title: Nurse Staffing Calculation in the Emergency Department - Performance-Oriented Calculation Based on the Manchester Triage System at the University Hospital Bonn.
abstract: To date, there are no valid statistics regarding the number of full time staff necessary for nursing care in emergency departments in Europe.
  
  
  
  Staff 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).
  
  
  
  Patients 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.
  
  
  
  Performance-oriented staff planning offers an objective instrument for calculation of the full-time nursing staff required in emergency departments.
authors.affiliation: Emergency Department, University Hospital Bonn, Bonn, Germany.
authors.forename: Ingo
authors.initials: I
authors.lastname: Gräff
authors.affiliation: Process Management, University Hospital Bonn, Bonn, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Goldschmidt
authors.affiliation: Emergency Department, University Hospital Bonn, Bonn, Germany.
authors.forename: Procula
authors.initials: P
authors.lastname: Glien
authors.affiliation: Department of Anesthesiology, Hospital Mechernich, Mechernich, Germany.
authors.forename: Sophia
authors.initials: S
authors.lastname: Klockner
authors.affiliation: Department of Anesthesiology, University Hospital Bonn, Bonn, Germany.
authors.forename: Felix
authors.initials: F
authors.lastname: Erdfelder
authors.affiliation: Department for Plastic, Hand, Reconstructive and Burn Surgery, Hospital Köln-Merheim, Köln, Germany.
authors.forename: Jennifer Lynn
authors.initials: JL
authors.lastname: Schiefer
authors.affiliation: Department of Anesthesiology, University Hospital Bonn, Bonn, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Grigutsch
mesh_terms: D004636:Emergency Service, Hospital; D005858:Germany; D006785:Hospitals, University; D006801:Humans; D009726:Nurses / Q000600:supply & distribution*; D010561:Personnel Staffing and Scheduling / Q000706:statistics & numerical data*; D014218:Triage; D000078329:Workforce; D016526:Workload