Changes in nurses' work during introduction of the DRG-system in German hospitals

2.50
Hdl Handle:
http://hdl.handle.net/10755/156279
Type:
Presentation
Title:
Changes in nurses' work during introduction of the DRG-system in German hospitals
Abstract:
Changes in nurses' work during introduction of the DRG-system in German hospitals
Conference Sponsor:Sigma Theta Tau International
Conference Year:2007
Author:Bartholomeyczik, Sabine U., RN, PhD
P.I. Institution Name:University of Witten/Herdecke
Title:Professor
Co-Authors:Elke Donath, PhD; Michael Galatsch, RN, student; Caecilia Krueger, RN, student; Tina Quasdorf, RN, student; and Markus Schroller, RN, student
[Research Presentation] In 2004 the DRG based financing system was introduced into German hospitals with the purpose to reduce hospital stay and the number of hospital beds. Both indicators are the highest in Germany in comparison to other European countries. Nurses are afraid that in the new system their work will not be visible, since DRG are built upon medical diagnoses and nursing diagnoses are not used. The project aimed to describe potential structure changes in nursing in hospitals during DRG introduction and the nurses' perspectives. An explorative descriptive longitudinal design with three measure points was used: October 2003(t1), 2004(t2), 2005(t3). Convenience sample of three large hospitals with a surgical and an internal ward each. Methods were a self-administered questionnaire for nurses and a computer-assisted work-sampling method, measuring tasks of the whole nursing staff every 5 minutes during 7 days in morning and afternoon shifts on these 6 wards. 156 questionnaires and 62 006 observations by the work-sampling method were analyzed. Results show, that close-to-patient activities were reduced, especially nurses' communication with patients. From the nurses' perspective training and counseling tasks were diminished. "Paper work" rose only in the year of the DRG introduction. Kitchen and cleaning work comprises as much time as direct nursing care. The utilization of a national guideline for discharge management has become common in 2005, however, the discharge work is rarely visible in the work-sampling data. Some results suggest that the patient during the short stay in hospital is more often left alone. Changes in nurses' work don't seem to be oriented towards patients needs. Work distribution among physicians and nurses should be reconsidered.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleChanges in nurses' work during introduction of the DRG-system in German hospitalsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/156279-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Changes in nurses' work during introduction of the DRG-system in German hospitals</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2007</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Bartholomeyczik, Sabine U., RN, PhD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Witten/Herdecke</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Professor</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">sbartholo@uni-wh.de</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Elke Donath, PhD; Michael Galatsch, RN, student; Caecilia Krueger, RN, student; Tina Quasdorf, RN, student; and Markus Schroller, RN, student</td></tr><tr><td colspan="2" class="item-abstract">[Research Presentation] In 2004 the DRG based financing system was introduced into German hospitals with the purpose to reduce hospital stay and the number of hospital beds. Both indicators are the highest in Germany in comparison to other European countries. Nurses are afraid that in the new system their work will not be visible, since DRG are built upon medical diagnoses and nursing diagnoses are not used. The project aimed to describe potential structure changes in nursing in hospitals during DRG introduction and the nurses' perspectives. An explorative descriptive longitudinal design with three measure points was used: October 2003(t1), 2004(t2), 2005(t3). Convenience sample of three large hospitals with a surgical and an internal ward each. Methods were a self-administered questionnaire for nurses and a computer-assisted work-sampling method, measuring tasks of the whole nursing staff every 5 minutes during 7 days in morning and afternoon shifts on these 6 wards. 156 questionnaires and 62 006 observations by the work-sampling method were analyzed. Results show, that close-to-patient activities were reduced, especially nurses' communication with patients. From the nurses' perspective training and counseling tasks were diminished. &quot;Paper work&quot; rose only in the year of the DRG introduction. Kitchen and cleaning work comprises as much time as direct nursing care. The utilization of a national guideline for discharge management has become common in 2005, however, the discharge work is rarely visible in the work-sampling data. Some results suggest that the patient during the short stay in hospital is more often left alone. Changes in nurses' work don't seem to be oriented towards patients needs. Work distribution among physicians and nurses should be reconsidered.</td></tr></table>en_GB
dc.date.available2011-10-26T14:37:43Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T14:37:43Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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