Background: Patient safety culture (PSC) is a vital feature to assess the ability of any healthcare setting in addressing and reducing patients harm. This study attempted to assess the PSC in Intensive Care Units (ICUs) at Alexandria Main University Hospital (AMUH) from the point of view of physicians and nurses. Methods: A cross-sectional study was implemented in two ICUs at AMUH over period of six months. Seventy-two participants were interviewed using the Hospital Patient Safety Scale, customized by the Agency for Healthcare Research and Quality (AHRQ). Results: The average positive response to individual items in the patient safety scale ranged from 2.7% to 79.2%. The "Teamwork within Units" dimension had the utmost average percentage positive score (63.5%) amongst all participants, on the other hand, the "Non-Punitive Response to Errors" dimension had the lowest one (12.0%). Less than half (45.8%) of the interviewed participants rated patient's safety at the hospital as accepted. Conclusions: PSC is friable in targeted ICUs, much of work is needed to raise the responsiveness of health care givers regarding this issue. Executives and supervisors need to encourage the practices of PS through a blame free culture.

Objective: The present study was conducted to investigate the impact of breastfeeding on the risk of development of acute leukemia among children Admitted to Alexandria University Children's Hospital. METHODS: A case control study included 134 ALL&AML cases & 134 matched controls for age & sex from the same family relatives to evaluate socioeconomic & genetic causes of the disease. The mothers were interviewed for the completion of interview format that included: duration & patterns of breastfeeding. RESULTS: lower proportion of acute leukemia cases 59.7% were exclusively breast-fed babies as compared to 89.6% of the control subjects. However, higher proportions of index children were either predominant breast-fed 19.4% or complementary-fed 10.4%. Nearly 10.4% were bottle-fed babies as compared to none of their controls. The differences between cases & controls as regards pattern of breast feeding were statistically significant where p<0.001. As regards duration of breastfeeding 75.4% of index children were breast-fed for more than 6 months as compared to vast majority of their controls (97.8%). The difference between cases & controls was statistically significant where p <0.001. The association also was statistically significant when 2 groups (standard & high risk) were considered as regards pattern of breastfeeding where x2=13.055, p =0.004. The multivariate logistic regression analysis indicated that bottle feeding had the odds of 7.76 of being at high risk level for acute leukemia (OR=7.76, 95% CI 1.9-33.8). CONCLUSION: Exclusive breast-feeding and breast-feeding for one year are protective against acute childhood leukemia. Table 1. Bivariate and multivariate analysis for pattern & duration of breastfeeding of the studied children with acute leukemia and their controls. Pattern and duration of breastfeeding Bi variant variable Multivariate variable Type of feeding during the first 6 month of life. Cases (n=134) Control (n=134) Significance OR (95% CI) Significance No. % No. % X2 = 37.6 P>0.0001* 1 Exclusive BF 80 59.7 120 89.6 Predominant BF 26 19.4 13 9.7 1.67 (1.26 - 2.2)* X2 = 9.4 P=0.002* Complementary feeding 14 10.4 1 0.7 21 (2.8 - 436.4)* X2 = 16.13 P>0.0001* Bottle feeding 14 10.4 0 0 2.5 (2.1 - 2.9)* X2 = 19.12 P>0.0001* Duration of breastfeeding 0-≤ 3 month 2 1.7 0 0 X2 =15.331 MC P=0.0001* AN- FEP=0.18 =13.06 P=0.0003* X2=0.38 P=0.537 3-≤ 6 month 17 14.2 3 2.2 7.6 (2.1 - 33.8)* 6-12 month 16 13.3 17 12.7 1.26 0.6-2.8 More than 12 month 85 70.8 114 85.1 1 - X2: Chi-Square test FEP: Fisher's Exact test -NA-: Not Applicable *significant at P≤0.0 Disclosures No relevant conflicts of interest to declare.

Deep vein thrombosis (DVT) is a silent killer and it is the third most common vascular disease. Critically ill patients have general and specific risk factors for DVT. DVT prophylaxis is the most efficient and cost-effective way to prevent fatal and nonfatal VTE in critical illness. Critical care nurses play a key role in the detection and prevention of DVT. Thereby, this study aimed to evaluate the clinical nursing prophylaxis of deep vein thrombosis in critically ill trauma patients. Subjects and method a descriptive exploratory research design was utilized. The study was conducted on a convenience sample of fifty critical care nurses who worked in trauma intensive care units (ICUs) at Emergency Hospital, Mansoura University. Data were obtained using one tool; Nursing performance observational checklist for DVT preventive measures. This tool includes two parts; demographic characteristics of the nurses and DVT preventive measures observational check list. Results revealed that 62% of nursing staff had 6-10 years of experience in ICU. It was found that 76% of the nursing staff graduated from secondary nursing school and 64% of them were in the age group of 30 years old and more with a mean age of (32.22 ± 5.29). It was noted that 88% of the nursing staff in the intended ICUs did not attended inservice training course on preventive measures of DVT. It was observed that all of the nursing staff applied elastic stocking to the patients but their performance was less than 80% from the total steps of performance and more than half of them changed patient's position, performed the range of motion exercises (ROM) for the lower limbs and provided the deep breathing exercises with more than 80% of the performance steps. Also, all of the nursing staff instructed the patients about coughing exercises with more than 80% of the total performance steps, While 80% of them moved the patient on the chair with less than 80% of total performance. Conclusion The critical care nurses didn't provide a prophylaxis for DVT in critically ill trauma patients with a high performance level and there is need for continuing education to improve nurses' practices regarding DVT prophylaxis. The study recommended designing an education program and protocol about DVT prevention and it must be provided to health team members to be used as a reference guide in their performance. Integrating the DVT prevention protocol into care plan to replace the traditional nursing care plan.

Background:The health technology has greatly influenced the health care system and the interaction between nurses and patients. Caring and caring attribute is the core of nursing profession; therefore, it is necessary to explore how nursing care is affected by technology. The aim of the study was to explore the attitude of pediatric and adult critical care nurses about technology uses in nursing care and caring attributes. Design: A descriptive exploratory research design was conducted for fulfilling the aim of this study. The study sample included a convenience sample of 215 nurses working at Mansoura University Children's hospital, Mansoura university hospital, Emergency hospital and oncology center affiliated to Mansoura university, Egypt. Tow tools were used for data collection: The first tool was the Influence of Technology on nursing care Questionnaire (ITQ) and the second tool was Caring Attribute Questionnaire (CAQ). In addition to demographic characteristics of studied nurses. Results: the results of the current study showed there were a statistical significant difference between pediatric and adult nurses in all items of the scale. Approximately two thirds of pediatric nurses (60.5% & 63.2% respectively) responded with agree that the technology uses in nursing care requires highly technical skills and the mastery of technology helped the nurses to take control of their work environment compared to 84.2% & of adult nurses responded with uncertain and disagree in this point. Conclusion: Pediatric and adult critical care nurses have positive attitude regarding technology uses in nursing care. Some negative attitudes concerning technology reported by nurses due to of lack of knowledge about technology uses and the relationship between technology and patient safety. Recommendation: Educational and training program are recommended to improve the overall nurses" attitudes about technology uses and advanced caring attributes in nursing care.