Postoperative care is very important phase for patient, as it can prevent or reduce the occurrence of the complications. Aim: Assess factors affecting postoperative nursing performance in the surgical units. Research design: A descriptive exploratory design. Setting: surgical units at Benha university hospitals. Subjects: Convenient samples of 75 nurses were worked at the previously mentioned setting at the time of data collection. Tools of the study: self-administered questionnaire and an observational checklist. Results: more than three quarters of the studied nurses had unsatisfactory level of knowledge, more than three quarters of the studied nurses reported that the total factors had an effective effect on their performance, about two thirds of the studied nurses had unsatisfactory level of practice, there were highly statistical significant relation between studied nurses' Knowledge and their experience, while there was statistically significant relation between studied nurses' knowledge and their job and their education, statistically significant relation between studied nurses' practice, their job, their experience and the courses which were taken, highly statistical significant relation between factors affecting nursing performance in the surgical unit and their age, while there was statistically significant relation between factors affecting nursing performance in the surgical units and their marital status and their experience, statistically significant relation between studied nurses' knowledge and studied nurses' practice, anda significant correlation between studied nurses' knowledge and a studied nurses' practice. Conclusion: It was concluded from this study that nurses' performance depends on education, training, experience and attending of courses. Recommendations: The study recommended the importance of implementing an educational training program to improve nurses' performance regarding management of patient after surgery, and recommended to develop a good nurse job description.

Background: Though creation of an ostomy is a life saving procedure and increased lifespan it may result in significant number of complications which impact body image, daily functioning, social activities and a significant reduction in the quality of life. So persons living with colostomy require comprehensive education, training to manage their stoma and to identify, prevent stomal or peristomal complications during the early postoperative period. Aim of the study: To evaluate the effect of a designed nursing and patients self care protocol on reducing the colostomy and peristomal skin complications among the elderly patients. Research design: A Quasi-experimental research design was utilized in the current study. Subjects: A purposive sample including (60) elderly patients from both sexes (males & females) aged 60yrs old and older were included in the current study, they were classified into two equal groups (no=30) for the study group and (no=30) for the control group. Setting: This study was carried out at General Surgical Department and Surgical Outpatient Clinics in Minia University Hospital. Tools of data collection: Four tools were utilized to collect data. Tool I: Patient assessment sheet, Tool II: Designed colostomy nursing and patient's self-care protocol. Tool III: Observation Check list designed by the researcher, Tool IV: Peristomal skin assessment scale. Results: The results of the current study revealed that, the majority of the study group had normal skin along all observations, while all of the control group didn't have normal skin along the 7 observations. Also, there were statistically significant differences among the study and control groups regarding total DET score along the 7 observations. Conclusion: It was concluded that implementation of the educational guideline about stoma self care had a positive effect on improving awareness regarding practice among the study group which leading to prevention of the peristomal skin complications. Also, it was found the majority of study group didn't have peristomal skin complications along all observations while among the control group there was an increase of peristomal skin complications. Recommendations: proper counseling sessions as well as pre and post operative education for ostomy patients that will help them to adjust to their stoma care in a better way. There is need for a simplified illustrated and comprehensive Arabic-language booklet to be used as reference educational guidance for patients with colostomy. In-service educational programs and job training to upgrade nurse's knowledge, attitudes and practices toward providing essentials components of nursing care.

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Background: Critical care nurses have an important role in care of vascular access difficulties' patients. Intraosseous is parenteral vascular access through the bone marrow. Aim of the study: to assess nursing care regarding post intraosseous access insertion in critical care units. Design: A descriptive exploratory design was utilized in this study. Research questions: What are the nursing care regarding intraosseous (IO) access insertion in critical care units? Setting: The study was carried out at different Critical Care units at Tanta University Hospitals, in Egypt. Sample: A sample of purposive of 40 nurses from different critical care units. The minimum 6 months of experience were included in the present study. Tools of data collection: Two tools were used to collect data; the first tool has two parts; part one is characteristics data that included gender, age, years of experience, educational level and area of work. Part two was intraosseous access knowledge questionnaire to assess knowledge regarding indication, contraindication, and nursing measures towards intraosseous access. The second tool was intraosseous observational checklist that was designed to assess nurses' practices while preparing patient and equipment, handling the physician during insertion, administering fluids and medication and removing of intraosseous access. Results: The current study findings revealed that 65% of studied nurses had unsatisfactory level of knowledge regarding intraosseous access care. While, 35% of studied nurses had satisfactory level of knowledge. Regarding nurses' level of practice, it was found that, 55% of nurses had unsatisfactory practical level. While, 45% of studied nurses had satisfactory practical level regarding intraosseous access care. Regarding intraosseous insertion. A significant correlation were existed between age and practice also between their level of knowledge and practice regarding caring of theintraosseous access. Conclusion: it can be concluded that critical care nurses have unsatisfactory level of knowledge and practice regarding nursing care post intraosseous access insertion in critical care units. Recommendations: Carrying out educational programs about nursing management of patients with vascular access difficulties especially intraosseous access. Replication of the study on a large probability of sample from different ICUs concentrated on emergency departments for benefits of emergency situations is required.