Nursing staff regulation

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The regulation on standards and principles for staff requirements in inpatient nursing , in short nursing staff regulation ( PPR ) was a component of the German Health Structure Act of 1992 and was used to determine the necessary number of nurses in hospitals through the daily determination of the care expenditure of inpatients . With 21,000 positions, a need 8,000 positions higher than originally planned was determined. Therefore, because of the unrealistic minute values ​​and because of the high input effort, the PPR was suspended in 1996 and suspended in 1997 by the Second GKV Reorganization Act.

Categories

After the PPR care categories by age (adults, children ages) and levels of care (were A eneral care, S pecial care) distinguished.

  • A1 encompassed all services for patients without special care needs.
  • A2 designated patients who needed help in at least two areas, e.g. B. Help with getting up, carrying out prophylaxis, partial washing, escorting to the toilet, preparing meals in bite-sized format.
  • A3 designated patients for whom the care in at least two areas completely took over the implementation, e.g. B. Storage, full body wash, care for incontinence, handing out meals, monitoring in case of disorientation.
  • S1 comprises treatment care services that do not fall under S2 or S3, e.g. B. measure blood pressure once a day.
  • S2 designated patients who received at least one treatment care service with increased effort, e.g. B. Continuous infusions, simple dressing changes, control of medication intake.
  • S3 designated patients who received at least one service of treatment care with high effort, e.g. B. costly dressing changes, monitoring of side effects of drugs.

Today's use of the PPR

Since the introduction of the DRG , the direct billing-related use of the PPR has initially become pointless, as its use is expressly excluded when billing via case-based flat rates . However, the PPR is still used as an internal control instrument ( benchmarking ) in hospitals. So z. For example, the nursing services provided on different wards can be compared with one another and used for personnel planning by the nursing management. The PPR is also used in the further development of flat rates per case to become clinical treatment pathways . Under DRG conditions, the nursing staff regulation plays a role in the calculation of the nursing complex measures score in an extended form .

See also

Individual evidence

  1. ↑ a b c Friedrich Keun, Roswitha Prott: Introduction to hospital cost accounting: Adaptation to new framework conditions, p. 11 f., P. 227 f. Gabler Verlag, Wiesbaden 2008, ISBN 978-3-8349-0746-2 . Online: limited preview in Google Book search
  2. ↑ Federal Law Gazette Model Project Part I and Part II, October 1990 to December 1997, with full-text search and systematic indexing. Retrieved February 4, 2012 .
  3. ↑ Bernhard J. Güntert, Günter Thiele: DRG after the convergence phase, p. 69 ff. Medhochzwei Verlag, 2008, ISBN 978-3-87081-568-4 . Online: limited preview in Google Book search
  4. ↑ Calculation PPR for treatment cases with high-cost care. (No longer available online.) InEK - Institute for the Hospital Remuneration System , June 7, 2010, archived from the original on February 17, 2012 ; Retrieved February 20, 2012 .