Background: Chest tube is an essential life saving measure for the management of pneumothorax, hemothorax and hemopneumothorax developed as a consequence of chest trauma or surgery. The aim of this study was to assess the effect of developing and implementing guidelines of nursing management of patients with chest tube drainageon nurses'Performance. Subjectsand method: Quasi experimental design was utilized to carry out this study. Study Subjects:All available nurses were included in the study (44) nurses of both sexes who are working in chest department at Mansoura University Hospitals.Two tools were used for data collection; first tool included two parts sociodemographic characteristics of the studied nurses and interview questionnaire sheet about nursing management of patients with chest tube drainage. Second tool isnurses' performance observational checklist about nursing management of patients with chest tube drainage. Results: the majority of the studied nurses were females in their second and third decade.Before implementing the guidelines62.5% of the studied nurses had low knowledge level, and 70% of them had moderate practice level, while after direct implementation of the guidelines 65.0% of them had moderate knowledge level and 90% had high practice level. The study concluded;nursing management intervention guidelines significantly improved nurses' performance for patients with chest tube drainage. The study recommended;administrators should create policies and plans for providing education to the nursing staff, evaluating nurses' Performance periodically to determine the effect of the training programs, and chest department should be supplied by checklists about all chest tube procedures.