Background: Hepatic encephalopathy is an extra hepatic complication of impaired liver function and is manifested as neuropsychiatric signs and symptoms associated with acute or chronic liver disease in the absence of other neurological disorders Aim: To evaluate the effect of designed nursing guidelines on the outcomes of hepatic encephalopathy patients.Design:A quasi-experimental research design was utilized in this study Setting: This study was conducted at the Medical Intensive Care Unit and Endemic Disease Unit (Hepatology Unit) at El-Fayoum University Hospitals. Sample: A purposive sample of 60 adult patients aged 18-65 years from both genders who was diagnosed as having hepatic encephalopathy. Tools: Four tools were used to collect study data, a structured interviewing questionnaire,evaluation sheet of hepatic encephalopathy patients, patient‟s knowledge assessment questionnaire and Patient‟s self-care checklist.Results: this study revealed that, there was a statistically significant difference in the patient‟s outcomes between study and control group in which study group showed better outcomes than control group. Conclusion: the study concluded that, the designed nursing guidelines improve the hepatic encephalopathy patients‟ outcomes. Recommendation. Continuous Implementation of the designed nursing guidelines for hepatic encephalopathy patients to improve patient's knowledge about hepatic encephalopathy, its prevention and early detection.