A gap between Need and Reality: Neonatal Nursing Staff Requirements on a German Intensive Care Unit.
Recently, new staffing rules for neonatal nurses in intensive care units (ICU) were issued in Germany, using categories of care of the British Association of Perinatal Medicine as blueprint. Neonates on intensive care require a nurse-to-patient ratio of 1:1, on intensive surveillance (high dependency care) of 1:2. No requirements exist for special care, transitional care, and pediatric ICU patients. Using these rules, nursing staff requirement was calculated over a period of 31 consecutive days once a day in a combined pediatric and neonatal ICU of a metropolitan academic medical center in southwest Germany. Each day, 18.9±0.98 patients (mean±standard deviation) were assessed (14.26±1.21 neonatal, 4.65±0.98 pediatric). Among neonates, 9.94±2.56 received intensive therapy, 3.77±1.85 intensive surveillance, and 0.65±0.71 special care. Average nursing staff requirement was 12.10±1.81 full time equivalents (FTE) per shift. Considering additional pediatric patients in the ICU and actual nursing staff availability (8.97±0.87 FTE per shift), this ICU seems understaffed.
Department of Neonatology, University Medicine Mannheim, University of Heidelberg , Mannheim, Germany.
Christian
C
Patry
Department of Neonatology, University Medicine Mannheim, University of Heidelberg , Mannheim, Germany.
Monika
M
Schindler
Department of Neonatology, University Medicine Mannheim, University of Heidelberg , Mannheim, Germany.
Julia
J
Reinhard
Department of Neonatology, University Medicine Mannheim, University of Heidelberg , Mannheim, Germany.
Steffen
S
Hien
Department of Neonatology, University Medicine Mannheim, University of Heidelberg , Mannheim, Germany.
Süha
S
Demirakca
Medical Service of Statutory Health Insurance in Baden-Württemberg , Karlsruhe, Germany ; Mannheim Institute of Public Health, Medical Faculty at Mannheim, University of Heidelberg , Mannheim, Germany.
Thomas
T
Böhler
Department of Neonatology, University Medicine Mannheim, University of Heidelberg , Mannheim, Germany.
Thomas
T
Schaible
German Federal Joint Commission; categories of care; neonatology; nurse-to-patient ratio; pediatric intensive care unit