الفهرس 
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Abstract
Pneumonia is the second most common infection in pediatrics.Effective nursing interventions could decrease complications of pneumonia. Furthermore, prevention and management of pneumonia must be regarded as one of the most important issues in critical care nursing. Therefore, nursing care protocols elicit the best-practice performance for healthcare practitioners and improve children outcomes Purpose of the Study:To assess the effect of a nursing care protocol on the duration of hospitalization of children with pneumonia Research Design:-A quasi experimental design was utilized (pre, post and follow up test).Research setting:This study was conducted in the Pediatric Intensive Care Unit and medical words at Meet Khalaf Chest Hospital, Shebin El kom City.Subjects:A Convenience sample of 40 nurses (27 from the medical word and 13 from the PICU) in the above mentioned setting who are caring for children with pneumonia were included. All hospitalized children diagnosed with pneumonia during the period of data collection were involved in this study.E-Instruments of the Study:Two instruments were developed for data collection.1-Instrument One:A structured interview questionnaire (pre/post, follow up test) it was developed by the Center for Disease Control and Prevention (CDCP,2004) and adapted by the researcher to assess nurse’s knowledge about pneumonia. It consists of two parts.Part One:- characteristics of the studied nurses such as age, level of education and years of experience.Part two:-Nurses knowledge about pneumonia. It contains multiple choice questions about pneumonia such as definition, causes, signs and symptoms, types of infection, dangerous signs, prevention, diagnosis,standard case management, weighing, dehydration prevention, principles of documentation and preparation for discharge.2-Instrument Two:An observational checklist (pre/post and follow up test) it was adapted by Labeau (2007) and modified by the researcher to assess nurse’s adherence to the protocol of care for children with pneumonia.The researcher observed nurses while caring for children with pneumonia and fulfilled the checklist. It consisted of two parts:Part one: characteristics of the studied children such as age, sex, classification of children and length of hospital stay Part two: Nurses practice about pneumonia such as promote rest, control fever, wash hand, mouth care, oral medication, intramuscular and intravenous injection, measuring vital signs (temperature, pulse,respiration), feeding (nasogastric, bottle feeding), oxygen therapy,mechanical ventilation , suctioning (nasal- oral and endotracheal), postural drainage, assist in diagnostic measures, psychological support (child and parent) and preparation for discharge. F-The main results of the study showed that: 1- Approximately less than half of studied nurses aged from 25-30 years old. 2- Approximately more than one third of studied nurses were bachelor and diploma degree (37.5). Also, they had 1-3 years of experience (35.0%). 3- Approximately more than half of studied children were boys and aged from 1-5 years old. Also, three quarter of them have very severe pneumonia. 4- There were statistical significant differences between pre and posttest regarding all steps of standard case management of pneumonia It was found that 5- The total mean and standard deviation of nurse’s knowledge were 64.07±5.97, 80.55 ±3.19 and 77.63±3.28 respectively on pre, post and follow up tests.6- The mean and standard deviation for children length of hospital stay tests were 3.67 ±.572, 1.900 ±.900, and 2.37 ±.806 respectively on pre, post and follow up tests. 7- There were highly statistical significant differences on post and follow up test than on pretest regarding mean and standard deviation of nurses practice (p<0.001).mechanical ventilation , suctioning (nasal- oral and endotracheal),postural drainage, assist in diagnostic measures, psychological support(child and parent) and preparation for discharge.F-The main results of the study showed that:1- Approximately less than half of studied nurses aged from 25-30 years old.2- Approximately more than one third of studied nurses were bachelor and diploma degree (37.5). Also, they had 1-3 years of experience(35.0%).3- Approximately more than half of studied children were boys and aged from 1-5 years old. Also, three quarter of them have very severe pneumonia. 4- There were statistical significant differences between pre and posttest regarding all steps of standard case management of pneumonia It was found that 5- The total mean and standard deviation of nurse’s knowledge were 64.07±5.97, 80.55 ±3.19 and 77.63±3.28 respectively on pre, post
and follow up tests.
6- The mean and standard deviation for children length of hospital stay
tests were 3.67 ±.572, 1.900 ±.900, and 2.37 ±.806 respectively on
pre, post and follow up tests.
7- There were highly statistical significant differences on post and fol low up test than on pretest regarding mean and standard deviation of nurses practice (p<0.001).mechanical ventilation , suctioning (nasal- oral and endotracheal), postural drainage, assist in diagnostic measures, psychological support (child and parent) and preparation for discharge.F-The main results of the study showed that: 1- Approximately less than half of studied nurses aged from 25-30 years old.2- Approximately more than one third of studied nurses were bachelor and diploma degree (37.5). Also, they had 1-3 years of experience (35.0%).3- Approximately more than half of studied children were boys and aged from 1-5 years old. Also, three quarter of them have very severe
pneumonia.4- There were statistical significant differences between pre and posttest regarding all steps of standard case management of pneumonia It was found that 5- The total mean and standard deviation of nurse’s knowledge were 64.07±5.97, 80.55 ±3.19 and 77.63±3.28 respectively on pre, post and follow up tests.6- The mean and standard deviation for children length of hospital staytests were 3.67 ±.572, 1.900 ±.900, and 2.37 ±.806 respectively on pre, post and follow up tests. 7- There were highly statistical significant differences on post and follow up test than on pretest regarding mean and standard deviation of nurses practice (p<0.001).mechanical ventilation , suctioning (nasal- oral and endotracheal),postural drainage, assist in diagnostic measures, psychological support(child and parent) and preparation for discharge.F-The main results of the study showed that:1- Approximately less than half of studied nurses aged from 25-30 years old.2- Approximately more than one third of studied nurses were bachelor and diploma degree (37.5). Also, they had 1-3 years of experience(35.0%).3- Approximately more than half of studied children were boys and
aged from 1-5 years old. Also, three quarter of them have very severe pneumonia.4- There were statistical significant differences between pre and posttest regarding all steps of standard case management of pneumonia It was found that 5- The total mean and standard deviation of nurse’s knowledge were 64.07±5.97, 80.55 ±3.19 and 77.63±3.28 respectively on pre, post and follow up tests.6- The mean and standard deviation for children length of hospital stay tests were 3.67 ±.572, 1.900 ±.900, and 2.37 ±.806 respectively on pre, post and follow up tests. 7- There were highly statistical significant differences on post and follow up test than on pretest regarding mean and standard deviation of nurses practice (p<0.001).8- The total mean and standard deviation of nurse’s practice on pre,post, and follow up tests were 2.68 ±1.61, 4.75 ±2.00, and 3.96 ±2.20 respectively. 9- There were positive correlation between total nurse’s knowledge and total practice scores on pre, post and follow up tests (p<0.001). 10- There were positive correlation between total nurse’s knowledge,total practice scores of studied nurses and length of children hospital stay.G-The study concluded that Duration of hospitalization of children with pneumonia reduced after implementation of the nursing care protocol. Also, nurses gained more knowledge and had better practices on posttest following adherence to the nursing care protocol. H- Based on the result of the study, it was recommended that: a- Newly staff members in PICU and medical word should be oriented with standardized nursing care protocol to manage pneumonia. b- Continuous in- service educational program should be designed and implemented to motivate nursing staff to achieve high level of nursing care. c- Strict policies for supervision should be developed to ensure nurses adherence to protocol of care. d- Adequate and appropriate supplies should be accessible for all nurses at all times to follow infection control measures. e- Further studies in this field should be done on a larger sample to assess the effect of nursing care protocol on the length of hospitalization of children with pneumonia and to allow the generalization of the findings.