gms | German Medical Science

Background and Purpose: With the recent implementation of the PEPP-based reimbursement system in German mental hospitals, there is a research need to determine the routine tasks nurses perform during working hours without direct patient contacts and to estimate the mean proportion of time spent for these tasks.

Methods: Survey

Research Focus: Between 9/2016 and 4/2017, 30-minutes semi-standardized telephone interviews were conducted with 39 nurses from six psychiatric specialties in eight large public mental hospitals. Beyond standardized time estimation of routine tasks, participants could name further tasks they perform without direct patient contact. In addition, we asked for clinic-wide regulations for trainings etc. and time consumed thereby.

Methodological and Theoretical Focus: While the “PEPP-Entgeltkatalog” honours therapy-related time spent with more time-consuming patients, it does not provide reimbursement for the time nurses spend with shift changes, securing patient safety, instructing nurses-to-be and other health-maintenance-related back-stage tasks.

Results: In the sample, normal nurses routinely spend more than 25%, ´head nurses´ even more than 45%, of their respective working hours with the performance of tasks without direct patient contact.

Conclusions: If many valuable working hours spent by nurses are systematically ignored by the new PEPP reimbursement system, nurses in mental hospitals will either be forced to focus their working hours more on PEPP-honoured ´co-therapy´ or a consequent reduction of the nurse-to-patient-ratio will result in a worsening of patient safety, ward atmosphere, and on-the-job-training of nursing students.