Patient classification used as a tool for assessment of staff/patient ratios

Within the bounds of health care reforms nephrology nurses have a joint responsibility to make costs transparent and to decrease them. Care for chronically ill patients must constantly be delivered and there should be no limitations and changes in nursing and medical care. With the establishment of a clear job description and a performance profile for nephrology nurses a reorganisation of staffing is possible. The employment of non-qualified staff for indirect and parts of general patient care is possible as long as the work is done under the supervision and responsibility of a registered qualified nephrology nurse. With patient classification it is clear how much and which kind of care has to be provided and who should carry the costs. Furthermore documentation of actually needed care is possible. The further qualification of nurses with a post basic course for nephrology enables us to work with non-qualified staff and contributes to a high qualified standard of care. With regard to material used for dialysis costs should be transparent and nurses should be aware of them. The amount of unnecessarily used materials should be reduced and working process reviewed and economically organised. There are some aspects to be considered, e.g. the use of sterilised material for work which could be done with non-sterilised material which is much cheaper. We should have in mind that reimbursement rate combines costs for material and staff and if we could reduce the costs for used material there is more money left to pay the nurses. Last but not least all dialysis is providers should work closer together and should avoid confrontation. Confrontation means counterproductive and this is expensive. Only a concerted action of everybody involved in renal care may contribute to ensure the current standard of renal replacement therapy. The awareness of nurses should be developed that they contribute to safe their own place of employment.