A competent transcultural health care service has been identified as essential for the delivery of safe health care in the United Arab Emirates (UAE) and the Kingdom of Saudi Arabia (KSA) and indeed internationally. Delivery of contextually informed educational programs to new employees forms an important component of achieving this requirement. Nurse educators have an essential role in identifying the cultural and religious knowledge needed by new employees and in designing programs to address these needs. The objective of this article was to explore the cultural and religious educational needs of overseas nurses working with Muslim patients in the KSA and the UAE as derived from the experience of nurses themselves. Written narratives from nurses employed to work primarily with Muslim nurses were analyzed using a qualitative descriptive methodology. In the UAE and the KSA context, and perhaps for nurses working with Muslim-Arabic patients worldwide, the culturally and religiously specific topics that need to be a component of preemployment education include the basic Islamic principles (5 daily prayers, Ramadan fasting, Zamzam water, and time management skills to accommodate religious practices within care); Kinship and Social Factors (family structure, gender-related issues, and social support system); and Basic Arabic language skills.

Cultural competence in nursing care has always been emphasized and recommended as a quality indicator and a core knowledge requirement for all nurses. However, the provision of such culturally competent care can only be achieved when patients' cultural values and systems are known to the nurses and used appropriately to inform their practices. This study will help to reveal the different components of nurses' experiences while caring for patients from Islamic culture. This will inform the practice of service planners, managers and educators in designing interventions that address the needs of these nurses, hopefully making the nursing service more satisfying for both the nurses and the patients. A qualitative exploratory research design utilizing written narratives was used within this study. The study revealed three themes and five subthemes. The main themes were: (1) Right to practice Vs impact on care: A matter of balance; (2) Islamic principles: Nurses' knowledge; and (3) Broken lines of contact with social systems and patients. Most of participants have demonstrated insufficient knowledge and experience of Islamic principles which cannot aid them in providing culturally competent nursing care. It has also revealed that nurses should further recognize religion as an important part of the healing process and not as a factor that negatively impacts their role and hinders patient care.

Cultural competence in nursing care has always been emphasized and recommended as a quality indicator and a core knowledge requirement for all nurses. However, the provision of such culturally competent care can only be achieved when patients' cultural values and systems are known to the nurses and used appropriately to inform their practices. This study will help to reveal the different components of nurses' experiences while caring for patients from Islamic culture. This will inform the practice of service planners, managers and educators in designing interventions that address the needs of these nurses, hopefully making the nursing service more satisfying for both the nurses and the patients. A qualitative exploratory research design utilizing written narratives was used within this study. The study revealed three themes and five subthemes. The main themes were: (1) Right to practice Vs impact on care: A matter of balance; (2) Islamic principles: Nurses' knowledge; and (3) Broken lines of contact with social systems and patients. Most of participants have demonstrated insufficient knowledge and experience of Islamic principles which cannot aid them in providing culturally competent nursing care. It has also revealed that nurses should further recognize religion as an important part of the healing process and not as a factor that negatively impacts their role and hinders patient care.

(10%) patients had HAS-BLED scores of more than 3 (high risk). Bleeding (cerebral, gastrointestinal, or hemoglobin <100 g/L) occurred in 32 (12.3%) patients; 12 (37.5%) of these patients had a HAS-BLED score of more than 3 (p=0.0001). TTR was not different between patients with or without bleeding (64.1+19.4% versus 66.3+16.1%). On the other hand, mean HAS-BLED and ATRIA scores were significantly higher in patients who had bleeding. Using multivariate analysis, ATRIA score followed by HAS-BLED score was the best predictor of bleeding. Age, sex, and TTR as a measure of INR variability did not show a significant difference between the two groups. Conclusion Similar to previous reports of patients with atrial fibrillation, ATRIA and HAS-BLED scores were the best predictors of bleeding in our cohort of patients with mechanical heart valves, with no independent contribution of TTR to estimation of bleeding risk.