الفهرس 
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Abstract
A
round 60-70% of diagnostic and therapeutic decisions are based on blood tests. Blood tests are the most commonly used diagnostic aids in the care and evaluation of neonates. Collection of blood specimens for various diagnostic investigation is done routinely, the nurse should collect the blood soecimens with proper technique, label it correctly and send to the right labs with dully filled out requisition forms giving all the details (Kyle and Carman, 2017).
Several errors occur during the pre-analytic phase (Masotto et al., 2015). Pre-analytical laboratory errors can arise throughout the pre-analytical phase, because this phase comprises a lot of manual activities and accounts for most of the errors encountered within the testing process as a whole. Unsuitable, inappropriate or wrongly handled procedures during collection and handling of specimens are very likely to lead to pre-analytical errors (Cornes et al., 2016).
Aim Of The study.
The present study aimed to assess nurses malpractices during blood samples withdrawal from neonates at Neonatal Intensive Care Units
Subjects and Methods
Research design:
A descriptive design was used in this study
Settings:
This study was conducted at Neonatal Intensive Care Units (NICUs) at Children’s Hospital affiliated to Ain Shams University Hospitals, NICU at Children’s Hospital affiliated to Zagazig University Hospitals and NICU at Hehia Central Hospital affiliated to Ministry of Health.
Subject
The study was comprised all nurses working in the previously mentioned study settings regardless to their qualifications or years of experience and all neonates admitted o the previously mentioned study settings during time of data collection regardless to their gender, birth weight and gestational age.
Tools and Technique of Data Collection:
Data were collected through using the following tools.
Self administrative questionnaire sheet: It was used to assess nurses’ knowledge about blood samples for neonates. It was designed by the researcher and developed based on review of relevant recent literature and developed in a simple Arabic language,
Observational checklist: It was adopted from (Bowden and Greenberg, 2016; Neonatal Coordinating group, 2017; Bindler and Ball, 2008) that used for assessing practices of nurses during performing blood sampling withdrawal.
Attitude assessment sheet: It was designed by the researcher to assess nurses attitude before, during and after blood samples withdrawal from neonates.
Administrative design:
To carry out the study, the necessary written approval was obtained from the directors of NICUs, nurses in the previously mentioned setting, explaining the aim of study to obtain their permission for data collection. Official letters were issued to them from the faculty of nursing, Ain Shams University.
Ethical considerations:
The approval for data collection from the nurses was obtained and the researcher clarified the aims, objectives and expected outcomes from the study. They are assured that all the gathered information will be confidential and will be used for the research purposes only.
Operational design:
Pilot study:
A pilot study was carried out before starting the data collection for two weeks in June in 2017, to test the applicability, clarity and efficiency of study tools. It was applied on (10) nurses are who withdrawing blood samples for neonates to evaluate the content validity of the study tools and their number was excluded from study sample after modifications done in the tool of the study.
Field work:
The researcher collected the data two days / week (Sunday and Wednesday) for each hospital from 8 am to 2 pm in NICUs after administrative and ethical considerations. The actual period of data collection started from august 2017 up to the end of January 2018 (100) nurses in the study were assessed for knowledge, practice and attitude during blood sampling withdrawal.
Statistical Design
The collected data were organized, revised, scored, tabulated and analyzed using the number and percentage distribution. Data were analyzed using Statistical Program for Social Science (SPSS) version 20.0. Quantitative data were expressed as mean± standard deviation (SD). Qualitative data were expressed as frequency and percentage.
Finding of the current study can be summarized as
1- The mean age of studied nurse was 26.87±8.69. Regarding the gender, the majority of the studied nurses were females, more than half of the studied nurses were married, that only one third (33%)of them were nursing bachelor and nearly half of them had diploma from technical nursing institute or health institute nursing division. Regarding the years of experience, more than two fifths of them ranged from 1–<5years and four fifths received training courses about nursing care of neonates
2- The mean age of the studied neonates was 4.5±1.50 a day. Regarding the gender, more than of the studied neonates were male. Regarding the weight of the studied neonates on admission, two thirds of them had weight above 2000 gm.
3- Regarding the total knowledge for the studied nurses more than three quarter (77%) of the studied nurses had satisfactory level of knowledge and less than one quarter (23%) had unsatisfactory level of knowledge.
4- Regarding the total practice for the studied nurses, more than half of the studied nurses had incompetent practice (57%) and more than two fifths of the studied nurses (43%) had compotent practice.
5- Regarding the total attitude for the studied nurses, more than two fifths (47%) of nurses included in this study sample had positive attitude during performing blood samples withdrawal, more than one third (34%) of them had indifferent attitude and less than one fifth (19%) of them had negative attitude.
6- Regarding the correlation, there were significant relation and positive correlation between total knowledge of the studied nurses and their attitude and practice regarding withdrawal of blood samples in neonates