IV.

Contractures are a common complication following sever burn injury, and are characterized by a reduction in joint mobility. Aim: was to evaluate the impact of active verses passive range of motion exercises on contracture severity among burn patients. Method: Quasi-experimental pre-test, posttest research design was utilized. The study was conducted in Burn Unit at General Kafrelsheikh Hospital-Kafrelsheikh City-Kafrelsheikh Governorate; affiliated to Ministry of Health, Egypt. A purposive sample of 60 patients was the study sample. The actual time of data collection started from beginning of October 2018 to the May of 2019. Patients were received the routine hospital treatment regimen plus range of motion exercise for each patient at least for one time daily. Tools: Two Tools were used for data collection; tool Ι; Assessment questionnaire sheet, and Tool Π Joint motion measurement scale. Results: A highly statistically significant correlation was found between following active range of motion exercises and joint contractures among the study group (r= 0.624; P = 0.000). Compared with a highly statistically significant correlation between following passive range of motion and joint contracture among the study group (r = 0.811, ;p-value = .000). Conclusion: Despite the frequency of contractures at time of hospital discharge, very few contractures were severe, and this may be emphasized the importance of practicing range of motion exercises during acute hospitalization Recommendations. Early application of range of motion exercise is an important intervention for minimizing contracture in sever burn patients.

Background: Chest tube is an essential life saving measure for the management of pneumothorax, hemothorax and hemopneumothorax developed as a consequence of chest trauma or surgery. The aim of this study was to assess the effect of developing and implementing guidelines of nursing management of patients with chest tube drainageon nurses'Performance. Subjectsand method: Quasi experimental design was utilized to carry out this study. Study Subjects:All available nurses were included in the study (44) nurses of both sexes who are working in chest department at Mansoura University Hospitals.Two tools were used for data collection; first tool included two parts sociodemographic characteristics of the studied nurses and interview questionnaire sheet about nursing management of patients with chest tube drainage. Second tool isnurses' performance observational checklist about nursing management of patients with chest tube drainage. Results: the majority of the studied nurses were females in their second and third decade.Before implementing the guidelines62.5% of the studied nurses had low knowledge level, and 70% of them had moderate practice level, while after direct implementation of the guidelines 65.0% of them had moderate knowledge level and 90% had high practice level. The study concluded;nursing management intervention guidelines significantly improved nurses' performance for patients with chest tube drainage. The study recommended;administrators should create policies and plans for providing education to the nursing staff, evaluating nurses' Performance periodically to determine the effect of the training programs, and chest department should be supplied by checklists about all chest tube procedures.

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Background: Malnutrition is mostly common worldwide among hemodialysis patients which increased risk of morbidity and mortality. Aim of the study: To evaluate efficacy of nutritional support educational program on anthropometric measurement and subjective global assessment score among hemodialysis patients. Methods: With in this study Quasiexperimental research design was utilized. A purposive sample of 100 adult patients of both sexes diagnosed with chronic renal failure and on maintenance hemodialysis (MHD), the tool used for data, collection included nutritional assessment sheet, and nutritional formula. Results: the study sample consists of certain hundred hemodialysis patients who met the inclusion criteria and agreed to take part into the study; Their main age was between 30 to ≥ 60 years old .The sample consisted of 49) male and 51) female. In regards renal failure causes identified by the participants, the majority had hypertension (83%), 36% of patients had diabetes and 55 % of the sample had virus C infections. Almost all the participants (92.5%) had a three times frequency of hemodialysis per week 48%on dialysis more than 5years. 39 % of study sample were considered mildly to moderately malnourished according to subjective global assessment score. Nutrition support educational program resulted in improvements in subjective global assessment score , anthropometric measurements and nutritional knowledge of the patients. Conclusion: Planned dietary education or counseling for hemodialysis patients performs a main function withinthe preservation concerning scientific outcome and the universal health regarding aff ected person. Recommendation: Continuous education and training are required for all hemodialysis patients about nutrition.