Background: The surge in patients during the COVID-19 pandemic has exacerbated the looming problem of staﬀ shortage in German ICUs possibly leading to worse outcomes for patients.
Methods: Within the German Evidence Ecosystem CEOsys network, we conducted an online national mixed-methods survey assessing the standard of care in German ICUs treating patients with COVID-19.
Results: A total of 171 German ICUs reported a median ideal number of patients per intensivist of 8 (interquartile range, IQR = 3rd quartile - 1st quartile = 4.0) and per nurse of 2.0 (IQR = 1.0). For COVID-19 patients, the median target was a maximum of 6.0 (IQR = 2.0) patients per intensivist or 2.0 (IQR = 0.0) patients per nurse. Targets for intensivists were rarely met by 15.2% and never met by 3.5% of responding institutions. Targets for nursing staﬃng could rarely be met in 32.2% and never in 5.3% of responding institutions.
Conclusions: Shortages of staﬃng in the critical care setting are eminent during the COVID-19 pandemic and might not only negatively aﬀect patient outcomes, but also staﬀ wellbeing and healthcare costs. A joint eﬀort that scrutinizes the demands and structures of our health care system seems fundamental to be prepared for the future.