Background: ChatGPT, a language model developed by Open AI, has the potential to play a role in nursing education. This study aims to evaluate effectiveness of ChatGpt as an educational tool for nurses regarding ICU-acquired muscle weakness. Design: A quasi-experimental study design was used. Setting: The study was conducted in general intensive care unit at Sohag main University Hospital. Subjects: Convenient sample of all available nurses working in general ICU. Three tools were used in this study. Tool I: Structured Interview Questionnaire, Part I: Personal and Sociodemographic Data, Part II: Nurses Knowledge Assessment Questionnaire pre &post-test. Tool II: Nurses’ Attitude Assessment Questionnaire: Pré/Post test. Tool III: Feedback from Nurses about ChatGPT Usability and Satisfaction. Results: 77% of the studied nurses had good knowledge versus 23% had inadequate level of knowledge in the Post-test. Also, 72% of the studied nurses revealed satisfied attitude toward using Chat GPT posttest versus 28% of them had unsatisfactory attitude in the post-test. Conclusion: ChatGPT was effective in improving nurses’ knowledge and attitude regarding ICU acquired weakness. Recommendations: Nurses as educators should carefully consider how to integrate ChatGPT into their learning practices.

Background: Sound therapy can successfully relieve a variety of painful symptoms and is one of the most popular non-pharmacological treatments utilized by clinical personnel. Through pitch and rhythm, it activates the limbic system, which in turn triggers the pituitary gland to release endorphins, which results in a feeling of wellbeing Aim of study to evaluate the impact of sound therapy on pain and agitation during endotracheal suctioning in critically ill patients Research design: A Quasi-experimental study design was used. Setting: the study was conducted in General intensive care unit at Sohag main University Hospital. Subjects: Convenient sample of 79 patients were included in the study and they were assigned randomly to a control group and an intervention group. Five tools were utilized in this study: I: sheet for patient assessment, II: Critical-Care Pain Observation Tool (CPOT), III: Richmond Agitation-Sedation Scale (RASS), IV: Glasgow coma scale (GCS), V: Clinical outcomes assessment sheet. Results: revealed that Patient in the intervention group had significant relief of pain 5 min, and 15 min after intervention in comparison with control group patients, as indicated with P=0.04*&0.001**. According to the results, the study group's agitation levels were significantly lower than those of the control group five, three, and five minutes after the intervention (p values of 0.005**, 0.005**, and 0.04*, respectively). Conclusion: Sound therapy was effective in the reduction of pain and agitation level among critically ill patients. Recommendations: Provide in-service education about the importance of sound therapy inside the intensive care unit.

Abstract Background: Critically ill intubated and mechanically ventilated patients are usually kept sedated and their mobility is limited, with only passive movement provided through routine nursing care and regular repositioning. Early mobilization of critically ill patients seeks to improve management outcomes and enhance the quality of life for the patients. Aim of the study: to assess the effect of early abdominal mobilization exercise on gastrointestinal outcomes among mechanical ventilation patients. Design: a quasi experimental research design. Setting: The study was conducted at the Intensive Care Unit in Qena Main University Hospital. Subjects: a purposive sample of approximately thirty critically ill patients attached with invasive mechanical ventilation for more than 24 hours. Tools: Gastrointestinal outcomes assessment sheet used to assess gastrointestinal outcomes after the abdominal mobilization exercise program. Results: 86.7% of the participants experienced reduced distention after abdominal exercises. 83.3% of them had a softer abdomen after the intervention. Concerning abdominal characteristics, 83.3% of the study sample had a soft abdomen after the intervention, and only 16.7% had a tense abdomen after the intervention. Regarding of gastric residual volume, 100.0% of the study sample had less than 50 ml after the early abdominal exercise intervention. Conclusion: early abdominal mobilization showed significant improvement in gastrointestinal functions and reduced the signs of enteral feeding intolerance as distension, tense abdomen, vomiting, constipation, and gastric residual volume which means improvement in the digestion process and gastric emptying time. Recommendations: early abdominal exercise and massage should be included in the routine patient’s care at the ICU and further researches are needed.

Background: High Flow Nasal Cannula appears to be a promising alternative to standard oxygen and non-invasive ventilation for treating patients with hypoxemic acute respiratory failure. Therefore, the present study aimed to evaluate the effect of high-flow nasal cannula versus non invasive ventilation on critically ill patient outcomes. Research hypotheses: high-flow nasal cannula is expected to be more effective than non-invasive continuous positive airway pressure in reducing the length of stay, mortality rate, and post-extubation complications. A comparative, Descriptive research design was used. The study was conducted in ICUs of the anesthesia department at Assuit Main University Hospital. A purposive sample of 60 adult male and female patients who were aged (18-60 years) was included in the study and they were assigned into two groups (HFNC and NIV). Five tools were used to gather data, I: Patient assessment sheet, II: Glasgow coma scale (GCS), III: Dyspnea Visual Analogue Scale (D-VAS), IV: Device-related discomfort visual analogue scale and V: Clinical outcomes assessment sheet. Results: revealed that half of the patients in both the HFN and NIV (CPAP) groups stayed in the hospital for 6-10 days. Regarding patient progress, there is a statistically significant difference between both groups, with patients using the HFN protocol showing greater improvement than patients using the CPAP protocol. Conclusion: The patient in HFN protocol shows improvement in the level of progress than NIV (CPAP). Recommendations: High-Flow Nasal Cannula may serve as an alternative treatment for hypercapnic respiratory failure, particularly for patients who do not tolerate Non-Invasive Ventilation well.

