The Nursing Staff Lower Limits Regulation in brief
To ensure high quality patient care in the hospital, the use of an adequate number of nurses is necessary. To ensure this, the Nursing Staff Lower Limits Ordinance (PpUGV), initiated by the Federal Ministry of Health, has been in force since the beginning of 2019. It defines area-specific lower limits for the number of nurses that must be adhered to, depending on the number of patients. The number is different for the day and night shift. In addition to the qualified nursing staff, nursing assistants (with at least one year of training) are credited proportionally. Hospitals with affected departments are obliged to demonstrate compliance with the lower limits on the basis of monthly average values. Only in the case of so-called exceptional circumstances may there be shortfalls: on the one hand, in the case of short-term illness-related staff absences that exceed the usual level, and on the other hand, in the case of strong increases in the number of patients such as in the event of epidemics or major disasters. If notification obligations are not met, not fully or not in time, sanctions apply analogous to non-compliance.
The development of the Nursing Staff Lower Limits Ordinance 2018 to 2021
In October 2018, the PpUGV came into force for four particularly care-sensitive hospital areas: intensive care, geriatrics, cardiology and trauma surgery. The PpUGV is gradually being expanded to other areas with the aim of developing an instrument for defining needs-based nursing staff. Since the beginning of 2020, the regulation now also includes cardiac surgery, neurology, neurological stroke unit and neurological early rehabilitation as additional specialist departments. Due to the current corona situation, the reporting and proof obligations were suspended from March 1, 2020 to the end of 2020. One exception concerns the areas of intensive care medicine and geriatrics, which have been required to comply with and report the limit values again since August 1, 2020.
The regulations from 2021 in detail
The ordinance will come into force again in full on January 1st, 2021. The areas of internal medicine, general surgery, pediatric intensive care medicine and pediatrics are also added as additional specialist areas. According to the “Ordinance on the Establishment of Nursing Staff Lower Limits in Nursing-Sensitive Areas in Hospitals for the Year 2021” (dated November 9, 2020), the following lower nursing staff limits will apply from February 1, 2021:
How can you avoid red tape?
The documentation of the necessary data for the quarterly report, which is prescribed in the PpUGV, poses great challenges for many hospitals. Since occupancy data from the HIS and duty roster data from the personnel administration system have to be brought together, interfaces between the systems are necessary. Where these do not exist, an enormous manual effort is usually required to create the report. In addition, due to the data storage in separate systems, ongoing monitoring of compliance with the lower nursing staff limits is not possible. This can inadvertently lead to the limits being exceeded, resulting in suboptimal patient care and sanctions for the hospital.
The development of interfaces between the data-handling systems as well as the consideration of the data for personnel deployment planning represent a significant added value in this challenge. This reduces the bureaucratic effort for your caregivers and avoids sanctions.