronic kidney disease (CKD) is often unpredictable and patients may not feel ill as the disease

progresses to end stage renal disease (ESRD), and requires dialysis or kidney transplant. Patients

on hemodialysis (HD) account for approximately 92% of the overall dialysis population. This

study aim was to assess the psychological problems such as fatigue, depression and sleep

disturbance among hemodialysis (HD) patients. The study design was a descriptive cross-

sectional design. The study was conducted in the hemodialysis units at the General and Fevers

Hospitals in Zagazig City. All patients attending the study settings105during the time of data

collection were eligible for participation in the study if they fulfill the following criteria Adult:

age 18 -65 years on hemodialysis in the study setting for at least 3 months. Data collection tool,

an interviewing questionnaire sheet, Fatigue Severity Scale (FSS), Beck Depression Scale and

Sleep Disturbance Scale. Results: the total sleep problems were 90,5%, the highest weresleep

disturbance (85.7%) and sleep insufficiency (85.7%). Conversely, the lowest type was that of

daytime functioning problems (77.1%). More than one third of the patients in the study sample

had severe depression symptoms (37.1%). An additional third had moderate depression

symptoms (33.3%), while only 12.4% had no such symptoms. The majority of the patients in the

study sample (83.8%) had total fatigue symptoms.There were not any correlation of statistical

significance among patients’ scores of depression, sleep, and fatigue.In conclusion, the patients

on HD have a very high prevalence of various types of sleep problems, depression symptoms,

and fatigue. Patient’s age, income, marital status, and duration of illness have significant

influences on these disorders. Hence, these patients need psychological support in order to

relieve these symptoms and prevent their untoward effects on their health and wellbeing. The

study recommends that the patients on HD must be periodically assessed for the presence or

development of depression, fatigue or sleep problems using simple scales as those used in the

present study by the psychiatric or HD nurse. The psychiatric nurse should provide HD patients

with information regarding healthy sleep habits, and train them in relaxation techniques. Special

care should be provided to older patients, with no education and with insufficient income, and

those with long duration of HD or renal disease. Further research is proposed to test the

effectiveness of nursing interventions in decreasing depression and fatigue symptoms, and

improving the quality of sleep among HD patients.

Key Words: Chronic kidney disease, hemodialysis psychological problems depression,

fatigue, sleep problems.


26

Nurses’ knowledge and practice in maintaining adequate fluid and electrolyte

balance among patients with congestive heart failure

1Samah Ebrahim Eldsouky,

2Nadia Mohammed Taha, &

3Maha Desoky Saleh

(1) Assis. lecturer of Medical Surgical Nursing, Faculty of Nursing, Zagazig University


(3)


Abstract

Critical care nurses have a vital role in identifying and treating the physiologic stressors

experienced by critically ill patients that disrupt homeostasis such as the patients with Congestive

Heart Failure (CHF). The aim of this study was to assess nurses’ knowledge and practice

concerning fluid and electrolytes balance among patients with congestive heart failure and

investigating the relation between their knowledge and practice. This cross-sectional analytic

design was carried out at Zagazig Main University Hospital on 160 nurses and 160 CHF patients

for assessing nurses’ practice. The data collection tools consisted of a self-administered

questionnaire sheet and an observation checklist. The study findings revealed that nurses'

knowledge about CHF and related fluid/electrolytes balance was high, with an overall good

percentage having total satisfactory knowledge. The practice was deficient regarding assessment

of peripheral circulation, skin and mucous membranes, signs of altered tissue perfusion,

ineffective breathing pattern, and alteration in fluid balance. Nurses’ knowledge was positively

influenced by their age, while female gender. The practice was negatively influenced by the

knowledge score and the number of medications taken by the patient, and the knowledge and

practice scores are negatively correlated. Hence, nurse’s age and gender as well as the attendance

of training courses are the factors influencing their knowledge, while the factors affecting

practice are their knowledge and the number of medications given to patients. In conclusion,

nurses' knowledge about CHF and related fluid/ electrolytes balance is variable, with an overall

good percentage of total satisfactory knowledge. The practice is generally higher. The knowledge

and practice scores are negatively correlated and the training courses have a negative influence

on nurses’ knowledge. Hence, it is recommended that the nurses working with patients with CHF

improve their knowledge, particularly the younger ones. The content and process of training

courses need to be revised, with more focus on applied knowledge. Further research is proposed

to assess the effectiveness of training programs fostering applied knowledge on nurses’

performance.

Keywords: Congestive heart failure, Fluid-electrolyte balance, Critical care nursing

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