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

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


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).
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.
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.
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.


Crowding; Staffing; Emergency nursing; Pneumonia; Timeliness

MeSH Terms

Anti-Bacterial Agents
Electronic Health Records
Emergency Nursing
Emergency Service, Hospital*
Length of Stay
Multivariate Analysis
Anti-Bacterial Agents


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


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