الفهرس 
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Abstract
Meconium Aspiration Syndrome is a life-threatening respiratory disorder that occurs when meconium is expelled in uterus or during labor, resulting of Meconium-Stained Amniotic Fluid (MSAF). it can aspirated by the fetus and result in very dangerous complications these included, partial or complete airway obstruction, pneumonitis (lung tissue inflammation), Persistent Pulmonary Hypertension of the Neonate (PPHN), pneumothorax, surfactant displacement, atelectasis, respiratory failure and death (Johansson & Curstedt, 2019).
Aim of the study
This study aimed to assess nurses’ performance regarding the care of neonates suffering from meconium aspiration syndrome.
Research Questions
1. What is the level of nurses’ knowledge regarding the care of neonates with meconium aspiration syndrome?
2. What is the level of nurses’ practice regarding the care of neonates with meconium aspiration syndrome?
3. What is the level of nurses’ attitude regarding the care of neonates with meconium aspiration syndrome?
I. Research Technical design:
Research design:
A descriptive study design was utilized in this study.
Research setting:
This study was conducted at NICU\ El-Fayoum General Hospital affiliated to Egyption Ministry of Health and population at Fayoum Governorate.
In the general hospital,the NICU located at the third floor of the hospital building and consists of 4 rooms; first and second room for routine care equipped with 20 incubators and ventilator and third room for isolation equipped with 12 incubators and fourth room for intensive care equipped with 12 incubators..
Research subject:
A convenient sample composed of 70 nurses working at the previously mentioned setting during the study period regardless their characteristics (age, gender, qualifications and experience).
Tools of data collection:
Data was collected through using the following tools:
Tool I: Nurses’ Pre-designed Questionnaire Sheet: (Appendix II):
It was designed by the researcher after reviewing the related literature and reviewed by supervisors. Adjusted to the Egyptian culture and translated into an Arabic language by the researcher to assess nurses’ knowledge about meconium aspiration syndrome. It was divided into the following parts:
Part 1: This part was concerned with the characteristics of the study subjects including:
A. Characteristics of studied nurses namely age, gender, qualifications, years of experience in NICU, as well as the attendance of previous training courses related to Meconium Aspiration Syndrome.
B. Characteristics of the studied neonates: gestational age (weeks): gender, mode of delivery, birth weight.
Part II:
This part was concerned with assessment of nurses’ knowledge regarding the care of neonates suffering from Meconium Aspiration Syndrome (MAS). The total number 49 questions, in the form of Multiple Choice Questions (MCQS) about Definition, predisposing factors, clinical manifestation, diagnosis, management, complications and all aspects of the care for neonates with Meconium Aspiration Syndrome.
Scoring system:
A scoring system was followed to assess nurses’ knowledge about Meconium Aspiration Syndrome. The right answer was scored with one score and the wrong answer scored as a zero score. These scores was summed up and converted into a percent score. Then the result was classified into 3 categories (good if knowledge scores ≥75 %, average if knowledge scores 60< 70% and poor if knowledge scores <60 %.)
Tool II: Observational checklists (Appendix III):
The observational checklists were adapted from Perry & potter, (2015) and Lynn & Lebon, (2013) to assess nurses’ actual practices regarding the care of neonates suffering from MAS, It consisted of eleven observational checklists which used to assess the actual nursing practice at NICUs related to namely; Checking pulse oximeter (9 steps), capillary blood gases (12 steps), endotracheal suctioning (10 steps), oropharengeal and nasal suctioning (10 steps), oxygen therapy through nasal cannula or mask(8 steps), oxygen therapy through oxygen hood (5 steps), care for oxygen therapy on CPAP (8 steps), care for oxygen therapy on ventilator (9 steps), chest physiotherapy (7 steps), Minimize Stress and Pain(8 steps), Maximizing Environmental Impact (9 steps).
Scoring system:
A scoring system followed to assess nurses’ actual practices; The items was assessed as “done”, scored one grade and “not done or done incorrectly”, was scored zero. The total score was 95 grade. The score was summed up and converted into a percentage score and classified into 2 levels:
- Competent if score ≥ 90%.
- Incompetent if score < 90%
Tool III: Nurses’ Attitude Type- rating scale (Appendix IV): This scale was designed by the researcher in the light of related references and used to assess the attitudes of the nurses toward the care of neonates with MAS. It included 13 items.
Scoring system:
Neonatal nurses’ responses were classified as “agree”, “uncertain”, “disagree” and respectively scored 3, 2 and 1. The scoring of the items summed up and converted into a percentage scores. Then all data classified into 2 categories (positive attitude if score ≥ 70% and negative attitude if score < 70%).
Results:
The findings of the current study can be summarized as the following:
• More than half (52.9%) of the studied nurses were in the age group of 25 < 30 years (26.54±2.331 years). Also, the highest percentage (85.7%) of them had Technical Nursing Institute. Concerning years of experience, it is observed that, more than half (52.9%) of them had experience for 5 < 10 years
• All (100%) of the studied nurses were females and more than half of them had did not attend previous training courses about Meconium Aspiration Syndrome.
• Less than half (47.1%) of the neonates had gestational age more than 36 weeks) and nearly two thirds (67.1%) of them were males. As well as the majority (91.4%) of them born with cesarean section and 61.4% of them their birth weight ranged from 3 kg to less than 3500kg.
• About three quarters (74%) of the studied nurses had average knowledge regarding meconium aspiration syndrome, while, more than one quarter (26%) of them had poor knowledge
• Majority (94%) of the studied nurses had incompetence practice regarding meconium aspiration syndrome and only 6% of them had competent practice.
• Majority (94%) of the studied nurses had a positive attitude regarding the care of neonates suffering from Meconium Aspiration Syndrome and only 6 % of them had a negative attitude.
• There was statistical significance correlation between total nurses’ knowledge with total attitude
Conclusion:
In light of the current study findings it can be concluded that, less than three quarters of the studied nurses had average level of knowledge, the majority of them had an incompetence level of practice and majority of them showed positive attitude regarding meconium aspiration syndrome.
Recommendations:
In the light of the current study findings, the following recommendations are suggested:
• Orientation program should be developed to prepare new nurses before working in specialty area as NICU
• Standardized nursing procedure booklets and guidelines for the nurses should be available to guide them for giving the adequate care for neonates with Meconium Aspiration Syndrome
• Neonatal intensive care nurses must be attend refreshing courses and workshops regarding updated theoretical and clinical aspect of care for neonates suffering from Meconium Aspiration Syndrome
• Replication of this study using large sample size in different NICU over all Egypt for better generalization of the results.