Evidence-Based Practice: Nurse-to-Patient Ratios and Length of Stay in the Emergency Department

Background: The emergency department plays an essential role in delivering quality patient care. Factors that have contributed to fewer ED registered nurses are aging out of the field, lack of educators to teach nursing students which leads to fewer graduates entering the field, and burnout and exhausting of current registered nurses. Purpose: The objective of our study was to determine the impact of the ratio of registered nurses to patients on length of stay in the emergency department. Methods: We performed a systematic review identifying varying staffing levels and how they play a role in patient care. The PRISMA 2020 statement was used to develop and organize the protocol for our research. Only research presented on registered nurses (RNs) in the emergency department was considered. Results: While the extent of length of stay varied, all studies were congruent in that patient’s length of stay was significantly longer in emergency departments who had fewer registered nurses on staff. Likewise, emergency departments with mandated nurse-to-patient ratios consistently recorded shorter duration of care as well as better patient outcomes and satisfaction. Conclusion: It is essential to have an adequate number of registered nurses in the ED to ensure the safety of patients and decrease their length of stay. Better staffing leads to reduced errors, better patient care, and efficiency. It also improves registered nurse retention rates and quality of life, and prevents job burnout