Positionspapier zur Stärkung und Weiterentwicklung der Notfallpflege in deutschen Notaufnahmen

[Restructuring of inpatient emergency treatment : What will change?]

The resolution on the restructuring of inpatient emergency treatment was passed by the Federal Joint Committee (G-BA) on 19 April 2018 based on the Hospital Structure Act and became binding with the publication in the Bundesanzeiger on 18 May 2018. The resolution describes the future structural and qualitative prerequisites for participation of hospitals in the provision of emergency treatment in three levels: basic emergency treatment, extended emergency treatment and comprehensive emergency treatment. Furthermore, a level of nonparticipation is also planned. In addition, there are special modules, e.g. for the treatment of children and auxiliary modules for specifically equipped hospitals with highly specialized patient treatment (e.g. stroke unit). A transition regulation period of 3-5 years provides hospitals with the possibility to adjust to the new minimum requirements. The German Hospital Federation (DKG) and the National Association of Statutory Health Insurance Funds (GKV-SV) will negotiate the assessment of surcharges and deductions subsequent to the resolution.

[The Federal Joint Committee resolution on staged emergency care and impact on nursing education for emergency care : Cross-sectional survey on the status quo in Germany]

BACKGROUND

Decisive steps towards securing the advancement of emergency nursing care (ENC) include the establishment of state-approved training curricula and qualifications in Berlin and Bremen, the recommendation on ENC training issued by the German Hospital Federation (DKG), and the experts' report prepared by the Federal Joint Committee (G-BA) on how the provision of ENC should continue to evolve. The G‑BA resolution specifies that at least one specialist nurse with a specific qualification in emergency care must be on hand as required in every emergency department once this qualification becomes available in the relevant federal state. This poses the question as to how well established qualification programmes are in Germany.

METHODS

Cross-sectional data were collected between November 2018 and January 2019 in a whole-population descriptive study based largely on structured telephone interviews with directors of ENC training programmes in Germany. As a mixed-methods approach was considered desirable, an online search on training programmes was performed.

RESULTS

In all, 42 directors of a current 44 training programmes were interviewed. A temporal link is evident between the G‑BA resolution, the DKG recommendation, and an increase in the provision of ENC courses designed around the DKG's transitional arrangements for recognising the skills of existing nursing practitioners as new training requirements are phased in. Currently, 30 recognition examinations (without supporting courses) and 31 courses offering 170 h of training are available. Two-year programmes are provided at 28 locations, with four more currently at the planning stage. The qualifications of trainers and the modalities and duration of examinations vary strongly between programmes. An ENC qualification is currently held by 1861 nurses; 85% of programme directors expressed confidence that the G‑BA resolution will boost demand for education and training in ENC.

CONCLUSIONS

The number of 2‑year training programmes offered continues to increase. The demand for emergency care nurses with the qualification level specified in the G‑BA resolution is expected to rise again from 2020 as transitional arrangements cease.