J Korean Acad Nurs Adm.  2018 Mar;24(2):107-117. 10.11111/jkana.2018.24.2.107.

Effect of Crowding and Nurse Staffing on Time to Antibiotic Administration for Patients with Pneumonia in an Emergency Department

Affiliations
  • 1College of Nursing, Seoul National University, Korea.
  • 2College of Nursing, Research Institute of Nursing Science, Seoul National University, Korea. sunghcho@snu.ac.kr

Abstract

PURPOSE
This study was conducted to identify the effect of crowding and nurse staffing on time to antibiotic administration for pneumonia patients in an emergency department (ED).
METHODS
The sample included pneumonia patients visiting an ED from November 1, 2014 to February 28, 2015. Crowding was measured using ED occupancy rate, nurse staffing was measured as total length of stay per nurse and number of patients per nurse and the time duration was measured for the following processes: from patient arrival to prescription, from prescription to blood culture and antibiotic administration, and from blood culture to antibiotic administration. Data collected from the electronic medical records were analyzed using multivariate analyses.
RESULTS
The mean times from arrival to antibiotics administration, from prescription to antibiotic administration, and from blood culture to antibiotic administration were 128.31, 47.29, and 15.60 minutes, respectively. Crowding, nurse staffing, work experience of the nurse and severity of the patient influenced the time duration of each process from patient arrival to antibiotic administration.
CONCLUSION
The results reveal that crowding and nurse staffing affect length of time to antibiotic administration in pneumonia patients. Guidelines for safe nurse staffing in ED are required to improve patient outcomes.

Keyword

Crowding; Staffing; Emergency nursing; Pneumonia; Timeliness

MeSH Terms

Anti-Bacterial Agents
Crowding*
Electronic Health Records
Emergencies*
Emergency Nursing
Emergency Service, Hospital*
Humans
Length of Stay
Multivariate Analysis
Pneumonia*
Prescriptions
Anti-Bacterial Agents

Figure

  • Figure 1. Clinical process and time durations from patient arrival to antibiotic administration in patients with pneumonia.


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