Abstract
BackgroundTo date, there are no valid statistics regarding the number of full time staff necessary for nursing care in emergency departments in Europe.Material and MethodsStaff requirement calculations were performed using state-of-the art procedures which take both fluctuating patient volume and individual staff shortfall rates into consideration. In a longitudinal observational study, the average nursing staff engagement time per patient was assessed for 503 patients. For this purpose, a full-time staffing calculation was estimated based on the five priority levels of the Manchester Triage System (MTS), taking into account specific workload fluctuations (50th-95th percentiles).ResultsPatients classified to the MTS category red (n = 35) required the most engagement time with an average of 97.93 min per patient. On weighted average, for orange MTS category patients (n = 118), nursing staff were required for 85.07 min, for patients in the yellow MTS category (n = 181), 40.95 min, while the two MTS categories with the least acute patients, green (n = 129) and blue (n = 40) required 23.18 min and 14.99 min engagement time per patient, respectively. Individual staff shortfall due to sick days and vacation time was 20.87% of the total working hours. When extrapolating this to 21,899 (2010) emergency patients, 67–123 emergency patients (50–95% percentile) per month can be seen by one nurse. The calculated full time staffing requirement depending on the percentiles was 14.8 to 27.1.ConclusionPerformance-oriented staff planning offers an objective instrument for calculation of the full-time nursing staff required in emergency departments.
Highlights
BackgroundCentralization of processes for intra-hospital emergency treatment through the establishment of central emergency departments (ED) in Europe is supposed to improve the quality of nursing as well as reduce medical engineering and equipment expenses, especially through a more efficient nursing workforce [1]
Patients classified to the Manchester Triage System (MTS) category red (n = 35) required the most engagement time with an average of 97.93 min per patient
For orange MTS category patients (n = 118), nursing staff were required for 85.07 min, for patients in the yellow MTS category (n = 181), 40.95 min, while the two MTS categories with the least acute patients, green (n = 129) and blue (n = 40) required 23.18 min and 14.99 min engagement time per patient, respectively
Summary
Centralization of processes for intra-hospital emergency treatment through the establishment of central emergency departments (ED) in Europe is supposed to improve the quality of nursing as well as reduce medical engineering and equipment expenses, especially through a more efficient nursing workforce [1]. Labor costs account for 60–70% of the overall expenses in a central emergency department (of which 30% are for nursing alone) [2]. The traditional calculation of full-time staff based on the predicted number of emergency patients per year is not sufficiently sensitive for the calculation of nursing staff in an emergency department [3], as nursing minutes per patient may represent only a preliminary value [4].
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