الفهرس 
High Risk Neonates for Endotracheal TubeOnly 14 pages are availabe for public view
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Abstract
The aim of the current study was to assess quality of
nursing care provided to neonates in the first 24 hours post
extubation through Assessment of nurses’ applicability of the
standards of care for neonates in the first 24 hours post
extubation and Assessment of factors hindering non
applicability of the standards care for neonates in the first 24
hours post extubation.
Subjects and Methods
Setting:
The study was conducted at Neonatal Intensive Care
Units (NICUs) at:
1. Obstetrics and Gynecological Hospital affiliated to Ain
Shams University Hospitals.
2. El Mansoura Health Insurance Hospital affiliated to
Ministry of Health and Population.
Subjects:
The study subjects included:
1. All nurses with different categories working in the
previously mentioned settings regardless their age,
level of education, or years of experience.
2. All neonates in the previously mentioned settings
who are just extubated in the first 24 hours.Tools of Data Collection:
Data was collected by using the following tools:
1- A pre-designed questionnaire format:
It was designed by the researcher in the light of
relevant literature and studies. It is written in simple Arabic
llanguage to suit the understanding level of the study
subjects. It consisted of three parts as the following:
Part I: characteristics of the studied nurses such as; age,
level of education, years of experience...etc.
Part II: characteristics of the studied neonates such as;
chronological age, gestational age, birth weight,
diagnosis...etc.
Part II: Nurses’ knowledge regarding applicability of the
standards care for neonates in the first 24 hours post
extubation.
The Nurses’ knowledge was checked with a model key
answer and accordingly the nurses’ total knowledge was
categorized into either satisfactory < 75% and un satisfactory
>75%).
2- Observational Checklists:
It was adopted from relevant references to assess the
actual nurses’ practice regarding care of neonates in the first
24 hours post extubation such as assisting in removal of endotracheal tube, nebulizer, cardio-respiratory monitoring,
drawing blood gases sample….etc.
Scoring System
The Nurses’ knowledge was checked with a model key
answer and accordingly the nurses’ total performance was
categorized. Each step of procedure was distributed as done
competent, done incompetent and not done.
The total scoring of checklists was classified into:
Competent level of performance >85%
In competent level of performance <85%
Field work:
The study was carried out three days per week
(Sunday-Tuesday-Thursday) for six months during the
morning shift by using the previously mentioned study tools.
The researcher explained the purpose of the study to all
nurses before starting the interview where each nurse was
interviewed individually. The questionnaire was filled by the
nurses, and the researcher checked the observational
checklists while observing the nurses’ actual care for
neonates during the first 24 hours post extubation.
Findings of the current study can be summarized as:
1- The mean age of studied nurses was 24.6+3.4
years. In relation to their educational level; five third of them (35.1%) had degree of nursing
(secondary school). Also, the mean years of
experience of studied nurses were 5.6 + 3.9 years.
More than half of them (52.61%) were married.
More than half of nurse’s attended training
courses and (45.6%) not attending training
courses.
2- The mean chronological age of studied neonates
was 2.4+.8 weeks while the mean birth weight
was 1880.7+564.5 gram. Also, the mean
Gestational Age, weeks of studied neonates was
33.8+5.4. Two thirds (66.7%) of them were males
and approximately three quarters (73.7%) of them
were delivered by Cesarean section. Moreover;
the majority of neonates their gestational age were
appropriate to weight (78.9%).
3- The majority (84.2%) of neonates delivered
oxygen via nasal CPAP and (15.8%) received
oxygen via nasal cannula. As regard to
complication occurred after extubation, more than
three quarters of neonates (78.9%) of them had
chronic lung disease, (14%) had lung emphysema
and only (7.0%) have sepsis after extubation.
4- The mean % score of all dimensions reflecting
nurses’ knowledge regarding nursing care in the
1st 24 hours post extubation was ranging from (71.9 + 16.6) to (87.7 + 15.7), however; the
dimension (Oxygen therapy) had got the lowest
mean % score (46.3 + 20.4).
5- The mean % score of all dimensions reflecting
nursing care practice of neonates post extubation
was ranging from (87.2 + 10.2) “cardiac and
respiratory monitoring” (99.1 + 3.7).
6- More than half (56.1%) of studied nurses had
Good Knowledge regarding nursing care in the 1st
24 hours post extubation. In addition to that; all
(100.0%) of the studied nurses were competent to
nursing care practice of neonates post extubation
7- Concerning the Relation between nurses’ total
knowledge regarding nursing care in the 1st 24
hours post extubation and their Sociodemographic
characteristics; it was noticed that there is a
statistically significant difference between study
participants’ knowledge score level according to
their marital status (P<0.01); however, there is a
statistically insignificant difference between study
participants’ knowledge score level according to
their Age, Education, Years of experience and
attending training courses.