ArticleDie Anaesthesiologie2026
[Structures and perspectives of intensive care and anesthesia nursing in Germany: a nationwide cross-sectional survey].
Article in Die Anaesthesiologie, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe long-standing shortage of qualified nursing staff in intensive care and anesthesia nursing poses substantial structural and organizational challenges for hospitals in Germany. Working conditions, qualification structures, nursing leadership resources and organizational frameworks have become increasingly more important for maintaining high-quality specialist nursing care and supporting professional nursing development. Despite ongoing discussions regarding workforce development, advanced nursing roles and qualitative skill and grade mix, systematic nationwide data describing leadership, team composition, qualification structures and organizational conditions within intensive care and anesthesia nursing in Germany have so far been lacking.
aimThe primary aim of this nationwide cross-sectional survey was to assess the current state of nursing development in intensive care and anesthesia nursing in Germany. Secondary objectives were to describe leadership structures, team composition, organizational characteristics and structures for specialist education, continuing professional development and qualification pathways.
methodsA quantitative nationwide cross-sectional online survey was conducted among individuals holding leadership positions in intensive care and anesthesia nursing in German hospitals. A 44-item questionnaire was distributed through professional nursing networks. Data were analyzed using descriptive and bivariate statistical methods.
resultsOf the 749 participants 550 datasets (73.4%) were included in the analysis. State-certified specialist nurses (German postregistration specialist nursing qualification; Fachkrankenpflege) assumed extended professional responsibilities in some departments (17.1%, n = 94), whereas academically qualified nurses had so far only been integrated into clinical practice on a selective basis. Many nursing managers reported limited or no protected time for leadership responsibilities (35.9%, n = 118), despite simultaneously leading large teams and facing persistent staff shortages (49.6%, n = 273 reporting vacant positions). The team composition was heterogeneous and included registered nurses as well as other professional groups, including anesthesia technical assistants. Organizational structures supporting nursing development, specialist education, continuing professional development and nursing leadership varied considerably across institutions and frequently depended on the personal commitment of individual nursing managers.
conclusionThis nationwide cross-sectional survey demonstrates considerable variation in the organizational structures supporting intensive care and anesthesia nursing in Germany and identifies structural barriers to effective nursing leadership, qualification development and the systematic implementation of advanced nursing roles. The findings provide a comprehensive baseline for describing current organizational conditions within the German healthcare system and couldsupport future workforce planning, leadership development and qualification strategies. Strengthening organizational support for nursing leadership, establishing clear responsibilities and consistently utilizing existing professional qualifications appear essential for the sustainable development of intensive care and anesthesia nursing and for implementing an appropriate qualitative skill and grade mix.
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