Using Computer Simulation to Study Nurse-to-Patient Ratios in an Emergency Department

J Nurs Adm. 2015 Nov;45(11):551-6. doi: 10.1097/NNA.0000000000000262.


Objective: To study the impact of nurse-to-patient ratios on patient length of stay (LOS) in computer simulations of emergency department (ED) care.

Methods: Multiple 24-hour computer simulations of emergency care were used to evaluate the impact of different minimum nurse-to-patient ratios related to ED LOS, which is composed of wait (arrival to bed placement) and bedtime (bed placement to leave bed).

Results: Increasing the number of patients per nurse resulted in increased ED LOS. Mean bedtimes in minutes were impacted by nurse-to-patient ratios.

Conclusions: In computer simulation of ED care, increasing the number of patients per nurse resulted in increasing delays in care (ie, increasing bedtime).

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Bed Occupancy / statistics & numerical data
  • Computer Simulation
  • Efficiency, Organizational
  • Emergency Service, Hospital / organization & administration*
  • Humans
  • Length of Stay / statistics & numerical data*
  • Patient Admission / statistics & numerical data*
  • Personnel Management*
  • Quality Improvement
  • United States
  • Workforce