الفهرس 
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Abstract
Hearing is one of the vital five senses because it helps in the understanding and gives alert of any danger in the surrounding environment (Anna, 2017). Hearing loss or hearing impairment is refers to a complete or partial decrease in the ability of the ear to hear or recognize sounds (Ha et al., 2022). Congenital hearing loss present at delivery which occurs when the ability of the ear to change the vibratory mechanical energy of sound into the electrical energy of nerve compulsions is impaired (Korver et al., 2017). Hearing loss may be caused by a number of reasons which include genetics,exposure to noise, some infections, ageing, birth complications, certain medications or toxins and trauma in the ear. Common disorders that result in hearing loss among children are chronic ear infections and certain infections during pregnancy such as cytomegalovirus, syphilis and rubella (Morsy et al., 2022). Hearing loss can be divided into congenital hearing loss and acquired hearing loss.Congenital causes may lead to hearing loss being present at or acquired soon after birth. Hearing loss can affect a child’s ability to develop speech, language, and social skills. It also leads to delayed education and poor academic level due to poor educational attainment. In addition, it leads to psychological, social, financial problems, family fear and social shame (Khan, 2022; Poonual et al., 2022). Hearing loss in newborns can be avoided through good hygiene, immunization to prevent most infections, good ear care, improved maternal and child health practices and avoidance of use of ototoxic drugs during pregnancy and diagnosing of hearing loss in newborns by application hearing screening. (World Health Organization, 2016). Community health nurses play an important role by communicating with families and encouraging them for follow-up services .They can educate and advise expectant mothers as well as during the postpartum period on the need and importance of newborn hearing 66screening, the steps involved, early detection, intervention, and timely follow-up. Also, they can provide valuable information on motor, sensory, and language developmental signs, and form an essential emotional support system for families during a newborn hearing screening (Ravi et al ., 2017). Aim of the Study The aim of the present study was to enhance knowledge and practice about hearing screening test among primary health care nurses. Research hypotheses 1- Nurses, who will attend in-service training intervention about newborn hearing screening test have higher knowledge scores post-intervention compared to pre-intervention. 2- Nurses, who will attend in-service training intervention about newborn hearing screening test have higher scores of practice post-intervention compared to pre-intervention.Research design: A quasi- experimental study design (pre &post-test) was used to achieve the aim of the study. The setting This study was conducted at five primary health care units at kom Hamada center affiliated to Ministry of health in Elbehera Governorate. Subjects: All primary health care nurses (116) who are workingr in above mentioned setting >Sample selection: Random sample of the nurses who are working in five primary health care units selected out of ten of primary health care. This will constitute the sample. 67 Tools for data collection: The researcher used two instruments in order to collect the necessary data and achieve the study purpose. The instrument included the following: Instrument I: A structured interview questionnaire was constructed and developed by the researcher after reviewing the related literature. It is used to assess socio-demographic data and nurses, knowledge. It included two parts: Part (I): Socio demographic characteristics of nurses such as age, marital status, educational level and experience years. Part (II): Nurses, knowledge regarding hearing loss disease of newborn and hearing screening test. This part consisted of fourteen closed- ended questions which classified into two subparts as the following:- I- Nurses, knowledge regarding hearing loss disease of newborn, This part consisted of six closed- ended questions Five questions were developed by the researcher numbered 1-5 in the tool as definition of newborn, stages of hearing development and speech from one day to five years, the function of the hearing nerve, causes of hearing loss among newborns and definition of neonatal hearing loss. While the sixth question (complication of hearing loss disease) was developed by Barbosa et al, 2013.II- Nurses, knowledge regarding hearing screening test. This part of questionnaire consisted of eight closed- ended questions. Five questions were developed by the researcher numbered 1-2-4-5-6 in the tool as the reason for performing the hearing test for newborns, the importance of hearing screening, method of performing the hearing test, obstacles that may prevent completion of examination if the newborn didn’ t pass the first test while three questions were developed by Barbosa et al, 2013 numbered 3-7-8 in< the tool as time of performing hearing screening test, ideal age to diagnose the newborn hearing loss and ideal age to start an intervention to treat hearing loss 68 Instrument II: Observational checklist to assess nurses’ practices regarding hearing screening test. This instrument was developed by the researcher which consisted of twenty four closed ended questions answered by done or not done and classified into three parts: Part (1): Preparing equipment before the test. This part was consisted of four questions numbered 1-4 as wash hands before dealing with hearing equipment, check the device battery before the use checks the prop for the presence of wax and disinfect probe with alcohol before use.Part (2): During the examination and dealing with the child. This part was consisted of twelve questions numbered 5-16 as check the baby’s ear before the test, cleans the baby’s ear out of the wax, chose the right size from the sensor, Part (3): Take care of the device This part was consisted of eight questions numbered 17-24 as wear gloves when cleaning hearing aids, wash the plugs with clean water, dry the plug with a clean towel, etc. The main results of this study showed that: x The main findings revealed that good knowledge among studied nurses increased from 23.3% in pre-test to 86.2 % in post-test. While in retention test, it increased to 87.1 %There was highly statistical significant improvement in different item of knowledge in post-test and retention test than in pretest (p <0.0001). x The good practice responses increased from 57.8 % pre-intervention to 93.1% in post-test and 96.6 % in retention test. In addition, it shows the total mean practice score increased from 19.8±4.8 pretest to 24.0±0.31 posttest and 23.7±1.2 in retention test. 69 x There was a highly significant relation between age and practice (p<0.05). And there is a non-significance relation between education and practice. The study concluded that There was a significant improvement nurses’ knowledge level and mean score about newborn hearing screening test post the nursing intervention compared to pre intervention. Furthermore, nurses’ level of practice regarding newborn hearing screening test improved significantly after nursing intervention compared to pre intervention. Additionally, there was a statistically significant relationship between nurse’s experience and their level of knowledge about newborn hearing screening test Recommendations Focused on the results of the current study, it was recommended that:-1. Continuous training and teaching sessions to enhance knowledge and practice of nurses on hearing screening test should be applied in all primary health care nurses 2. Simplified booklet on newborn hearing screening should be available for nurses. 3. Health education and brochures on newborn hearing problems and hearing screening should be provided to antenatal women in all primary health care units. 4. Further studies with the use of the program should be done with more sample size to increase the ability to generalize the findings.