Do emergency nurses spend enough time on nursing activities? The relationship between actual and expected patient care nursing time

Background: The overcrowded environments of emergency departments (EDs) lead to increased clinical workloads for nurses and influences the quality of patient care. This study aimed to evaluate whether the quality of patient care meets the expectations of emergency nurses in Taiwan by measuring the amount of time nurses spend on patient care activities. Methods: The direct observation study was conducted in one suburban academic hospital with approximately 80,000 annual ED visits. This study observed emergency nurses and the time they spent on their nursing activities. The directly measured times and nurse expected patient care nursing times were compared. Results: For all 88 types of nursing activities recorded, each measured nursing time was less than the expected nursing time. On average, the measured nursing time was 82% less than the expected nursing time (2.0 ± 0.3 minutes vs. 11.6 ± 1.5 minutes, p < 0.01). Among the 88 types of nursing activities recorded, the average measured time spent on 76 types (86%) was less than 3 minutes. The nursing activity on which the longest time was spent was cerebrospinal fluid study nursing (7 minutes). The most frequent nursing activity was documentation. Conclusion: The nursing time spent on patient-care activities in EDs was much less than the nurses expected. The results may provide a basis for nursing quality measurements and manpower calculations for EDs.