Background: Surgical cancellations at the day of surgery present major difficulties to both health care organizations as well patients and families. In a low middle income country (LMIC), cancellations stress an already resource limited system and result in significant financial burden and loss of resources. Due to a limited number of tertiary care hospitals, most families have to travel great distances and outpatient visits for preoperative assessment are unfeasible. We describe a protocol using screening phone calls and patient’s family counseling prior to admission to reduce same-day cancellations rates. Objective: To determine whether implementation of nurse –led protocol involving screening phone call and standardized questionnaire, along with patient’s family counseling 48 hours prior to surgery results in reducing day-of-surgery cancellations. Methods and measures: Pre-intervention data to calculate rate of cancellations was collected. Patient’s families were called 48 hours prior to surgery. A standard assessment checklist was used to cover pertinent points. A brief counseling session was also carried out regarding the surgery .In case of any concerns, attending surgeon and cardiologist were informed and a follow up call made on the day before surgery. A satisfaction survey regarding the effectiveness of the phone call was carried out after discharge from the hospital. Post intervention data was then collected and cancellation rate calculated. Results: Post-intervention, data from 144 screened patients was collected. Day of surgery cancellation rate decreased from 15.2% to 1.43 %( p<0.05) (fig 3). An average cost of $540 (Pakistan Rupee 80000) was saved per cancellation. Most families reported overall satisfaction with the phone call. Conclusion: Implementation of standardized protocol for preoperative assessment has decreased day of surgery cancellations, resulting in better resource utilization and reducing overall hospital costs. It has also helped in improving communication between patient’s family and heath care providers and improved overall patient satisfaction.

Objective: To explore a selection of psycho-social variables with potential influence on exercise and dietary behaviors in patients with cardiovascular disease and diabetes in Saudi Arabia and to elicit salient directions and themes for further examination on a larger scale. Method: This was a phenomenological qualitative study informed by the Self-Determination Theory and the COM-B Model. It involved fully structured, open-ended interviews administered to 8 inpatients at a governmental hospital in Riyadh between October and December 2020. Data was examined using a hybrid of deductive and inductive content analysis. Results: Patients with a higher degree of basic psychological need satisfaction lived healthier lives and displayed more positive emotional responses. We detected differences between physical activity and nutritional behavior in terms of the associated perception of autonomy and competence, as well as motivational quality. The family emerged as major social support source for both behaviors. Environmental opportunities provided for exercise and diet support were commonly perceived as insufficient. Conclusions: We suspect the level of perceived psychological need support to be linked to the patients’ behavioral and psychological outcomes. We also expect local inequalities in the available behavior change support across different health behaviors and the need to adequately foster patient autonomy in clinical interventions in Saudi Arabia.

Nurses are the vital part of the health care departments and there is no doubt that nurses are the prime unit of the health care profession. According the world health statistics analysis there are approximately 29 million nurses worldwide and there is an estimation that one million nurses are further needed by the year of (2020) Shortage of nurses affect the country health care setting and significantly, it also affect the patient care which results in overall health decline in the whole country. Pakistan is also facing great challenges regarding the nursing profession and shortage of nurses is at the top of these challenges and nursing profession is female dominated profession which also increases the social cultural boundaries. As per results of a research conducting regarding Pakistan nursing work in overcoming the shortage of the nurses in the Pakistan as it is a big challenge faced by the Pakistan in the last decay. I feel very disappointment that in Pakistan this profession faces more problems/ shortage of nurses as compare to other countries. The facts and figures related to the health care in Pakistan are alarming and to handle these the health care provider and the government of Pakistan should take the strong steps. Due to this shortage patient care effects. The nursing workforce in Pakistan is 4.9: 10,000 (WHO, 2016) which indicates a shortage for a country with population of about 193 million (WHO, 2019). Unluckily, the education role of the nurses in Pakistan is not improper shape as it should be only good nurses can be produce by the good educator nurses. In the past nursing care was limited to the bedside patient care but now a days nursing research and advance studies have opened new horizons for the nurses in the country .

Nurses in all part and site can establish leadership in contaminating prevention and control using the knowledge skills and site judgment to initiate proper and immediate infection control nurses play a very important role in infection control. Health care professionals in certain are often showing to several infections healing their daily work nurses have complete awareness and infection control practice. All health care workers whose responsibility to protect the patients from getting infection in hospital and other health care center. Keeping an infection free setting patient’s recovery will be promoted and provide the great quality of care. Nurses can do a great agreement to communicate effectively e.g. Nurses should provide the information charge nurses visitors and patient. Provide the proper information patient how to protect themself including support staff in team. Nurses contribution in this war against infection control using the barrier precaution like face marks caps gowns and gloves. Infection control and prevention practices minimize the infection to apply the patient care use the standard Precautions the practices are protect and prevent to spread infections among patients and healthworker and nurses. Frequently hand washing, use of proper personal protective measures sharp safety respiratory care and hygiene good practices of safe injection and use the sterilized instruments. Nightingale mentioned the person as a patient. Atmosphere affects the person. Better atmosphere help to heal the patient soon as compared to polluted. Health is the complete well-being not only to be well. Good environment provide healthy life and prevent the disease.