Background: Central venous pressure (CVP) monitoring remains in common use as an index of circulatory filling and cardiac preload. Positive end-expiratory pressure (PEEP) in mechanically ventilated patients can affect CVP via increasing intra-thoracic pressure. Critical care nurses should be able to measure the CVP competently and identify the factors affecting its readings. Aim: The current study was conducted to determine the effect of PEEP on the CVP readings in mechanically ventilated patients. Methods: a descriptive design used in this study. A convenient sample of 200 adult critically ill patients of both sex, hemodynamically and respiratory stable, having a central venous catheter (CVC) in place, and attached to a mechanical ventilator and pulse oximeter were included in the study. The patient's baseline CVP was recorded while the patient connected to the mechanical ventilator, then the patients were temporary disconnected from the mechanical ventilator and the CVP measured again without the effect of PEEP. Results: About 40% of the study sample aged 45 to 64 years, 52.5% were males, 50 % suffered from respiratory disorders, and 49% were overhydrated. Eighty eight percent of the study sample was on PEEP levels between 5 to < 10 cmH 2 O. The CVP readings while the patients connected to MV were higher than CVP reading while the patients without PEEP, but these differences were not significant. Conclusion: CVP readings are not significant affected by the PEEP up to 15 cmH 2 O. The CVP can be reliably measured while patients are connected to MV. Recommendations: Measurement of CVP can be obtained while the patient is connected to MV.

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High qualified specialized oncology nurses are considered the backbone in any chemotherapy administration agency. Using standardized protocol for administration of chemotherapy is a pressing demand for prevention of medication errors with promotion of patients' safety and satisfaction. Aim: Evaluate the effect of chemotherapy nursing protocol application on patients' care competency, safety, and satisfaction. Design: Quasi experimental design. Setting: Oncology institution of Menoufia University. Subjects: A convenience sample of 44 oncology nurses and 36 patients receiving chemotherapy. Tools: Socio-demographic questionnaire, Oncology Nurses' knowledge questionnaire, Self-assessment chemotherapy related clinical competency questionnaire, Patient safety culture questionnaire and patients' satisfaction questionnaire. Results: The number of reported errors decreased throughout study phases with high statistically significant difference. The total knowledge score of studied nurses was improved from 7.75 pre protocol application to 21.45 immediately post protocol application with high statistically significant difference. The total nurses' competency score was improved from 48.79 to 88.50 then 87.57 respectively with high statistically significant difference. The total patients' satisfaction score was improved from 10.61 to 25.29 then 25.09 respectively with high statistically significant difference. Conclusion: A considerable improvement was observed in oncology nurses' knowledge, clinical competency and patients' safety and satisfaction after chemotherapy nursing protocol application. In addition, there was positive correlation between nurses' knowledge and competency and both patients' safety and satisfaction. Recommendation: Application of chemotherapy nursing protocol is recommended routinely for managing all chemotherapy patients.