Hepatic encephalopathy is the occurrence of confusion, altered level of consciousness and coma us a result of liver failure. In the advanced stages it is called hepatic coma. It may ultimately lead to death. It is caused by accumulation in the blood stream of toxic substances that are normally removed by-the liver. Standards of nursing care provide the required knowledge and skills that can be used to orient new staff and guide nurses in clinical practice; moreover, standards form a basis for monitoring, evaluating and improving quality of care. Therefore, the aim was to identify the impact of implementing standardized nursing care on hepatic encephalopathy patient's outcome. Quasi-, experimental research design was used to conduct this research. This study was carried out in intensive care unit of gastroenterology and hepatology in internal medicine department at main Assuit University Hospital. The sample of this study consisted of 60 patients, divided into study and control group equally. Tools used in this study comprised three main. Tool 7> patients groups assessment sheet. Tool II- Neurological examination including mental state assessment. Tool 111-Evaluation sheet of hepatic encephalopathy patients. The

results:

it revealed that majority of the study sample was older than 55 years with a mean age [55.9 +/- 7.8 and 60.2 +/- 5.1 respectively] for the study and control group with significant difference. Regarding length of hospital stay there was a significant difference between both study and control group with p-value [< 0.001]. There results revealed significant difference between both groups regard the level and grade of lower limb edema [p < 0.01]. On the other hand, the result showed skin ulceration with statistically significant difference ktween both groups [p< 0.01]. In addition the current study revealed significant increase in both groups as regard neurological assessment using GCS, while it showed significant decrease as regards west haven criteria [p < 0.05].

Conclusion:

-Based on the findings of the present study, it can k concluded that the standardized nursing care were better than the routine care of the hospital for hepatic encephalopathy