الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 276 |  |  |
| | | from | 276 | | |
Abstract
Liver surgeries in pediatric patients are considered one of the most complex procedures in modern surgery. Its process depends on a complete hospital infra-structure, in addition to a competent multi-professional team in the delivery of care to severely debilitated and immune depressed pediatric patients. Liver surgeries used as a resource to guarantee the survival of pediatric patients with irreversible hepatic failure, when there is no other form of treatment available. Most important liver surgeries in pediatric are liver resection, Kasai surgery for biliary atresia and liver transplantation (Sepanlou et al., 2020).
Nursing interventions, which span all facets of preoperative, postoperative, and follow-up care, are thought to be the most crucial management method for pediatric liver surgeries. The pediatric patient’s preparation for surgery is essential, and the nursing staff’s input impacts how successfully the procedure proceeds. Therefore, the nurses are responsible in planning and executing the care provided to pediatric patients undergoing liver surgeries and their families (Mendes et al., 2015).
Aim of the study
Study the effect of nursing intervention on children undergoing liver surgeries through:
1- Asses nurses’ knowledge and practice regarding care of children undergoing liver surgeries.
2- Design, implement and evaluate nursing intervention protocol based on the actual need assessment of the studied nurses regarding care of children undergoing liver surgeries.
Research hypothesis:
Nursing intervention will be effective in improving nurses’ knowledge and practices regarding care of children undergoing liver surgeries.
Subjects and Methods:
Setting: This study was conducted at Pediatric Surgery Unit in the Children’s Hospital affiliated to Ain shams university hospitals and Liver Surgeries Unit affiliated to Air Force Specialized Hospital.
Subjects: A purposive sample of (50) nurses working in the previous mentioned settings were included in the study throughout a period of six months of data collection from the beginning of January up to the end of June 2021.
All available (30) child undergoing liver surgeries in the previously mentioned settings during the study period.
Tools of data collection:
Data was collected through using the following tools:
Tool I: A structured interviewing questionnaire sheet pre & post nursing intervention:
It was designed by the researcher in an Arabic language after reviewing past and current related literature. It was consisted of two parts as the following:
Part (1): characteristics of the studied nurses (age, marital status, qualifications, years of experience and previous training program related to pediatric liver surgeries).
Part 2: a) Nurses’ knowledge about pediatric liver diseases.
b) Nurses’ knowledge about pediatric liver surgeries.
Tool II: Observation checklists pre & post:
The observational checklists were developed by (Anne et al., 2018), to measure nurses’ practices regarding care of children undergoing liver surgeries.
Tool III: children’s assessment sheet to assess medical and family history, it included
Characteristics of the studied children (age, gender, level of education, nationality and residence).
Physical assessment of the studied children (weight, height and length).
Previous health history of the studied children (pathological jaundice at birth, birth defect, previous liver surgeries and previous hospitalization related to liver diseases).
Family history of the studied children related to liver diseases and the presence of consanguinity between child’s parents.
Nursing intervention program:
It was designed by the researcher according to actual needs assessment of the studied nurses providing care to children undergoing liver surgeries. It was designed as a program guided by booklet in simple Arabic language.
The nursing intervention was implemented through seven sessions for theory & six for practical sessions the number of participants for each session was 5 nurses. The duration of each session was about 30 to 60 minutes.
Results:
The main findings of the study were as follows:
Near to half (48%) of the studied nurses were aged 30-≤ 35 years with X ̅±SD =29.40±5.59 and 66% of them were males.
Near to half (48 %) of the studied nurses had 1<5 years of experience in pediatric surgical units.
More than three quarters of the studied nurses (76%) hadn’t attended any training in pediatric liver surgeries.
There was marked improvement in the studied nurses’ total level of knowledge regarding liver diseases and its surgeries post nursing intervention compared to pre nursing intervention with 2 = 23.605 and P<0.001**.
There was marked improvement in nurses’ total level of practices post nursing intervention compared to pre nursing intervention with a highly statistical significance difference 2 = 23.123 and P<0.001**.
There was a highly statistically significant relation between the studied nurses’ total level of practices and their years of experience post nursing intervention (P= <0.001).
Conclusion:
Based on the findings, it could be concluded that, implementation of the nursing intervention program had a positive effect on the improvement of nurses’ knowledge and practice regarding care of children undergoing liver surgeries.