الفهرس 
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Abstract
Hepatitis C is the most common liver disease in renal dialysis patients while liver disease itself is a significant cause of morbidity and mortality in patients with end-stage renal disease (ESRD) treated by dialysis or transplantation. Patients with renal disease are at an increased risk of acquiring HCV because of prolonged vascular access and the potential for exposure to infected patients and contaminated equipment. 1-Research Design: A retrospective Descriptive analytic research design was used. 2-Setting: The study was conducted in El-Gharbia Governorate sector (B) Including HD units in: El-Santa, El Mahala Elkopra, Samannud, zifta. 3-Sampling: 1- A convenience sample of all files of –ve patients Undergoing maintenance hemodialysis from 2012 to 2014 (n=120). 2-All nurses working in the above mentioned settings (n=100). 4-Tool: Tool 1: A structured interview questionnaire: It was developed by the researcher to assess nurse’s knowledge regarding virus C for hemodialysis patient. It comprises of two parts: Part A: Personal data Part B: Nurses knowledge about virus C: Tool 2: Observation checklist of infection control practices of nurses related to initiation and monitoring of patient during hemodialysis that Include:
Part 1) observation checklist of infection control for nurses practices in hemodialysis unit: Part 2) observation checklist of performance of Infection control precautions for dialysis services in different dialysis units: Tool 3: Patient files for getting recorded data Socio demographic data -Clinical data 5-Methods: Approval: A formal letter was issued from the Faculty of Nursing, Menoufia University, to obtain an official approval to carry out the study at El-Gharbia governorate hospitals (sector B) the letter explained the aim of the study, clarifies its procedure and tools to be used for data collection also ,an informed consent of nurses was taking to participate in the study. Validity: All tools were tested for content validity by experts in the field of Medical Surgical and Community health nursing. The modifications of the tool were done according to the panel’s judgment on the clarity of the sentences and the appropriateness of its content the sequence of its items and the accuracy of scoring. Reliability: Reliability analysis was used to determine the extent to which the items in the questionnaire are stable and related to each others of the tool .it was for internal consistency using test -retest reliability that was done to assess the consistency of the tool, by administration of the same tools to the same subjects under similar condition on two different occasion. The reliability of tools were 0.867.Pilot study Pilot study was carried out on 10 of nurses and 12 of patient’s files from the same chosen departments for testing the applicability and clarity of the tools. This sample was excluded from the study sample. Ethical consideration & human right: Written consent for participation in the study was obtained from nurses after explanation of the aim of the study, Confidentiality and privacy was assured. Participation of nurses was voluntary and they were allowed to withdraw from the study at any time without penalty. Field work: The process of data collection took two months.it was carried out in the period from May 2014 and completed by December 2014. The researcher visited the selected areas two weeks for each unit, three days in the week for collecting data from patient files using tool 3 parts A, B. Also, Assessment of nurses using tool1 part A and B and tool 2 part A and Assessment of hospital using tool 2 part B, were done 6-The main results: The present study concluded that there was 20% patients converted to positive state throughout their duration of HD (3years). Present study included 79 male patients (65.8%) and 41 female patients (34.2%), the age of the patients ranged from 30 years to 49 years. The statistical analysis denoted that 75% of patients had a history blood transfusion. The results listed that 70% of the surveyed nurses did not attended training courses Also the statistical analysis denoted that there was no significant relationship between the rate of conversion of the HCV negative hemodialysis patients and their duration of dialysis. In current study the knowledge of the hundred nurses working at hemodialysis unit (HDU) about causes of HCV transmission, 88% did not know its cause. Also, the data indicated that less than half (40%) did not know what to do when stick by a needle. In current study nurses performance of infection control measures were mostly inadequately done, especially asepsis 100%, hand hygiene 94%, environmental cleaning 71% and medication precautions 69%. Also < concentrate containers and water dialysates not done by 86%, 63% respectively. 7-Recommendation: 1- An educational program should be designated to the nurses who are working in hemodialysis units including the standard actions that should be applied to care for patients in hemodialysis units. 2- A booklet should be designated and distributed to all nurses who were working in hemodialysis units including the standard actions that should be applied and followed to care for patients in hemodialysis units. 3- All hemodialysis centers should ensure implementation of, and adherence to, strict infection-control procedures designed to prevent the risk of cross infection amongst hemodialysis patients. 4- Screening of HCWs for HCV (together with other blood-borne viruses and immunization to HBV) must be done at the beginning of the initial formation. Similarly, those HCWs must be checked regularly (at least once a year) for HCV status. 5- Replication of the study using larger sample to attain more generalizable results.