Objectives Thalassemia is the most common genetic disorder in Egypt, with an estimated carrier rate of 9-10%. It is a genetic blood disorder which can be fatal if proper chelation is not received. The introduction of chelating agents capable of removing excessive iron from the body has dramatically increased life expectancy and improved the overall quality of life. The aim of this study was to assess the impact of educational programmes regarding chelation therapy on the quality of life of thalassemic children. Methods The study was carried out at the Mansoura University Children's Hospital in the period between March 2010 and May 2011. It included 173 B-thalassemia children (84 boys and 89 girls) with age ranging between 8-18 years. The researcher used a predesigned interviewing questionnaire to collect data regarding children's knowledge about thalassemia and its management, especially regarding chelation therapy. The paediatric quality-of-life inventory tool (Peds QL 4.0 generic core) was also used to assess the studied children's quality of life. Results There was a significant statistical difference of the studied children's knowledge regarding chelation therapy and their quality of life. Conclusion There was a positive effect of the educational programme in improving children's knowledge score and their quality of life. Application of educational programmes for thalassemic children and their nurses regarding chelation therapy and its importance in preventing thalassemia complications is established.

Background: Ventilator-Associated Pneumoniais considered a severe health care-associated infection that results in severe morbidity and increase mortality rate. Moreover, it also lengthens hospital staying and increase hospital expenses. The study aims to evaluate the effect of care bundle strategies on nurses' performance regarding prevention of ventilator associated pneumonia at neonatal intensive care Units. Design: Quasi-experimental, pre-and post-intervention study. Subjects: All nurses(65) in neonatal intensive care units at 10 th of Ramadan Charity Hospital and Aga Central Hospital. Tools: Two tools were used; 1 st tool; sociodemographic data and predesigned questionnaire for nurses' knowledge and 2 nd tool; observational checklist to assess nurses' performance regarding ventilator-associated pneumonia. Results: shows a significant improvement of nurses' knowledge regarding ventilator-associated pneumonia care bundle immediately after and at follow up in relation to neonates' positioning, oral care and ventilator care measures and the majority of them had a competent level of performance regarding observed ventilator-associated pneumonia care bundle before, immediately after and three months after program application. Conclusion:The application of care bundle strategies for the nurses had improved their level of knowledge and performance regarding prevention of ventilator-associated pneumonia with highly significant difference between mean score of total nurses' knowledge and performance.Recommendations: Continuous up to date guided protocols should focus on enhancing nurses' performance regarding ventilator-associated pneumonia care bundle.

Background: Urinary tract infection is the most common healthcare associated infection (HCAI) that usually results from prolonged use of urinary catheter that results in prolonged hospital stay. Prevention of catheter associated urinary tract infection (CAUTI) in pediatric patients regarded now as an important hospital policy worldwide. Aim: The aim of this study was examining the effectiveness of evidence-based guidelines on catheter associated urinary tract infection rate among pediatric intensive care children. Design: A quasi-experimental design was utilized. Setting: The study was conducted in acute care units (medical pediatric intensive care unit "PICU", surgical PICU and cardiac PICU) at Mansoura University Children's Hospital. Subjects: The subjects of the study included 84 nurses who are working at the above-mentioned study settings &102 pediatric patients who are divided randomly into 2 identical groups, case& control groups, each group consists of (51) pediatric patients. Tools: I: A Structured self-administered questionnaire, II: evidence-based guidelines on Urinary catheter maintenance and removal observational checklists, III: A structured questionnaire of pediatric patients' health condition & IV: Catheter-associated urinary tract infection criteria checklist. Results: There was an improvement in the mean scores of nurses' total knowledge and practice with statistically significant difference (P<0.001) in the post intervention compared to pre intervention stage, additionally, the positive symptoms and signs suggesting CAUTI were more evident in control group compared to case group with significant difference (P <0.05 & P <0.001) post intervention. Conclusion: the implementation of evidence-based guidelines about CAUTI prevention for pediatric patients with urinary catheter has positive significant improvement on the prevention of CAUTI rate. Recommendations: there is a requisite to educate the pediatric nurse to avoid routinely use of urinary catheters and remove them when they are no longer required. The use of urinary catheter evidence-based guidelines checklists should be kept in the pediatric patient file and reviewed regularly by pediatric nurses.

Hemodialysis (HD) is the most common treatment modality for end-stage renal disease (ESRD). Hemodialysis imposes a variety of physical and psychosocial stressors that challenge not only the adolescents but also the care givers. Muscle cramps and fatigue are common complications of HD treatment that adversely affects adolescent's wellbeing, activities, relationships and tolerance to treatment. There is no well-defined mean of preventing or treating these symptoms. Exercises are very important element in the overall health of people at any age. Reflexology massage have been used with apparent success in some patients. It may be the best measure in reducing or preventing muscle cramps and fatigue levels from occurring. The nurse can play an important role in management of these symptoms by applying a safe and an effective assistant method beside the standard medical care as reflexology massage that can promote well-being, relaxation and improve the severity of these symptoms. This article review describes the technique of reflexology massage, the physiology behind it, and discusses the available evidence for its efficacy in reducing common complications of HD such as muscle cramps and fatigue.

Background: Virtual reality technology is a remarkably effective method to distract attention from painful stimuli. It is a promising and attractive intervention to help reduce anxiety and pain of children undergoing painful procedures. Aim: to evaluate the effect of applying virtual reality glasses on reducing pain and anxiety of children undergoing chemotherapy. Method: A quasi-experimental research design was used to conduct the study at the Oncology Department of the Specialized Children's Hospital in Benha, affiliated with the Ministry of Health and Population, Egypt. A purposive sample of 50 children undergoing chemotherapy was included. Four tools were used for data collection: A structured interviewing questionnaire, pain rating scale, Beck anxiety inventory scale, and Physiological assessment of children. Results: The results of the study revealed that more than half (52.0%) of the children experienced severe pain before the intervention, while less than two-thirds (60.0%) of the children reported no pain after the intervention. Furthermore, less than two-thirds (60.0%) of the studied children had a high anxiety level before the virtual reality glasses intervention. However, during the intervention, less than half (46.0%) of the studied children had a low anxiety level Conclusion: Children who received the virtual reality glasses exhibited less pain and anxiety score compared to children who did not receive them Recommendations: Virtual reality should be used as a technology to reduce pain and anxiety during painful procedures of children admitted in pediatric oncology departments.