الفهرس 
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Abstract
Sudden cardiac arrest is defined as the sudden cessation of heart function,breathing, and consciousness.The condition usually results from a problem with your heart’s electrical system, which disrupts the heart’s pumping action and stops blood flow to the body (AHA, 2020). If not treated immediately, sudden cardiac arrest can lead to death. Survival is possible with fast, appropriate medical care.Cardiopulmonary resuscitation (CPR), using a defibrillator, or even just pressing on the chest can increase the chances of survival until help arrives (Jeejeebhoy, 2019).Cardiac arrest in pregnancy is one of the most challenging clinical scenarios.Although most features of resuscitating a pregnant woman are like standard adult resuscitation, several aspects and considerations are uniquely different. The most obvious difference is that there are 2 patients, the mother, and the fetus (Jeejeebhoy,2019). Caregivers must have a thorough understanding of maternal mortality to best prevent and treat cardiac arrest in pregnancy. Maternal mortality is when a woman dies during pregnancy or up to 42 days after giving birth or ending the pregnancy if the cause of death is related to or made worse by the pregnancy or how it was handled (AHA, 2020).Causes of cardiac arrest during pregnancy:The most common causes of maternal cardiac arrest include bleeding, heart failure, and amniotic fluid embolism-when the fluid around the fetus enters the mother’s bloodstream and causes an allergic reaction or sepsis (Zelop et al., 2019).Causes of cardiac arrest during labor:Several health problems that can happen during childbirth can lead to cardiac arrest, including excessive bleeding, heart failure, heart attack,preeclampsia, blood infection, and amniotic fluid embolism, which is when amniotic fluid gets into the mother’s bloodstream (zelop et al., 2019).Causes of cardiac arrest during postpartum:Severe bleeding and infection are the main causes of cardiac arrest during the postpartum period (Zelop et al., 2019). Cardiopulmonary resuscitation can save the lives of both the mother and the baby in the event of a cardiac arrest.Cardiopulmonary resuscitation (CPR) is a combination of techniques,including chest compressions, designed to pump the heart to get blood circulating and deliver oxygen to the brain until definitive treatment can stimulate the heart to start working again (Lee, 2015).The nurse’s role during CPR is as follows:The nurse plays a key role in the response to a cardiac arrest and initiates basic life support while waiting for the advanced cardiac life support team to arrive(Terzi, 2017). Nurses are the central part of the healthcare system, and they are believed to be knowledgeable and competent in caring for patients (Ray, 2016). Maternity nurses should know how to care for pregnant women who have a cardiacarrest. They should be able to do this from the first assessment of pregnant women who are likely to have risk factors for cardiac arrest, during cardiac arrest, and for rehabilitation after cardiac arrest (Soskin and Yu, 2019).Simulation and its importance in maternity nurses’ education:simulation is the re-creation of a real-world process in a controlled environment. It uses something called ”modelling” to figure out the result of the simulation. Kristin et al. (2015) defined a ”model” as a picture of an object or process that describes and explains a phenomenon that cannot be seen or felt directly.Simulations represent an innovative teaching method that stimulates several senses at the same time among learners. Kristin et al. (2015) say that simulation is a method that can be set up to be like real life and gives people the chance to work in settings that are closer to and more like real life.The purpose of the current study is to evaluate the effect of simulation intervention on a maternity nurse’s performance regarding cardiopulmonary resuscitation.The current study was conducted at the Obstetrics and Gynecology Departments of Benha University Hospital Health Insurance in Benha and Quisna General Hospital.A quasi-experimental research design was used to evaluate the effect of simulation intervention on maternity nurses’ performance regarding cardiopulmonary resuscitation. The target population of this study is maternity nurses. A convenience sample of a total of 100 maternity nurses who work at the Obstetrics and Gynecological departments at general hospitals in Quisna, Health Insurance, and Benha University Hospital.Throughout the course of the present study, data was collected using two instruments:Instrument 1: Self-administered interview questionnaire: This instrument consists of two parts:Part 1: Nurses’ professional data such as age, educational level, educational qualifications, and years of experience.It was six questions about nurse’s professional data.Part 2: Knowledge Assessment Questionnaire: This was used to test how much maternity nurses knew about cardiac arrest during pregnancy and CPR.It consists of sixteen questions about maternity nurses’ knowledge about CPR Knowledge’s scoring system:The maternity nurses’ knowledge is calculated for each item as follows:Calculation of sample size:There were 30maternity nurses worked at the Obstetrics and Gynecological Department at Quisna General Hospital There were 30 maternity nurses who worked at the Obstetrics and Gynecological Department at Health Insurance Hospital