Abstract Background: Competent nurses must be able to comprehend and manage a patient's fluid and electrolyte balance in order to provide critical care. Abnormalities in these bodily fluids can have catastrophic implications. Aim: Effectiveness of an educational program about fluid, electrolyte and Acid Base disturbances among acute liver failure patients on nurses' competency and patients' outcomes. Patients and Methods: quasi-experimental research design. Participants: A convenience sample of 50 nurses working in the intensive care unit at a liver hospital and eighty patients with acute liver failure. Method: Three tools were used to collect the data: the Tool (I): Before/after knowledge estimation questionnaire and the Tool (II): Before/after observational checklist. Tool (III): was a patients' outcomes evaluation sheet used to assess the effect of an educational program on nurses' competency about fluid, electrolyte, and acid base disturbances among acute liver failure and Patients' outcomes. Results: The majority of nurses have insufficient total knowledge before the teaching program; after the teaching program, the mean score improved significantly, and patients outcomes improved. Conclusion: Implementing a teaching program leads to important progress in nurses' knowledge and acute liver failure patients' outcomes. Recommendations: continuous In–service training programs for the purpose of updating nurse`s knowledge and acute liver failure patients' outcomes.