الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Chronic renal failure is a worldwide health problem. Haemodialysis remains the major modality of renal replacement therapy in the world. The quality of nursing care is influenced by the knowledge judgment and skills. Gutirrez and Petron(2007). Hemodialysis nurse is skilled and competent professional with specialized experience in caring for and maintaining high quality care for haemodialysis patients. Hemodialysis nurse plays an essential role in ensuring adequacy of the Hemodialysis standard and providing effective quality patient care in supportive and comment process in three phases (pre, during and post dialysis phases). Hemodialysis nurse assists also patients and their families in meeting all the challenges they face, encouraging them to feel strong, capable, and eager to live a normal productive life Smeltzer & Bar (2010)
In-service educational program had good effect in improving the nurses’ knowledge and performance in haemodialysis units. The nurses must be knowledgeable in giving supportive care to the patients. This knowledge would be gained by the educational program. Badawy(2004)
The aim of this study is to assess the effect of nursing training program on care offered to Patients undergoing haemodialysis through the following:
• Assessing the needs of nurses caring for Patients undergoing Haemodialysis needs.
• Developing nursing training program based on needs assessment.
• Implement nursing training program.
• Evaluating the effect of nursing training program on:
a- Nurses performance (level of knowledge, practice and attitude)
b- Patients’ outcome (level of satisfaction and compliance to haemodialysis sessions, medications, diet and activity)
Research design:
Quasi- experimental study design was conducting in this study.
Setting:
The study conducted in the haemodialysis unit at Ain shams university hospital. It composed of 3 units including 30 haemodialysis machines.
Subjects:
Study subjects involved two groups, nurses and patients.
1- The Nurses: total subjects of 30 registered nurses providing direct care to patients on maintenance haemodialysis in the above mentioned area were included in the study.
2- The patients: Adult patients on maintenance haemodialysis in the above mentioned area (about 60 patients based on a sensitive statistical analysis to the exact significant number) included in the study.
Tools of the study:
1- Questionnaire assessment sheet: To assess the nurses’ knowledge regarding caring of patients undergoing hemodialysis. It was divided into 3 parts as follow:
Part 1: “Nurses demographic characterstics: 5 questions covered items related to data as (age, sex, marital status, level of education, years of experience in haemodialysis unit, in addition to question related to previous attendance training program.
Part 2: Assessment of nurses’ knowledge. This part was used pre and post implementation of the training program to assess Nurses’ level of knowledge regarding caring of patient on haemodialysis. It included 8 items related to nurses’ Knowledge as anatomy and physiology of the kidney, renal failure, hemodialysis: (definition, purpose, components and complications), nursing care related to patient in 3 HD.phases as (pre, during and post dialysis, in addition to teaching the patient during session.
Part 3: 20 questions covered nurses’ attitude toward patients. This part was used pre and post implementation of the training program to assess nurse’s attitude toward patient undergoing haemodialysis unite.
Evaluation was considered as follow:
Unsatisfactory score ≤70%
Satisfactory score >70%.
II- Nurses’ observation checklist Sheet
Observation check list was adopted from reviewing the recent related literature, used before and after implementation of the program to assess nurses practice related to the care which be given to such group of patients on haemodialysis (pre, during and post session).
Evaluation was considered as follow:
Unsatisfactory score ≤70%
Satisfactory score >70%.
III- Patient’s Assessment tool:
Patient’ knowledge assessment level sheet was developed by the researcher after reviewing the related literature in Arabic language. It was divided into 4 parts as follow:
Part 1: “patients’demographic data “It included items related to (age, sex, marital status, level of education and occupation).
Part 2: Patients level of knowledge: It was used pre and post implementation of the training program to assess patients’ knowledge related to compliance of medication, diet and activity.
Part 3: patient satisfaction; 20 questions covered patient satisfaction toward care given. This part was used pre and post implementation of the training program to assess patient’s satisfaction level toward care offered.
Evaluation was considered as follow:
Unsatisfactory score ≤70%
Satisfactory score >70%.
Part 4: Clinical assessment sheet developed by the researcher to measure patient outcome pre and post implementation of the program.
Field work
Field work included three phases: Assessment, implementation phase & evaluation, they were completed in duration of 9 months, starting from January 2012 to the end of September 2012. Practical session and lectures sessions about training program were developed by the researcher based on review of related literature and revised by experts in the Medical Surgical Nursing field. The researcher was attending inside H D. Unite at Ain Shams University, 3days per week from 9am to 3pm at second and third shift. The purpose of the study was explained for nurses’ prior data collection. The researcher assured them the data collected and information will be treated confidentially.
The main results:
• Most of the studied nurses had unsatisfactory performance level (knowledge, attitude and practice) in most items pre implementation of the training program.
• There was satisfactory nurses’ practice level, related to machine care such as preparation of machine and termination of dialysis while there was an unsatisfactory nurse practice level related to patients’ care such as data collection, physical examination and health assessment, patient’s and nurses preparation. pre implementation of the training program.
• Most of the studied nurses had satisfactory level and statistical significance improvement related to nurses’ performance level (knowledge, attitude and practice) in most items in post implementation of the training program.
• There was statistical significance improvement related to Patient satisfactions in post implementation of the training program.
• There was statistical significance improvement related to Patient’ outcome and clinical indicators regarding objective data included labe blood investigations, main blood pressure and excess weight in post implementation of the training program.
• There was statistical significance improvement related to Patient compliance to diet, activity and medications in post implementation of the training program.