IOSR Journal of Nursing and Health Science (IOSR-JNHS) e- ISSN: 2320–1959.p- ISSN: 2320–1940 Volume 7, Issue 4 Ver. VI (Jul.-Aug. 2018), PP 84-93 www.iosrjournals.org DOI: 10.9790/1959-0704068493 www.iosrjournals.org 84 | Page Implementation of Nursing Evidance -Based Practices in managing Interdialytic Hypotension during Hemodialysis sessions: A Quasi-experimental study Bayoumi M 1,2 1- Medical-surgical nursing department, Faculty of Nursing, Beni-Suef University, Egypt. 2- Medical-surgical nursing department, Nursing Division, College of Health and Sport Sciences, University of Bahrain, Bahrain. Corresponding author: Magda Mohamed Mohamed Bayoumi. Abstract: Background:Interdialytic Hypotension (IDH) is considering an important clinical health problem and may increase of mortality rate. Nurses at the dialysis unit facing a great challenge to manage patients with IDH. Practically using nursing evidence-based practices (EBP) is required to provide appropriate nursing care and improve patient outcomes. Aim:The aim of this study was to evaluate the impact of applying nursing evidence- based practices in managing interdialytic hypotension (IDH) during hemodialysis sessions. Methods: The Quasi- experimental study was conducted in the dialysis unit of Hurghada government hospital (October- December 2017) on 47 patients 24-70 years old, on maintenance hemodialysis therapy. Data were collected using a developed structured questionnaire to assess patients’ socio-demographic data, disease characteristics, and hemodialysis session records. The nursing evidence-based practices as developed based on literature and applied by the researcher. Results:The results have shown that patients’ duration of dialysi s mean ±SD (26.97±18.22) months and the main cause of ESRD among study sample was diabetes mellitus (38.3%), and the interdialytic weight gain ranged between 1 kg to 6 kg with mean±SD (2702.12±1369.93) grams. The blood pressure reading average highlighted that around 12% (n=6) were complaining of Interdialytic Hypotension (IDH) after assessment for 6 consecutive sessions. Moreover, the significant findings of the physical assessment for the patients with IDH was reported vomiting (67%), nausea (83%), cramps (83%). And other symptoms as headache (57%) and dizziness (67%). Statistically significant improvements were revealed between pre-post nursing intervention using EBP in the Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), and Mean Arterial Blood Pressure (MAP) scores, p<0.000. In conclusion, Nurses are playing a crucial role in the dialysis unit, implementation of EBP to managing patient with IDH was effective as guidelines to use cool Dialysate, high dialysate Ca concentration, reevaluate the dry weight, Trendelenburg position, slow Ultrafiltration rate, modification of dialysis session scheduling, provide continues Monitoring, aerobic exercise, prohibit eating during the dialysis session, fluid restriction, low salt diet, using of Midodrine and adjust antihypertensive drug. Keywords: Evidence-Based Practice- Nursing care- Hemodialysis- Interdialytic Hypotension I. Introduction Chronic renal failure has been growing worldwide, end-stage renal disease (ESRD) is defined as a permeant, irreversible in kidney function, eventually, it results to be treated by renal replacement therapy either hemodialysis or peritoneal dialysis and renal replacement for surviving. [1] El-Zorkany, (2017), who was mentioned that the prevalence of dialysis patients in Egypt is 483 pmp in 2008, and the main cause is diabetic mellites, hypertension, chronic glomerulonephritis, unknown and pyelonephritis. [2,3] Many studies highlighted that blood pressure fluctuations ordinary happen during dialysis therapy whether hypertension or interdialytic hypotension (IDH) and have an impact on patients‟ outcomes. Interdialytic hypotension occurs related to ultrafiltration throughout hemodialysis sessions and leads to increase mortality and mortality rate. [4,5] Interdialytic hypotension is defined as a decrease in the systolic blood pressure (SBP) equal or more than 20 mmHg or mean arterial pressure (MAP) equal or greater 10 mm Hg according to National Kidney Foundation Disease Outcomes and Quality Initiative (KDQOI). [6] Flythe et al, (2015) were reported that a nadir systolic blood pressure of 90 mmHg (interdialytic hypotension) is considering the primary risk factor of mortality based on large cohort observational study. [7] A recent study conducted by Buren, (2017), who has described the pathophysiology of IDH and explained that the hemodialysis therapy has dramatic side effect as other therapeutic intervention which leads to change in the patients‟ physiology related to the sudden reduction in the intravascul ar volume from aggressive