Abstract
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.
Highlights
Care unit (NICU) in Germany for the first time was required for each NICU patient in category has to cope with staffing rules for nurses The University of Heidelberg Hospital in 1, one for every two NICU patients in category 2, which have been imposed by the German Mannheim hosts a PNC which offers the highest and none for NICU patients in categories 3 and Federal Joint Commission
Due to the day-to-day variability of the number of neonatal patients in the ward and their allocation to different categories of care (Figure 1), neonatal nursing staff requirement varied between a minimum of 9 and a maximum of 15 full time equivaN lents (FTE) per shift (Figure 2)
Our observations clearly show that a com- NICU
Summary
Introduction edFor each shift, the neonatal nursing staff requirement was calculated in full-time equiva-Beginning from 2014, a neonatal intensive Materials and Methods lents (FTE) using the nurse-to-patient ratios defined by the G-BA: one neonatal nurse FTE care unit (NICU) in Germany for the first time was required for each NICU patient in category has to cope with staffing rules for nurses The University of Heidelberg Hospital in 1, one for every two NICU patients in category 2, which have been imposed by the German Mannheim hosts a PNC which offers the highest and none for NICU patients in categories 3 and Federal Joint Commission (Gemeinsamer level of neonatal care together with additional 4; patients admitted to the pediatric ICU wereBundesausschuss, G-BA) as part of new regu- specialized services such as surgical repair of not included in the calculation. No specific staffing for two additional patient categories defined by BAPM,[3] special care and transitional care, is requested by the G-BA, and the rules are restricted to preterm neonates.
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