الفهرس 
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Abstract
High risk neonates may be exposed to a number of life threatening problems that are associated with increased morbidity if not mortality, due to failure of adjustment to extrauterine environment, premature birth, congenital anomalies or bad environmental conditions. Therefore, the neonatal intensive care unit should be staffed with highly qualified nurses and advanced equipment to provide effective care with high quality performance and decrease number of neonatal deaths.
Aim of the study:
The study aimed to assess nurse’s knowledge, attitude and practice regarding to care of high risk neonates.
Subjects and Methods
Setting:
The study was conducted at the neonatal intensive care units of the Pediatric and Maternity Hospital affiliated to Ain Shams University Hospital, the Health Insurance Hospital as a governmental hospital, and Cleopatra and the American Hospital as private hospitals.
Subjects:
The subjects included of all available nurses working at neonatal intensive care units in the previously mentioned settings. The total number of nurses was 60; 20 nurses from Cleopatra Hospital, 10 nurses from the American Hospital, 15 nurses from Ain Shams Pediatric and Maternity Hospital and 15 nurses from the Health Insurance Hospital.
Tools of data collection:
I. Questionnaire sheet, designed by the researcher in Arabic language, included the following:
a) Nurses sociodemographic characteristics such as; age, qualification, years of experience, regular working in neonatal intensive care units and attendance of previous training courses.
b) Nurses’ knowledge related to care of high-risk neonates such as; prematurity, respiratory distress syndrome, neonatal jaundice, hypoglycemia, and neonatal infection.
II. Modified Likert type scale to nurses’ perceived attitude:
- A pilot study was conducted in order to test tools validity and reliability.
- Data obtained were analyzed by using mean, percentage, standard deviation, and Chi-square.
III. Observational checklist: It was developed to observe the actual nurses’ performance related to care of high-risk neonates such as; physiological measurements, growth measurements daily care, feeding, care during phototherapy and suction, drawing of blood sample, oxygen therapy and precautions for prevention of infection.
Results:
The main findings of the study are as the following:
- About two thirds (65%) of the sample was in the age group of 20 to less than 30 years, 70% graduated from faculties of nursing, 30% had diploma of secondary nursing school, 91.7% have experience in NICU for less than 10 years and 48.3% of the nurses attended training courses related to high risk neonate.
- The present study proved that total knowledge regarding high risk neonate was average for 70% of nurses, while their actual practice regarding to high risk neonates was competent for 63.3%.
- Three quarters of studied nurses (75%) showed positive attitude toward care of high risk neonates, while 25% of them showed negative attitude.
- There was no statistically significant differences between nurses perceived knowledge and practice and their attending to training courses regarding high risk neonates (X2=1.9 & 2.8 respectively at p>0.05) but there was statistically significant difference between nurses attitude and their attending to training courses (X2=5.0 at p<0.05).
- There were no statistically significant differences between nurses perceived knowledge and attitude and their qualification (X2=10.3 & 5.4 respectively at p>0.05), but there was statistically significant differences between nurses practice and their qualification (X2=12.1 at p<0.05).
- There was positive correlations and no statistically significant differences between nurse’s perceived knowledge and their actual practice and attitude toward high risk neonate (X2= +0.52 & +0.57 respectively at p>0.05).
Conclusion:
Based on the finding of the present study one can conclude that the highest percentage of nurses had average knowledge, while minority of nurses’ had good score regarding to high risk neonates. Also more than half of nurses’ were competent regarding practices related to high risk neonates as well as the bachelor degree of nurses had the highest scores of knowledge and practices, the majority of studied nurses showed positive attitude toward high risk neonates.
Recommendations:
In the light of the study findings, the following recommendations are proposed:
- Development of an orientation program to the newly admitted nurses to NICUs is mandatory to prepare them before working at neonatal intensive care units.
Establishment of in-service educational program to provide continuous education for nurses in the neonatal intensive care unit is aiming to refresh their knowledge, practice and attitude.
Apply the established standardized neonatal intensive care guidelines (policies and procedures) in dealing with high risk neonates.