Abstract Many patients with hematemesis had multiple complications as hypovolemic shock than death. Patient in ICU need special nursing guidelines to improve their outcomes. Aim of the study: to evaluate the effect of nursing guidelines in clinical outcomes for haematemesis patients at gastroenterology intensive care unit. Research design: quasi experimental research design was utilized in this study. Which was carried out in gastroenterology ICU at alrajhy liver hospital at Assiut University. The study sample consisted of study group (50 patients) who received the nursing guidelines and control group (50 patients) who received routine care. The following tools were utilized for data collection: Tool I haematemesis assessment sheet Tool II evaluation through different score, Tool III patient outcome and complication. Tools were applied in 3 phases; preparatory, implementation and evaluation phase. method record and document patient social and medical data, hemodynamic, respiratory, and cardiovascular status, assessment of blood transfusion, laboratory data, assess the patient status using different scale, and finally complications, Results: The majority of control group developed hepatorenal syndrome but (2.0%) patients in the study group had developed hepatorenal syndrome with higher in percentage in complication in control group than study group with significance difference (P<0.05). Conclusion: nursing guidelines leads to significant improvement in Patients outcomes for haematemesis patients. Recommendations suggest to emphasize the importance of accurate assessment of the patient with haematemesis