الفهرس 
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Abstract
SUMMARY
Promoting and controlling quality of care occur by setting standards related to the skills and knowledge, standards should be clearly stated desirable, achievable, observable and measurable for enhancing good care and improve poor care.
Arrhythmias monitoring is vital in the nursing assessment of the patient with cardiovascular problem, so it is essential that the critical care nurse must recognize that continuous monitoring is a nursing responsibility and must acquire a fundamental, usable knowledge of ECG because arrhythmias can be positively identified only by means of electrocardiograph and it is important to provide prompt prevention and control of premonitory arrhythmias, to decrease the incidence of more serious arrhythmias and thus improve the chance for survival.
Aim of the study:
The present study was aiming to evaluate the effect of implementing nursing care standards for nurses caring for patients with cardiac arrhythmias in coronary care unit (CCU) at Ain Shams University Hospitals.
Subjects and methods:
The sample consisted of all available nurse (40 nurse) working in CCU at Ain Shams university Hospitals. Nurse qualification was bachelor nurses, secondary nursing diploma, and specialty diploma.
The following tools were used to accomplish the purpose of this study:
a) Self administered questionnaire sheet, which constructed to assess nurses’ knowledge regarding care of patients with cardiac arrhythmias.
b) An observation checklist: which constructed to assess nurses’ practice during their care for patients with cardiac arrhythmias.
c) Educational sessions about the standards of nursing care
for patients with cardiac arrhythmias.
d) Opinionaire sheet, which designed to identify nurses’ opinions regarding the implemented standards of nursing care.
The important findings that were obtained from the study can be summarized as follows:
1- Majority of the nurses were more than 25 years of age .More than half of nurses were married and their qualification were bachelor degree with years of experience more than 5 years and attended training courses .
2- The majority of nurses’ had unsatisfactory knowledge and practice before implementation of the standards.
3- After getting the standards, there were statistically significant improvements in the nurses’ knowledge and practice.
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5- The nurses’ qualifications had a positive effect in improvements of nurses’ knowledge and practice post and follow up 2 implementation of the standards. While diploma nurses’ showed that, their positive improvements in practices scores were less than bachelor nurses.
6- There were negative correlation between pre, post and follow up1&2 implementation of the standards regarding age and marital status, years of experience with nurses’ knowledge and practice scores.
The most important recommendations inferred from the discussion were:
Written standards for nurses caring for patients with cardiac arrhythmias should be available in all coronary care units to be followed by all nurses and should be up date periodically.
Nurses working in coronary care unit should be selected based on criteria related to their qualification and years of experiences.
All nurses appointed in this area should be certified after attending in service training courses to practice in the CCU.
The initial training will not be enough and thus, regular refreshing programs should be planned to maintain quality assurance.
In addition to the above, enough reference material should be provided in the unit in form of audio visual aids, films, booklets, to make them familiar with the types of arrhythmias