الفهرس 
An overview about neonateOnly 14 pages are availabe for public view
Abstract
Malpractice is an improper or unethical conduct or unreasonable lack of skill by a holder of a professional or official position The Joint Commission on Accreditation of Healthcare Organizations (JCAHO, 2011). The National Practitioner Data Bank, shows that no signs of stopping nurses’ malpractice regarding to invasive procedures, despite efforts by nursing educators to inform nurses and student nurses of their legal and professional responsibilities and continues training for preventing harmful complication that can be occurred resulting from malpractice (American Journal of Nursing, 2009). Neonatal period in the first month of life represent the most vulnerable time for a child’s survival. Meanwhile, up to two thirds of newborn deaths could be prevented if skilled health workers perform effective health measures at birth and during the first week of life World Health Organization (WHO, 2013).
Aim of the study:
The aim of study was to assess the nurses’ malpractices for neonates undergoing invasive procedures at neonatal intensive care units.
Research setting:
This study was conducted at three different Neonatal Intensive Care Units at Children Hospital affiliated to Ain Shams University, Health Insurance Beni Suif Hospital, and Beni Suif General Hospital, because they are three big health sectors which are serving large number segment of community and had a high flow rate of sick neonates. In additional that, the previous mentioned settings represented different health organizations as University Hospitals, General Hospitals, and Health Insurance Hospitals.
Subjects:
Convenient sample that consisted of (50) nurses and 50 neonate from Neonatal Intensive Care Units at the previously mentioned settings and agreed to participate in the study and distributed as the following: Twenty nurses, and twenty neonates from Children Hospital affiliated to Ain Shams university, twenty nurses and twenty neonates from General Hospital of Beni Suif and ten nurses and ten neonates from Health Insurance Beni Suif Hospital.
Tools of data collection:
I- A structured questionnaire format (Appendix II):
It was designed by the researcher in Arabic language after reviewing the related literature such as Matthew, (2016), Lanzillotti, (2015), Klein, (2009), Kenner et al, (2013), Irving(2014). In the form of closed ended questions and multiple choices. It was categorized according to the following parts:
Part I: Which included characteristics of studied nurses as age, qualifications, work settings, years of experience and attendance of training programs related to malpractice regarding to invasive procedures.
Part II: Which included characteristics of the studied neonates as gender, age, birth weight, diagnosis, and types of invasive procedures.
Part III: Which included studied nurses’ knowledge regarding to invasive procedures as purpose, indications, contraindications, complications, role of nurse.
Part IV: Which included studied nurses’ knowledge regarding to malpractice as the following: Definition, causes, factors affecting malpractice and prevention.
II- Observational Checklist (Appendix III):
It was adapted by the researcher from Vicky, (2011) to assess nurses’ performance for neonates undergoing invasive procedures at neonatal intensive care units, and it included placement of naso/orogastric tube, naso/oropharyngeal suction, endotracheal tube suction, intravenous cannula insertion, performing intramuscular injections, and capillary blood sample.
Nurses’ attitude scale (Appendix IV):-
This tool adapted from Sheila & Jacqueline, (2014) and consisted of 12statements to assess nurses’ attitudes toward malpractice regarding to invasive procedures at neonatal intensive care units, and scale statements were categorized as positive, and negative.
Field work:
The actual field work was carried out over 6 months started from June (2018) to the end of November (2018). The researcher was available at study setting by rotation, at morning shift from 8 am to 2 pm and afternoon shift from 2pm to8pm three days weekly; (Saturday, Monday, Wednesday) at Children Hospital affiliated to Ain Shams University, (Sunday, Tuesday) at Beni Suif General Hospital, and Thursdayat health Insurance Beni Suif hospital), the researcher introduce herself to the nurses. After taking permission from nurses to participate in the study, the researcher then told them about the aim of the study. Each nurse was individually interviewed to fulfill the questionnaire sheet and attitude scale. The time consumed for completion of questionnaire ranged from 10-15 minutes and for attitude scale was 2 - 4 mints. As regards the nurses’ practices, they were observed in previously mentioned settings during performing the procedure according to checklist. Time consumed for assessing procedures ranged 5-10 minutes for each procedure according to checklist.
The results of the study can be summarized as the following:
• More than half (64%) of studied nurses their ages were 30<40 years with a mean of 26.60 ±5.128years,
• The majority (98%) of studied nurses were female.
• More than half (52%) of studied nurses their level of education was a diploma.
• More than two third (70%) of studied nurses their years of experience were 5<10 years with a mean of 8.4 ± 6.16.
• Less than half (36%) of studied neonates their gestational age was< 37 weeks,
• A half (50%) of studied neonates their weight was from 2500≤ 4000 gm.,
• More than one third (38%) of studied neonates their age ranged from 1 < 7 days with Mean ±SD 2.3±1.2.
• More than half (60%) of studied neonates were females
• More than two fifth (44%) of studied neonates their diagnosis was a respiratory distress
• More than two fifth (48%) of studied neonates their days stay in hospital were from 7 ≤ 10 days.
• More than half (60%) of studied neonates exposed to invasive procedures was to taking venous blood sample.
• More than a half (54%) of studied nurses had a good knowledge about invasive procedures,
• More than two thirds (68%) of studied nurses has a poor knowledge regarding to malpractice.
• More than a half of nurses (56%) had a competent level of performance regarding to invasive procedures.
• More than two thirds of nurses (62%) had positive attitude about malpractice regarding to invasive procedures.
• There was a statistical significant difference (p<0.005) between level of education of studied nurses, and their total knowledge about malpractice regarding to invasive procedures
• There were a statistical significant difference (p<0.005) between age, level of education and their total level of malpractice regarding to invasive procedures
• There was a statistical significant difference (p<0.005) between total level of attitude and total level of knowledge of studied nurses about malpractice regarding to invasive procedures
• There was a statistical significant difference (p<0.005) between total level of attitude and total level of malpractice regarding to invasive procedures.
The findings of the study can be concluded that:
Knowledge and attitude of studied nurses working at neonatal intensive care units are reflecting their performance and malpractice regarding to invasive procedure. There are a statistical significant difference (p<0.005) between age, level of education and of studied nurses and their malpractice regarding to invasive procedures. There is a statistical significant difference (p<0.005) between total level of attitude and total level of knowledge of studied nurses about malpractice regarding to invasive procedures. There is a statistical significant relation (p<0.005) between total attitude of studied nurses and their malpractice regarding to invasive procedures of studied nurses.
Based on the results of the current study. The following recommendations are suggested:
1. Prepare manual procedures checklists for neonatal nurses to minimizing malpractice.
2. Continuous assessment of nurses’ performance to identify weak points to be realized during training program.
3. Developing educational and orientation program for nurses about invasive procedures to improve their performance and eliminate nurses malpractice regarding to invasive procedures.