الفهرس 
Introduction and Review of LiteratureOnly 14 pages are availabe for public view
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Abstract
Musculoskeletal trauma is the most common emergency condition in children. Musculoskeletal trauma principally includes fractures of the bones of the extremities, ligamentous injuries, joint injuries and soft tissue trauma. Most musculoskeletal trauma is caused by falls, motor vehicle crashes and vehicle injuries. The child abuse is an extremely important cause of these injuries in both infants and young children. Several factors influence pediatric musculoskeletal trauma including age, sex, the child’s behavior and the surrounding environment. Male children have higher injury and mortality rates compared to female children while female patients suffer more sprains and fewer fractures than male patients. Nurses have an important role in the surgical management of this trauma through providing an effective pre-operative and post-operative care for the child based on updated knowledge and skillful practice. This care includes physical and psychological measures to promote the patient’s recovery, decrease the length of child’s stay in hospital and make him return to his normal life style easily. Hence, the aim of the present study was to evaluate the effect of implementing pre and post-operative nursing intervention on nurses’ performance for the care of children with musculoskeletal trauma The present study was conducted at Pediatric Surgical Orthopedic Department, Tanta Educational International Hospital and Pediatric Surgical Orthopedic and Deformity Unit at Tanta Main University Hospital. The subjects of present study consisted of sixty nurse (30) from Orthopedic Department at Tanta University Hospital and (30) from Orthopedic Department at Tanta Educational International Hospital. Tools of data collection: Three tools were used to collect data, these tools included the following: Tool (I): A Structured interview schedule and socio demographic characteristics for the nurses. It covers the socio demographic characteristics for the studied nurses such as age, educational level, marital status, previous experience and training. Tool II: Nurses’ knowledge about children with musculoskeletal trauma It was developed by the researcher after reviewing the related literatures to assess the nurses’ knowledge before and after the implementation of nursing intervention related to the pre and immediate postoperative car for children with musculoskeletal disorders .This tool was used at three times, the first time was prior to nursing intervention then immediately after it and finally two weeks after nursing intervention. It was designed in MCQ form and it was revised by pediatric nursing experts. The test was composed of 16 questions that cover all knowledge items about musculoskeletal trauma such as its definition, causes, types, the clinical manifestation, pre and post-operative care, complications after surgery, discharge instructions about exercise, pain medication and follow up plan. Tool (III): Nursing intervention related to the pre and post-operative care for Children with musculoskeletal trauma by using an observation check list. An observational checklist was developed by the Chapter VII Summa ry 651 researcher to assess the performance of nurses. This tool was used at three times. The first time was prior to nursing intervention then immediately after and finally two weeks after teaching it. Such checklist included the following items: Preoperative nursing intervention: 1. The Performance of physical assessment and evaluating the effect of musculoskeletal trauma on each system. It consisted of five performance categories; musculoskeletal system, respiratory system, gastrointestinal system, urinary system and integumentary system 2. Performing a laboratory investigation 3. Measuring vital signs: heart and respiratory rate 4. Nothing per mouth prior to surgery 5. The administration of intravenous fluids 6. The administration of blood transfusion if needed 7. The administration of medication Immediate Post-operative nursing intervention: Part I:- Physical assessment - Monitoring vital signs. - The administration of intravenous fluids. - Performing skin care. - The administration of medication to reduce pain as ordered. - Performing catheter care if present - The administration of nutrition planning - Nurses give instructions when children discharge as a pain medication, exercise driving the follow up plan Part II: (A) Pain assessment by using a numerical rating scale developed by Young and Farrar (2001) to assess the post-operative pain intensity. This scale line is numbered from 0-10 to assign a number from 0 to10 and thus 0 means no pain and 10 means a severe pain. B): FLACC behavioral pain assessment scale. This scale consisted of five elements such as face, leg, activity, cry/ vocalization and child’s consolation. It was developed by Kyle, Carman (2013). It was used for assessing the behavioral responses of children toward post-operative pain.