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Abstract The aim of the current study was to assess quality of nursing care provided to neonates in the first 24 hours post extubation through Assessment of nurses’ applicability of the standards of care for neonates in the first 24 hours post extubation and Assessment of factors hindering non applicability of the standards care for neonates in the first 24 hours post extubation. Subjects and Methods Setting: The study was conducted at Neonatal Intensive Care Units (NICUs) at: 1. Obstetrics and Gynecological Hospital affiliated to Ain Shams University Hospitals. 2. El Mansoura Health Insurance Hospital affiliated to Ministry of Health and Population. Subjects: The study subjects included: 1. All nurses with different categories working in the previously mentioned settings regardless their age, level of education, or years of experience. 2. All neonates in the previously mentioned settings who are just extubated in the first 24 hours.Tools of Data Collection: Data was collected by using the following tools: 1- A pre-designed questionnaire format: It was designed by the researcher in the light of relevant literature and studies. It is written in simple Arabic llanguage to suit the understanding level of the study subjects. It consisted of three parts as the following: Part I: characteristics of the studied nurses such as; age, level of education, years of experience...etc. Part II: characteristics of the studied neonates such as; chronological age, gestational age, birth weight, diagnosis...etc. Part II: Nurses’ knowledge regarding applicability of the standards care for neonates in the first 24 hours post extubation. The Nurses’ knowledge was checked with a model key answer and accordingly the nurses’ total knowledge was categorized into either satisfactory < 75% and un satisfactory >75%). 2- Observational Checklists: It was adopted from relevant references to assess the actual nurses’ practice regarding care of neonates in the first 24 hours post extubation such as assisting in removal of endotracheal tube, nebulizer, cardio-respiratory monitoring, drawing blood gases sample….etc. Scoring System The Nurses’ knowledge was checked with a model key answer and accordingly the nurses’ total performance was categorized. Each step of procedure was distributed as done competent, done incompetent and not done. The total scoring of checklists was classified into: Competent level of performance >85% In competent level of performance <85% Field work: The study was carried out three days per week (Sunday-Tuesday-Thursday) for six months during the morning shift by using the previously mentioned study tools. The researcher explained the purpose of the study to all nurses before starting the interview where each nurse was interviewed individually. The questionnaire was filled by the nurses, and the researcher checked the observational checklists while observing the nurses’ actual care for neonates during the first 24 hours post extubation. Findings of the current study can be summarized as: 1- The mean age of studied nurses was 24.6+3.4 years. In relation to their educational level; five third of them (35.1%) had degree of nursing (secondary school). Also, the mean years of experience of studied nurses were 5.6 + 3.9 years. More than half of them (52.61%) were married. More than half of nurse’s attended training courses and (45.6%) not attending training courses. 2- The mean chronological age of studied neonates was 2.4+.8 weeks while the mean birth weight was 1880.7+564.5 gram. Also, the mean Gestational Age, weeks of studied neonates was 33.8+5.4. Two thirds (66.7%) of them were males and approximately three quarters (73.7%) of them were delivered by Cesarean section. Moreover; the majority of neonates their gestational age were appropriate to weight (78.9%). 3- The majority (84.2%) of neonates delivered oxygen via nasal CPAP and (15.8%) received oxygen via nasal cannula. As regard to complication occurred after extubation, more than three quarters of neonates (78.9%) of them had chronic lung disease, (14%) had lung emphysema and only (7.0%) have sepsis after extubation. 4- The mean % score of all dimensions reflecting nurses’ knowledge regarding nursing care in the 1st 24 hours post extubation was ranging from (71.9 + 16.6) to (87.7 + 15.7), however; the dimension (Oxygen therapy) had got the lowest mean % score (46.3 + 20.4). 5- The mean % score of all dimensions reflecting nursing care practice of neonates post extubation was ranging from (87.2 + 10.2) “cardiac and respiratory monitoring” (99.1 + 3.7). 6- More than half (56.1%) of studied nurses had Good Knowledge regarding nursing care in the 1st 24 hours post extubation. In addition to that; all (100.0%) of the studied nurses were competent to nursing care practice of neonates post extubation 7- Concerning the Relation between nurses’ total knowledge regarding nursing care in the 1st 24 hours post extubation and their Sociodemographic characteristics; it was noticed that there is a statistically significant difference between study participants’ knowledge score level according to their marital status (P<0.01); however, there is a statistically insignificant difference between study participants’ knowledge score level according to their Age, Education, Years of experience and attending training courses. |