in Benha.There were 40 maternity nurses who worked at the Obstetrics and Gynecological Department at Benha University Hospital.The correct and complete answer took (2), the correct and incomplete answer took(1), and the incorrect answer took (0). The total score of knowledge is calculated as follows:● Good knowledge > 75%● Average knowledge of 50-75%● Poor knowledge < 50%● Instrument 2: Maternity nurse performance observational checklist It was conducted by the researcher after reviewing relevant literature. It was adopted by Hui et al. (2011), Rodrigues et al. (2014), and Adams et al. (2016). It was concerned with assessing the maternity nurse’s practice regarding cardiopulmonary resuscitation during pregnancy.It consists of five parts that include:(6) Practice of maternity nurses regarding CPR before starting procedure consists of 11questions.(7) Six questions are asked of maternity nurses during the demonstration of chest compression technique during chest compression.(8) Practice of maternity nurses regarding how to deliver breath and its technique consists of fifteen questions.(9) Practice of maternity nurses regarding defibrillator technique consists of seventeen questions.(10) The practice of maternity nurses regarding the application of intubation consists of twelve questions. It consists of five parts that include:1)Practice of maternity nurses regarding CPR before starting procedure consists Of eleven questions.2)Practice of maternity nurses about demonstration of chest compression technique during chest compression consists of six questions3)Practice of maternity nurses regarding how to deliver breath and its technique consists of fifteen questions 4)Practice of maternity nurses regarding defibrillator technique consists of seventeen questions.5)Practice of maternity nurses regarding application of intubation consists of twelve questions Performance scoring system.● Each done practice received a score of (2).● Each properly done received a score of (1).● Each not-done practice received a score of (0).● The score of items was summed up and the total score was divided by the number of questions, giving the mean score. This score was converted into a percent score.● The total performance score was assigned as follows: Aziza e al., (2018)● Satisfactory performance means >75% of the total performance score.● Unsatisfactory performance if less than 75%. Instrument validity The instrument was developed by the researcher and examined by a panel of five experts (three cardiologists and two professors of maternity nursing specialty) to determine whether the included items clearly and adequately cover the domain of content addressed. The percentage of consensus among experts regarding the structured questionnaire was 94%, and the pre-post-test was 87%. Instrument reliability Test-retest was repeated to the same sample of maternity nurses on two occasions and then compared the scores, and Cronbach’s coefficient alpha was 879.Pilot study:A pilot study was implemented to test the applicability of the instruments,the feasibility and clarity of the instruments, and to estimate the time needed for data collection. It was performed on 10% of the total participants, which were 10 maternity nurses who were included in the study.Ethical consideration:The approval of the study was obtained from the Ethical and Research Committee of the Faculty of Nursing, Menoufia University, on September 20,2020. Written consent for approval to participate in the study was obtained from maternity nurses after explaining the purpose of the study. They were assured of the confidentiality and anonymity of the collected data. Official letters were issued from the dean of the faculty of nursing at Menoufia University and sent to the directors of Benha University Hospital, Health Insurance in Benha and quisna general hospital concerning their approval for data collection from authorized personnel. The letters explain the purpose of the study and sought their cooperation.Regarding confidentiality, approaches to ensuring ethics were considered in the study. The researcher introduced herself to the participants in the study sample and explained to them what the study was about. This was done to gain their cooperation on the study. All maternity nurses were informed that participation in the study was voluntary, and they could withdraw from it whenever they decided to do so. Each participant was free to ask any question about the study details.There was a statistical improvement in the nurse’s knowledge of all items of CPR and simulation. Only 14% of the nurses in the sample performed well on the pre-test; 92% performed well on the post-test; and 96% performed well on the follow-up test. There was a statistically significant difference between the pre-test,post-test, and follow-up tests. Only 14% of the nurses in the sample had a good knowledge score in the pre-test; 61% had a good knowledge score in the post-test, and 37% had good knowledge in the follow up. This means that there was an improvement in the quality of nursing services. This means the current study’s findings succeeded in testing the research hypothesis. Maternity nurses who receive simulation intervention regarding cardiopulmonary resuscitation obtain higher knowledge scores than those who do not. Maternity nurses who receive simulation intervention regarding cardiopulmonary resuscitation will receive a higher performance level than those who do not.