الفهرس 
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Abstract
Liver transplantation is recognized as definitive management for patients with acute and chronic liver failure with excellent outcomes. Liver transplantation can be defined as a surgery to remove a diseased liver and replace it with a healthy liver (or part of one) from a donor. Donor evaluation criteria include that donors should be in a good health, normal liver function, stable cardiopulmonary function and blood type is compatible with the recipient.
The early post-operative period is a crucial time in which the nurse, as a member of the multidisciplinary team, plays a vital role in the success of the operation and decreases patient stay at critical care unit. Intensive care management of liver transplanted patients mainly centers on rapid hemodynamic stabilization, correction of coagulopathy, care of patient on mechanical ventilation, proper fluid administration, kidney function preservation, graft rejection prevention, and infection prophylaxis.
Aim of the study:
The aim of this study was to:
Assess nurses’ performance regarding management of patients post liver transplantation in critical care unit through:
1- Assess nurses’ level of knowledge regarding management of patients post liver transplantation in critical care unit.
2- Assess nurses’ level of practice regarding management of patients post liver transplantation in critical care unit.
3- Assess nurses’ level of attitude regarding management of patients post liver transplantation in critical care unit.
Research question:
1. What was the nurses’ level of knowledge regarding management of patients post liver transplantation in critical care unit?
2. What was the nurses’ level of practice regarding management of patients post liver transplantation in critical care unit?
3. What was the nurses’ level of attitude regarding management of patients post liver transplantation in critical care unit?
Research Design:
A descriptive exploratory design was utilized to conduct this study.
Setting:
This study was conducted in critical care unit at Ain Shams Specialized Hospital / Cairo/ Egypt.
Subject:
A purposive sample of (30) nurses who caring for patients post liver transplantation in critical care unit at Ain Shams Specialized Hospital and all of them met the criteria for selection as nurses was already dealing with patients post liver transplantation surgery, their years of experience not less than 6 months for working in critical care unit and they were agree to participate in the study.
• Tools of data collection:
Data was collected using the following tools:
I – Nurses’ knowledge assessment structured self administrated questionnaire (appendix I).
Section I: It was concerned with assessment of demographic data of the study nurses as (age, sex, level of education, marital status, years of experience, and training courses in liver transplantation).
Section II: It was concerned with assessment of the nurses̕ knowledge regarding liver transplantation and the nursing management post transplantation.
II- Nurses’ attitude likert scale (Appendix II):
It was used to assess nurses’ level of attitude in caring patients post liver transplantation by using likert scale.
III- Nurses’ practice observational checklist (Appendix III):
It was used to assess nurses’ level of practice regarding caring of patients post liver transplantation in critical care unit as (immediate post-operative receiving care, mechanical ventilator connection, drain connection check and wound observation, arterial blood gases, hemodynamics measures).
The results of this study showed that:
- Regarding nurses’ demographic characteristics 56.7%, of the study nurses’ ages were above 35 years old and 86.7% were females, 80.0% of them were married and their level of education at nursing secondary school diploma with experience more than 10 years. In addition, 96.7% of the study sample didn’t have any training course about liver transplantation.
- Concerning the nurses’ knowledge it was found that, 96.7% of them had unsatisfactory level knowledge regarding liver transplantation and 100.0% of them had unsatisfactory level of knowledge regarding post liver transplantation nursing care.
- Regarding nurses’ total attitude, 93.3% had positive attitude regarding caring of patients post liver transplantation and 66.7% had unsatisfactory total level of practice.
- Furthermore, there was no statistical significant relations between the studied nurses’ total level knowledge, practice, attitude and their demographic characteristics.
- Also, there was significant strong positive correlation between total knowledge and practice of the studied nurses, but there was no correlation between total knowledge & total attitude and also between total practice and total attitude.
The results of this study concluded that:
The study revealed that all of studied nurses of studied nurses had unsatisfactory total level of knowledge regarding managing of patients post liver transplantation in critical care unit and about two third of them had unsatisfactory total level of practice regarding caring of patients post liver transplantation. While, the majority of them had positive attitude regarding caring of patients post liver transplantation. In addition to, there was a significant strong positive correlation between total knowledge and practice of study nurses, but there was no correlation between total knowledge & total attitude and also between total practice and total attitude. Also, there were no statistically significant relations between the studied nurses’ total level of knowledge, practice, attitude and their demographic characteristics.
The study recommended that:
• A simplified and comprehensive booklet should be designed including guidelines about caring for patients post liver transplantation in critical care unit.
• Critical care units should be supplied by a protocol of nursing care for managing of patients post liver transplantation.
• Educational training program for nurses should be designed to improve nurses’ performance in critical care unit regarding management of patients post liver transplantation at Ain Shams Specialized Hospital.
• Further study is recommended to evaluate the effect of educational training program regarding managing of patients post liver transplantation and consequently their effect on the patients outcome.
• Replication of the current study on large sample and different hospitals settings to be able to generalize the results.