Abstract Background: Using mobile games during the rehabilitation phase of patients with acute stroke will have a progressive influence on cognitive and memory impairment, which will reduce costs and enrich their prognosis. The aim of the study to evaluate the effect of using mobile games on patients with acute stroke during cognitive rehabilitation at the intensive care unit. Design: A quasi-experimental research design (pretest and posttest research designs). Setting: The study was conducted at the neurological intensive care unit at Assuit University Hospital, Egypt. Methods: Fifty patients with acute stroke were chosen randomly; they ranged in age from 18 to 60 years old, were able to write and read, and had recently been diagnosed with an ischemic or hemorrhagic stroke. Tools: Two tools were used, the general patient’s assessment questionnaire and the Montreal Cognitive Assessment (MOCA), to assess the acute stroke patients’ cognitive abilities before and after the application of mobile games. Results: More than half of patients with acute stroke had mild cognitive impairment (58%) before application of mobile games, and the majority of them had normal cognitive ability after application of mobile games (100%). There were statistical significance differences in cognitive assessment between patients before and after the mobile game application (P value = 0.001**). Conclusion: Patients with acute stroke had better cognitive and memory functions after playing mobile games. Recommendations: Incorporating brain games into the rehabilitation protocol to improve cognitive function in patients with acute stroke at the ICU will produce significant results and shorten the length of stay.

Background: Critical responsibilities for emergency nurses require a diverse set of skills, which is called competence. Competence includes the desire to show prospective personality traits that can be advantageous in specific situations. Aim: Assess emergency nurses’ core competencies in the management of critically ill patients in the emergency department. Subjects and Method: Design: A descriptive research design was conducted in the Emergency Department of General Qena Hospital and Emergency University Hospital, Egypt. Subjects: A convenience sampling of 70 emergency nurses was recruited to provide direct care for critically ill patients. Tools: three tools used in the study: 1. Core competences of clinical skills and knowledge for emergency nurses. 2. Core competences of communication and teamwork skills for emergency nurses. 3. Core competences of professional development, organization awareness, research, and quality improvement for emergency nurses. Results: The emergency nurses’ core competencies during respiratory care were 75.14% from General Qena Hospital and 80.36% from the emergency University Hospital. The emergency nurses' core competencies in cardiovascular care were 71.45% from General Qena Hospital and 88.36% from Emergency University Hospital. There were statistically significant differences among the studied nurses from both hospitals in the majority of items. The levels of core competence criteria for emergency nurses were 45.7% in the general Qena hospital but 17.1% in the emergency university hospital. However, the level of core competencies for emergency nurses was good at 45.7% in the general Qena hospital and 80% in the Emergency University Hospital. Conclusion: Competency can be used as the cornerstone for evaluating critical nurses’ performance. Core competence should be used as a vital tool to evaluate nurses’ levels of performance and patient satisfaction.

 Abstract:
Background: Nurse caring interventions have been recognized as effective in improving nurse-patient interactions and alleviating environmental stressors in the ICU, which is crucial for enhancing the well-being of patients with diabetic crisis. Aim: To evaluate the effect of nurse caring intervention on nurse-patient interaction and minimizing ICU stressors among patients with diabetic crisis. Design: Quasi-experimental research design was used. Sample and setting: A convenient sample of 60 patients who fit the criteria and were admitted to Aswan University Hospital's ICUs and emergency units. Tools: Three main tools were used to collect data include Tool I: Patient assessment sheet, Tool II: Caring Nurse-Patient Interaction Scale and Tool III: Intensive Care Unit Environmental Stressor Scale (ICUESS). Results: The findings showed no significant differences between the control and study groups regarding their personal characteristic data. Patients in the study group demonstrated higher interaction scores, (p = 0.034). (ICUESS) scores were significantly lower in the study group, indicating reduced stress levels (p ≤ 0.001). Additionally, age and marital status were significantly associated with patient satisfaction. Conclusion: The study found that nurse caring interventions significantly improved nurse-patient interaction and reduced ICU stress levels. Recommendation: Enhancing emotional support, communication, and humanistic care, while tailoring approaches to the specific needs of adults and married patients to improve overall patient satisfaction and reduce ICU stress.