الفهرس 
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Abstract
SUMMARY
Hygienic care is a series of practices performed to preserve health. And prevent the spread of diseases. It also includes attention to keeping surfaces in the home and workplace, including bathroom facilities, clean and pathogen-free. Some regular hygiene practices may be considered good habits by the society, while the neglect of hygiene can be considered disgusting, disrespectful, or threatening (Rosa et al., 2020).
Aim of the study:
This study aims to assess the factors affecting nursing performance regarding hygienic care.
Research Questions:
The current study was formulated to answer the following questions; What is nurse’s knowledge toward hygienic care among critical ill patients? What is nurse’s practice toward hygienic care among critical ill patients? What are the factors affecting hygienic care among critical ill patients?
Subjects and Methods:
Research design:
A descriptive exploratory design was used to conduct this study. The study was conducted in the critical care units at El Demerdash hospital.
Setting:
The study was conducted at Critical Care Units ( Medical and Surgical Intensive Care Units) at El Demerdash Hospital 35 beds.
Subject:
A convenience sample of all available nurses who providing care for critically ill patients (60).
Tools of data collection:
Three tools were used in this study and classified as the following:
1. Structured Interviewing Questionnaire: consists of two parts.
Part I: Demographic characteristics of nurses such as (age, gender, educational level, years of experience, job title and attended a hygienic care training course) (7) questions.
Part 2: Knowledge questionnaire sheet: that developed by the researcher after reviewing the related literature it was adapted from (Heck, 2017) divided into three parts (pre, during and post nursing knowledge regarding hygienic care) (20) questions.
Tool II: Observational checklist of hygienic care:
It was adapted from literature (Wilkinson & Van Leuven, 2017), divided into six parts included preparation of hygienic care (7) items, morning care (6) items, mouth care (6) items, hair shampoo (8) items, perineal care (10) items and bed bathing (28) items and it was answered with done or not done.
Tool III: Factors affecting on hygienic care:
It is developed by the researcher after reviewing of the literature (Center of Disease Control 2018), Dorcas, 2017) and it was divided into three parts; factors related to nurse (13) items, factors related to patient (9) items & factors related to environment (5) items.
Results:
Main findings of the present study were as the follows:
Three quarters (75.0%) of the studied nurses were female, 36.7% of them aged between 20 to less than 25 years with mean± SD 30.6±4.88. More than half (53.4%) of them had technical institute and one third of them had 1 to less than 5 years’ experience. Two thirds (66.7%) of them had staff nurse, moreover less than two thirds (61.7%) of them did not attend a hygienic care training course inside ICU.
More than half of the studied nurses (55.0%) had poor for total knowledge scores, while, only 15.0% of them had good for total knowledge scores.
More than half (55.0%) of the studied nurses had incompetent toward total practice scores, rest of them had competent.
There was a highly statistical significant difference between studied nurses for total knowledge and their educational level, experience years & attendance courses at p value (.002**, .000** & 0.009**) respectively, moreover there was a statistical significant difference between studied nurses and their age and job title at p value (0.03*&.021*). On the other hand, there was no statistically significant difference between studied nurses and their gender at p value (.239)
There was a highly positive association between knowledge of studied nurses and Total practice and factors affecting nursing performance at r (.841 &.522) at p value (.000**& 002**) respectively.
Conclusion:
The Conclusion Based on the results of the present study:
The current study concluded that more than half of the studied nurses had poor knowledge, and incompetent practice about hygienic care in the intensive care unit.
Recommendation:
The following recommendations are suggested:
• Establish a standardized hygienic healthcare protocol in ICU.
• Schedule a regular in service education of hygienic care guideline especially for nurses in intensive care units.
• Apply evidence based practice regarding hygienic and oral care for critically ill patients in intensive care units.
• Hospitals should formally define the hygienic care guidelines as a standard procedure in their ICUs.
• Assess nurses’ attitude toward the provision of hygienic care for critically ill patients.
• The study should be replicated using a large sample indifferent hospital setting to generalized the results and evaluate the appropriate frequency of hygienic and oral care.
• Using a combination of current evidenced-based practices, open communication with the patient to discover their preferences, and frequent monitoring will allow for the best care possible for the patient.