Medical Staffing in Neonatal and Pediatric Intensive Care Units - an European Survey

Abstract

Recently, there is a growing scarcity of qualified personnel in German healthcare system. This can lead to problems especially in the highly specialized neonatal and pediatric intensive care. We conducted a survey to evaluate the staffing situation at 583 European neonatal and pediatric intensive care units (ICU). Response rate was 48.5%. As a main result our evaluation demonstrated a significant lower nurse-staffing in Germany compared to the other countries (90.4 vs. 95.8%, p<0.001). In addition, the average nurse-to-patient ratio was worse in German neonatal ICUs (3.0 vs. 2.3, p<0.001). The presence of senior doctors is also lower in German neonatal and pediatric ICUs compared to the other countries (on weekdays: 12.0 vs. 14.6 h, p=0.04; on weekends: 8.9 vs. 13.2 h, p=0.003). Our survey demonstrates that the nurse-staffing at neonatal and ICUs in Germany is worse than in other European countries. The resulting potential loss of quality is worsened due to lower presence of senior doctors at the ICUs. Possible consequences include increase of complications, impairment of treatment success, closure of intensive care beds, and mental and physical illness of the staff. Compared to other European countries, there is a lack of nurses at neonatal and pediatric ICUs in Germany. This study underlines the importance to take measures to counteract nursing crisis.