الفهرس 
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Abstract
Exchange ransfusion decreases the mortality of this group of critically ill newborn infants. Newborn infants in NICU, especially those born premature are at particular risk for exchange transfusion adverse effects. Moreover, ET carries a significant risk of morbidity and mortality due to vascular accidents, cardiac complications, biochemical and hematological disturbances and a low risk of blood borne infections. Therefore, it should be initiated only when the benefit of preventing kernicterus outweighs the complications associated with the procedure. So, it is essentially important for neonatal nurses to undergo training that not only enhance knowledge but also provide meticulous and high-quality care for those nurses, from her this study intended to assess nurses’ proformance regarding caring of risk neonates undergoing exchange blood transfusion in NICUs (Bujandric, & Grujic, 2016).
Aim: Assess nurses’ performance in caring of neonates undergoing exchange blood transfusion in neonatal intensive care units.
Research Questions:
- What are the nurses’ knowledge regarding exchange transfusion?
- What are the nurses’ practices regarding exchange transfusion?
- Is there a relation between nurses’ knowledge and their practices regarding exchange transfusion?
- Is there a relation between nurses’ characteristics and their practices regarding exchange transfusion?
This study was conducted at the Neonatal Intensive Care Unit (NICU) at University Hospital affiliated to Elmonfia University Hospital in El-monfia, Elshohada Hospital affiliated to Directorate of Hospital Affairs in El-monfiam, General Shuobra Hospital affiliated to Directorate of Hospital Affairs in Cairo and Ahmad Maher Teaching Hospital affiliated to General Organization of Teaching Hospitals and Institutes in Cairo. A convenience sample included forty nurses as staff nurses who were working in aforementioned four hospitals.
Tools of data collection:
Tools were used in data collection are two tools, Tool one: Predesigned Questionnaire Sheet in the light of relevant studies based on Stewart et al. (2020), it was consisted of the following parts: part one: A: characteristics of nurses. B: characteristics of neonates under exchange transfusion. Part two: Assessment of nurses’ knowledge. Tool two: Observational checklists were adopted from Beardsall, et al., (2018), Perry & Potter, (2015), Lynn & Lebon (2014) and MacDonald, et al., (2012). It was used to assess nurses practice regarding care of neonates undergo exchange transfusion.
Field Work:
The purpose of the study was simply explained to the studied nurses. The actual work of the study was carried out in a period of eleven months from the ending of December, 2019 to the begin of October, 2020. The researcher was available in each study setting during morning and afternoon shifts two days pre week alternated to observe the flow of neonates needed exchange transfusion. Data were collected by the researcher through interviewing each nurse individually according to the mitigates circumstances of the study setting in addition to the physical and mental readiness of each study subject in the previously mentioned settings. The studied nurses were directly observed and assessed during their actual care provided for neonates undergoing exchange transfusion. The time needed for completing the tools was about 15-20 minutes for questionair and 30 minutes for observational checklists.
Results:
The main study findings were as the following:
• The mean age of the studied nurses was 29.15±7.12, and 85% of them were female and 82.5% of them were married.
• Forty-five percentage of nurses had diploma of schools in nursing, and 50% of them their years of experience were ≥ 6 years.
• The mean age of the studied neonates was 3.83±2.33 and 50% of them were equal female and male. 77.5% of neonate were low birth weight and 77.5% of neonates the common reason for exchange transfusion was failure to respond to phototherapy.
• The total nurses’ knowledge regarding exchange transfusion, displayed that one quarter (25%) of the studied nurses had good knowledge. Also, 42.5% of them had average knowledge, while more than one third (32.5%) of them had poor knowledge.
• Three quarters (75%) of the studied nurses had competent practices regarding preparation during exchange transfusion, while less than half (45%) of them had incompetent practices regarding preparation after exchange transfusion.
• The total nurses’practices about all procedure related to exchange transfusion clarifies that more than two thirds (62.5%) of the studied nurses had competent practices regarding care of neonates undergoing exchange transfusion, while more than one third (37.5%) of them had incompetent practices.
• There were highly statistically significant relation between total score level of nurses’ knowledge regarding exchange transfusion for the neonates and their years of experience and training courses.
• Positive correlation between total score level of nurses’ knowledge regarding exchange transfusion for the neonates and the total score level of nurses’ practices regarding care of neonates undergoing exchange transfusion at p-value <0.001.