Synergy model gives nurses a common language for a definition and relation between patients and nurse's needs, so patient with acute coronary syndrome need immediate nurses knowledge in coronary care unit. Aim: the aim of this study is to investigate the impact of Synergy model application on patients with Acute Coronary Syndrome outcomes. Design: a quasi-experimental research design is used in this study. Setting: This study was carried out in the coronary care unit at Sohage University Hospital. Subjects: Sixty critically ill adult patients who are admitted to the previously mentioned setting, and 12 (twelve) number of nurses in coronary care unit. Tool: Synergy model tool which include two parts, Part I: Patients' characteristics, (Stability, Resiliency and Resource availability) Part two: Nurse-Competence (Advocacy moral agency, Caring practice and Clinical judgment). Results: Findings of the current study revealed statistical significance deference in both patient's needs and nurse's knowledge according to Synergy model for level I, level 3, level 5 which determine quality of nurses and the behavior toward the patient. In this study there are highly statistical significance different according to patients needs and nurses knowledge With (P=0.000*), (0.004)*. Conclusion: The synergy model outlines that when patients' characteristics and nurses competencies synergize, optimal patient outcomes are achieved. As the patient is primary focus, optimal outcomes are defined as what patients themselves acknowledged as important.

Infection of the lungs is the most common cause of acute exacerbation of COPD. Is often from a virus, but it may also by bacteria, the lungs react to infection by developing inflammation that makes the airways narrow from muscle swelling. Aim: Evaluate the effect of early CPT on occurrence of infection among patients with AECOPD. Design: A quasi experimental research design used to conduct this study. A convenient sample consisted of study group (n=30) and control group (n=30) admitted to chest care unit at Assiut University Hospital & intensive care unit at Sohag University Hospital Tool: I: Patient Assessment: as A: socio-demographic data B: Laboratory investigation II Patient pulmonary assessment as A: Respiratory assessment (respiratory rate, bronchial secretion & breathing sound) B: Clinical pulmonary infection score. Results: Revealed highly significance in 4 th &7 th days in study group compared with control group regarding breathing sound. Regarding occurrence of infection observed highly significance in 7 th day in study compared with control groups. Conclusion: Efficient early CPT among patients with AECOPD significantly success to minimize lung infection. Recommendation: Applied as a routine care for cases to improve the patient's outcomes.

Acute exacerbation usually accompanied by increased cough, fever, wheezing, nursing care have been involved in delivering non-pharmacological interventions aimed to reducing symptoms Aim of this study was to evaluate effect of implementing nursing care on respiratory parameters for patients with acute exacerbation of chronic obstructive pulmonary diseases. Design: A quasi experimental research design was used to conduct this research. A convenient sample consisted of 60 patients, they were enrolled into study group (n=30) and control group (n=30) who were admitted to Intensive care unit at Sohag university hospital & chest care unit at Assiut University hospital Tool: this study comprised from Tool I: patient's demographic and medical data. Tool II: Patient's clinical assessment sheet consists from: Part 1: Assessment of homodynamic parameters Part II: Respiratory parameters. Part III: laboratory investigation and Receiving medications. The main results: result revealed that there is significant difference regard to temperature in study group compared with control group in 1 st & 4 rd days. As regard respiratory parameters the result revealed significant difference regarding heart rate at 4 rd &7 th day. In addition current study revealed that highly significant difference in both groups regard breath sound (p<0.005). Conclusion: Efficient nursing management after acute exacerbation of chronic obstructive pulmonary disease improves respiratory parameters.

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