Master of Science in Nursing Theses

Date Degree Awarded


Document Type


Degree Name

Master of Science in Nursing (M.S.N.)



Committee Chair

Amy Voris, D.N.P., RN, CNE

Second Committee Member

Connie Ford, MSN, CFNP

Third Committee Member

Sharon Christman, Ph.D, RN


emergency, acuity, staffing, census, time interval


The number of emergency department (ED) visits in the US has increased over the past 20 years. In 1993 there were 90 million visits to the ED. In 2003 this number increased by 27% to 114 million while the population increased by only 12%. This statistic reveals there was more than one ED visit for every three people in the US in 2003 (Institute of Medicine, 2006). Patients who present to the Emergency Department (ED) during overcrowded conditions have an increased length of stay and increased risk of inpatient mortality compared to non-overcrowded conditions (, N.D.). Overcrowding has been defined as a situation where the need for emergency services is greater than the available resources in the emergency department (Committee on Pediatric Emergency Medicine, 2004; American College of Emergency Physicians, 2005). Overcrowded conditions compromise delivery of quality care, decreases patient satisfaction, and increases risk for patients with serious illnesses or injuries (, N.D.). It has been a problem reported by 90% of hospital directors (Parks, Klein, Frankel, Friese & Shafi, 2008). The purpose of this study was to determine the relationship between factors affecting overcrowding in the ED and departure time of patients in a mid-Western urban hospital. This was a descriptive correlational study set in Riverside Methodist Hospital in Columbus, Ohio of 192 eligible patients transferred from the ED to an intermediate unit from January 1, 2015 to January 31, 2015. A retrospective chart review was done to collect the following data: transfer intervals, ED nurse staffing numbers, ED census, and ED acuity levels. Statistical analysis included Pearson r, t-test, ANOVA with post hoc analysis, and multiple regression analysis using the software Statistical Package for the Social Sciences (SPSS). There was a strong positive correlation between the transfer interval and number of acuity level ESI-4 patients (p=.008). The transfer interval time was lengthened as the number of acuity level ESI-4 patients increased in the ED. There was no correlation between the transfer interval and ED census or RN staffing. This is an indication there were other factors in the ED which affected transfer interval which were not identified in this study. Transfer interval time of patients being transported to the intermediate unit should be consistently assessed to identify opportunities for improvement.



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This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

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Nursing Commons



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