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Electrical cardio version and defibrillation is a critical treatment for the survival of patients with cardiac arrest. Therefore, critical care nurses not only have to know how to monitor and operate the defibrillator, but also to provide interventions for preventing possible complications. The Aim of the present study was to evaluate the effect of educational program on knowledge and practice of nurses regarding defibrillation and cardio version. Method A convenient sample of 50 nurses working in coronary care unit and emergency care unit at Assiut University Heart Hospital. A structured interview questionnaire sheet and Nurses practice observational checklist tools were used to collect the data. Results the present study revealed that total mean scores of the nurses knowledge and practices were improved from a preprogram level of (26.04 ± 9.51) to knowledge and (75.54 ± 10.90) for practice to an immediate post of (68.84 ± 1.75) for knowledge and (134.70 ± 1.52) for practice. Conclusion Nurses' level of knowledge and practice in caring of patients was unsatisfactory before the program and significantly improved immediately post program and at follow up phase in all items. Recommendation: Orientation program should be utilized for newly graduated nurses'. Keyword: Nurse’s Practices ,Knowledge, Defibrillation, Cardioversion & Life Threatening Dysrhythmia. Introduction Defibrillators are life-saving and their early use improves survival of patients presenting with sudden cardiac arrest due to shockable rhythms if they are used safely and correctly. Of all health care professionals as critical care nurses' especially in coronary care unit are often faced with life and death situations and their ability to act quickly and efficiently is of paramount importance. Unless definitive action is taken, the patient will suffer irreversible brain injury. (Dulandas & Brysiewicz , 2018) The role of critical care nurse in life threatening dysrhythmias is the ability to detecting types of dysrhythmia during cardiac monitoring and rapidly assessment of patient for use of corrective action, obtaining 12lead ECG to identify the type of threatening dysrhythmias, and delivering adequate oxygen to reduce heart workload. In cases such as atrial fibrillation, ventricular tachycardia, ventricular fibrillation and cardiac arrest, the nurse should perform rapid and safe defibrillation and other cardiac life support protocols to preserve oxygen supply to vital organs .( Khalil et al., 2018) Despite the extension of training and the authorization of nurses to perform early defibrillation (advocated by the American Heart Association), such practice has not been widely adopted in hospitals. Lack of: continuing educational programs or sessions about cardiovertion and defibrillation, supervision and continuous evaluation of nurses' practice. So the nurses are not able to diagnosing pulseless fibrillation and ventricular tachycardia; for this reason the nurses have inability to do the defibrillation shock in hospitals. (Abd El naeem et al., 2016) Educational program for nurses regarding defibrillation and cardiovertion it is very important to meet the requirements of this complex role and cardiac devices to be able to meet the requirements and effects of patients' outcome or reduced of complication. So the critical care nurses are needed for continuous training to improve of nursing care and practices for critical ill patient. (Ruhwanya et al., 2018) Significance of the Study From researchers' clinical experience, it has been observed that critical care nurses are frequently the first responders and they witness nearly all the cardiac arrest in the unit. Also, according to patients' statistical record of coronary care unit, Assuite university heart hospital number of patients' admission during 2015 were (1144) per year. This high follow to coronary care unit at Assuite university heart hospital across Upper Egypt which admitted patients' with cardiac disease. So the trained Assiut Scientific Nursing Journal Ahmed et al., Vol , (7) No , (17) June, 2019 25 Critical care nurses were able to help correctly diagnose life threatening dysrhythmia and early detection of cardiac arrest, and the need to defibrillate, and execute sequential steps to complete defibrillation. Successful defibrillation delivered by the nurses facilitated the smooth completion of the procedure and avoidance of complications. They should have knowledge, good practice and be skillful in dealing with this complication. So there is a need for a study to promote the nurses' knowledge and practice that could help them to contribute successful patients' care outcomes. Aim of the study The aim of the study is evaluate effect of an educational program on nurses' knowledge and practice regarding defibrillation and cardio version Research hypotheses To fulfill the aim of this study, the following research hypotheses were formulated: H1. There will be a significant difference between post-test knowledge scores and the pre-test knowledge scores. H2.There will be a significant difference between the post-test practices scores and the pre-test practices scores. H3 .A positive relation will exist between knowledge and practices score obtained by critical care nurses' receiving educational program.

Effect of an Educational Program on Nurses' Knowledge and Practice Regarding Defibrillation and Cardioversion