الفهرس 
Literature reviewOnly 14 pages are availabe for public view
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Abstract
Total parenteral nutrition (TPN) is a method of supplying nutrients to the body by an intravenous route. The nutrients are a complex admixture containing proteins, carbohydrates, fats, electrolytes, vitamins, trace minerals, and sterile water in a single container. It is indicated to patients with impaired or nonfunctional gastrointestinal tract due to an interruption in its continuity or absorptive capacity is impaired. TPN can meet estimated nutritional needs, promote nitrogen balance, improve anabolism, maintain muscle mass, and promote weight maintenance or gain and enhancing healing process. When there is a risk of malnutrition and enteral feeding (EF) isn’t tolerated or where there is gut failure, parenteral nutrition is safe and encouraged Developing nursing educational program is considered as a step for reduction of complication occurrence in patient receiving total parenteral nutrition at emergency anesthetic intensive care unit of Tanta emergency hospital. This program can be used for identifying, nurses’ knowledge and practice regarding to TPN and improving the quality of care at health sectors. Hence, the aim of the present study was to design, implement educational program and evaluate their effect on nurses’ practice. The present study was carried out at Emergency anesthetic intensive care unit of Tanta emergency hospital. The subjects of the present study consisted of 40 nurses working in the previously mentioned setting who are responsible for providing direct care for patient receiving TPN. Two tools were used for data collection: Tool I: Nurses’ knowledge Assessment tool. It was developed by the researcher after reviewing the related literature to assess nurses’ knowledge regarding total parenteral nutrition. It consisted of two parts. Part A: Socio-demographic characteristics of nurses, to assess data related to age, sex, marital status, years of experiences, level of education and previous educational program about total parenteral nutrition . Part B: Nurses’ knowledge Assessment sheet to assess nurses’ knowledge about total parenteral nutrition. It was used three times; before, immediately after and 4 weeks after implementation of the educational program. It included; definition, indication, contraindication, advantage and disadvantage, methods of administration, Types, PN solution and complications. The questionnaire sheet contained 37 closed ended questions (27 question multiple choice and 10 question true and false about total parenteral nutrition. The nurses were asked to respond to these questions with only one correct response for each question before, immediately and after one month from the program application. The total score was 37. Tool II: An observational checklist for nurses’ practice regarding to administration of total parenteral nutrition. This tool will be developed by researcher guided by (Doyle G, Mccutcheon J and ASPEN (8, 20, 21) used to assess nurses, practice before; during and after administration of total parenteral nutrition. The observational checklist was consisted of 38 items and the total score for all items in observational checklist was 39. Developed Intervention program: It was developed by the researcher after reviewing the related literature. It was covered the following; definition, indication, contraindication, advantages, disadvantages, methods of administration, Types, PN solution and complications. The main results obtained from the present study were as follows: - It was found that the majority of the studied nurses (80%) were in early adulthood stage (20 to 30) years old. - Regarding their education more than half (6o %) of nurses are graduated from Technical Institute of Nursing while more than one third (35%) of them have bachelor degree and the rest of them have Post graduate certification. - The study showed that about three quarter (72.5%) of the studied nurses had less than 5 years of experience inside Emergency anesthetic intensive care unit. - It was observed that all nurses hadn’t attended any training courses about total parenteral nutrition. - The study revealed that more than half (60%) were married and 40% were single. Regarding their sex the majority of them (82.5%) were female and (17.5%) were male. - It was observed that the total scores of knowledge for most of nurses (80٪) were poor before the program application while immediately and after one month from the program application the total scores of nurses’ knowledge improved and all of nurses (100٪( and the majority(90٪) of them obtained good scores respectively. - It was observed that the total score of nurses’ practice regarding total parenteral nutrition administration were unsatisfied before the program application while immediately and after one month from the program application they were satisfied for the majority of them. Conclusion Based on the results of the present study, it can be concluded that program was effective and there was a significant improvement on nurses’ knowledge and practice regarding to total parenteral nutrition. Recommendations 1. Provision of institutional written policy regarding application of the program in daily routine care of critical ill patient receives total parenteral nutrition. 2. A special system for awarding, accreditation and certification should be taken into consideration to motivate nurses’ participation and enrollment into the training and educational programs which should be conducted in the work place.