Background and Objective: Nutritional support is an essential component of critical care with a significant effect on the outcomes of critically ill patients. Critical care nurses are in a central position to achieve the nutritional goals and preserve the nutritional status of patients at the best possible level. This study aimed to investigate the critical care nurses’ perceptions of the responsibility, knowledge, and documentation system support regarding enteral nutrition. Methods: Using a quantitative, descriptive, cross-sectional design data were collected from 292 critical care nurses in different healthcare sectors in Sana’a, the capital city of Yemen. A self-administered questionnaire containing 50 items was used for data collection. The data were collected between March and June 2021. The Statistical Package for the Social Sciences (SPSS) version 16 was used for the data analysis. Results: The study found that most of the critical care units did not have guidelines, protocols, or a nutritional support team, and the physicians prescribed the enteral nutrition. The critical care nurses perceived that they had a low responsibility, low knowledge, and moderate documentation support regarding enteral nutrition. The nurses in private hospitals had the highest responsibility, the nurses who received in-service education about enteral nutrition reported the highest level of knowledge, and the nurses in the Neuro critical care units had the best support from a documentation system. Scientific workshops and conferences were the main sources of knowledge regarding enteral nutrition. The nurses’ educational needs included the ability to evaluate the outcomes, goal setting, and nutritional assessment. Conclusions: The critical care nurses perceived a low responsibility, low level of knowledge, and moderate support from a documentation system regarding enteral nutrition. There is an urgently need to create or adopt enteral nutrition evidence-based guidelines, and protocols, and establish multidisciplinary nutritional support team with clear roles and responsibilities. In-service education and training related to enteral nutrition is paramount.

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.

Although endotracheal suctioning (ETS) is essential, the procedure, however, is not free of risks and complications especially when performed incorrectly. These risks and complications can seriously affect the stability of critically ill patients. Therefore, it is very important to perform this procedure with professional competence, which means not only having the necessary skills, but also knowledge based on recent scientific evidence, and ensures efficiency and the safety of the patient. The aim of this study is to evaluate the gap between knowledge and practice in open system ETS among critical care nurses (CCNs). Methodology: Sixty CCNs working at the Intensive Care Units (ICUs) of Alexandria Main University Hospital (AMUH) and providing direct care for patients with an artificial airway were included in the study. Two different tools were used to collect the data; Endotracheal suctioning knowledge 'structured questionnaire, and Endotracheal suction observational checklist. Results: more than two thirds of the study sample were female, and had bachelor degree either intern or staff nurses. 63.3 % of them had working experience of less than 5 years. Knowledge of CCNs regarding ETS was higher than their performance. Conclusion & recommendations: it can be concluded that CCNs had inadequate knowledge and poor performance in relation to ETS and there was a gap between knowledge and practice of CCNs in relation to ETS. These findings suggest that CCNs should be continuously assessed for their knowledge and practices regarding ETS and CCNs' performance in relation to ETS should be improved. In service educational programs should be conducted for critical care nurses regarding ETS.

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