الفهرس 
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Abstract
Summary
Nurses – patient’s ratios must be carefully calculated because they have a great impact on patient’s health and quality of health service provided Min & Scott, (2016). Nurses have a responsibility to address and maintain patient safety standard in all aspects of their work including applying all patient’s safety standards for improving health care outcome and focus on the patient as the source of control and reduce or eliminate any disparities associated with access to needed care and quality (WHO, 2013)
Aim of the study
This study aimed to determine the effect of nurses patient’s ratio on patient’s safety at Assiut Fever Hospital.
Study question
Does nurses patient’s ratio has significant effect on patient’s safety at Assiut Fever Hospital?
Subject and Method
Study design: A descriptive correlational study design was used.
Setting: The present study was conducted at (Isolation unit, Health insurance unit and Hemodialysis unit), at Assiut Fever Hospital affiliated to Ministry of Health and Population Egypt.
Sample: The present study was included on 55 nurses works in 3 units; Isolation unit 38 nurses, Hemodialysis unit 7 nurses and Health insurance unit 10 nurses. The sampling technique was convenient.
Tools of the study
The data of the present study were collected by using two tools:
- Tool (I): Personal Data Sheet: was designed to collect personal data about nursing staff (gender, educational qualification, age and years of experience).
-Tool (II): Patient’s safety observational checklist adopted from Egyptian Hospital Accreditation Standards, (Ministry of Health and population, 2012): to determine the nurses performance regarding patient safety standards, it consisted of two parts;
Part I: General patients safety standard consists of (33) items under (12) dimensions; patient identification included (7items), critical results (10 items), verbal orders (6 items), awareness of medical team regarding verbal orders, prevent faulty connection or disconnection of all types of pipes and catheters, evaluate the probability of a patient falling, reduction or prevention of any specific risk of falls, evaluate the probability of risk exposure to bed ulcers, reduction or prevention of exposure to bed ulcers, alarms are designed in a way that suits the place and is clearly audible, presence of a documented system for shift handover, and medical team are committed to shift handover system.
Part II: Medication safety standards had (29) items under ten dimensions: medication management (6 items), medication storage (7items), drug description, giving medication included (10 items), how to deal with similar medications, how to deal with concentrated solutions, how to separate medications, how to discriminate medications, receiving drug list during admission, and receiving drug list during discharge.
Scoring system
Nurses performance was observed by the researcher from the beginning of the shift to the end, it’s repeated three times in every shift (morning, evening, and night shift) and each item was scored as follow : Not Met=0, Partially Met= 1 Met=2, Not applicable= NA. The total score was summed up then the percentage was measured accordingly A=95% mean standards are met, B=80% mean standards are partially met and C=70% mean standards are not met.
Data collection
An official approval had been obtained to carry out this study from Administrative responsible personnel (the Dean of Nursing Faculty, Assiut University, Director of Assiut Fever Hospital, Nursing Director, and Head of each units) mentioned before to be able collect necessary data of the present study. Pilot study was carried out to assess tool clarity, understandability, applicability, time estimate required for data collect also to identify any problems that may encountered during data collection phase. It applied on 6 nurses.
After obtaining verbal agreement, the researcher observe the nurse, when providing nursing care in morning, evening and night shift 3 times in each shift from the bingeing to the end of the shift by using observational check list, Total durational data collection took about 8 months from the bingeing of June 2019 to end of January 2020. Data entry and analysis were done using SPSS version 20.
The study has generated the following findings:
There was statistically significant differences between nurses application of all general and medication safety standards dimensions in the three shifts
There was statistically significant difference between the nurses patient’s ratio with application of general and medication safety standards in morning shift. Nurses patient’s ratio had positive relation with nurse’s application of general and medication safety standards in morning shift. In contrary there was positive relation between the nurses patient’s ratio with not met items of general and medication safety standards in evening shift.
There was no significant relation between nurse’s application of general and medication safety standards with personal data : age, years of experience, and educational qualifications.
In the light of the present study results, the following recommendations are suggested:
Developing strategies to use floating staffing.
Encourage close supervision and evaluation until patient’s safety standard application become adherent in all nurse’s attitude.
Establish patient’s safety committee.
Further studies by Ministry of health and population must be done to distribute nurses all-over the country to overcome this problem.
Provide enough resources which required for applying the national patient’s safety standards.