ED Staffing Ratios Affect Performance?

More and more information is coming out that we are putting patient at risk for adverse effects in the hospital by under staffing and overworking. This sounds like it is a no-brainer, but a study was done this year that looked at how staffing of nurses in the emergency room actually affects metrics. We all feel anecdotally that if we had a lower case load, we would perform better in our nursing duties. We feel that our charting is getting in the way of our patient care! Is that really true though?

Within a one year period about 100,000 patients were seen and their length of stays were averaged in relation to nursing hours. Overall, it was found that length of stay while in the ED greatly decreased with more staff in the emergency room. This consideration should be further explored and implemented if it means better patient outcomes and turnaround time for the ER.

This is so vital because the ED is the gate to the rest of the hospital. Unless you are a direct admit bringing your wheelbarrow of home meds for us to process while we try and get you admitted like any other patient. We love that they act as a buffer for us, but they can only do so much with limited staff. Patient use of the emergency department as a source of primary care has significantly increased as people struggle to afford health services. This influx could greatly overload the health system if not properly addressed. ER administration needs to look at the causes in delays of care and mitigate them as much as possible to help provide smooth and efficient service. There are many factors affecting emergency room times ranging from the socioeconomics of the area to nurse staffing.

One effective way that facilities can improve patient outcomes, staff satisfaction, patient satisfaction, and benchmarks is decrease nursing and patient ratios. It would be interesting to see if there are any studies on decreased patient ratios on inpatient populations length of stay.

If there is another area you would like us to look at or a topic your itching to hear about, let us know! As always, please continue to monitor.

References:
Western J Emerg Med. 2018;19(3):496-500. © 2018 Western Journal of Emergency Medicine

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