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Tense situation in Bonn and Sankt Augustin: Hardly any free beds in the children's hospitals

Tense situation in Bonn and Sankt Augustin : Hardly any free beds in the children's hospitals

The RS virus in particular is the reason for a high workload in the wards and outpatient clinics in the region. Hospitals have to refer some patients to the surrounding area. A doctors' association proposes the temporary suspension of the nursing staff lower limit regulation.

The Bonn children's clinics and the Asklepios children's clinic based in Sankt Augustin are currently working to capacity. "Our clinic is working at maximum capacity, so we have to postpone some elective admissions - those that can be scheduled," said Rainer Ganschow, Director of the Polyclinic for General Paediatrics at Bonn University Hospital (UKB). For the past three to four weeks, many children with infectious diseases have been coming to the Venusberg. Many of them can be treated as outpatients, but babies and toddlers in particular often have to be admitted as inpatients. Last autumn and winter, considerably fewer children came to the emergency department, which was due to the Corona protection measures.

Many upper respiratory tract infections

In contrast to the previous year, very many of the young patients were infected with the RS virus, he said. "The children visit the emergency outpatient department especially with upper respiratory tract infections," Ganschow explained. The human respiratory syncytial virus (RS virus for short) attacks the respiratory tract. Typical symptoms are fever, rhinitis and cough, which especially affect infants because the diameter of the airways is not yet as large as in older children. According to Ganschow, an inpatient stay can last a good five days.

The Medical Director of the UKB, Wolfgang Holzgreve, said about the high occupancy rate: "We try very hard to care for all children who need our help, even when other hospitals have an admission freeze. This occasionally poses a great challenge to our bed management.“

Bonn's Sankt-Marien-Hospital is observing the same development in its own hospital. And the Asklepios children's hospital in Sankt Augustin also describes a situation like that in Cologne, where the university hospital and the city recently spoke of an impending supply bottleneck. In Sankt Augustin, no child has yet had to be turned away and the infection ward has been relieved by internal transfers. "Actually, all paediatric clinics in North Rhine-Westphalia have full wards at the moment," said Stephan Buderus, head of the paediatric and adolescent clinic there. According to Buderus, it could be observed that the increase in the number of patients with infectious diseases, especially frequently with the RS virus, began about four weeks ago and thus about one month earlier than in previous years.

In his function as state delegate for the Association of Leading Paediatricians, Adolescents and Paediatric Surgeons of Germany (VLKKD), Buderus has written a letter to the NRW Ministry of Health, which speaks of a "dramatic supply bottleneck in NRW clinics". According to a survey by the association, the hospitals cite the lack of nursing staff as the main reason for this, which also affects private nursing services and old people's homes. In the letter, the association suggests temporarily suspending the Nursing Staff Lower Limit Ordinance, as was done once before during the pandemic. It contains clear guidelines on how many nurses have to look after how many beds.

If hospitals violate this fixed key, they have to pay penalties. This regulation is "very sensible", Buderus clarified. However, it currently means that about one third of the hospitals adhere to the key and the others accept the penalties in order to be able to care for the patients. Accordingly, these hospitals have more work to do and are thus penalised twice.

There are transfers to the surrounding areas and vice versa

In the current situation, it also happens in Bonn that children have to be transferred to the surrounding area for in-patient treatment and vice versa, "although the infection season of the winter half-year has not even started yet", the association's letter formulated by Buderus says. Without good care, the likelihood of respiratory infections developing into more serious illnesses such as pneumonia, or of a bacterial infection being superimposed on the actual viral infection, increases.

Axel Gerschlauer, paediatrician from Bonn, and spokesman for the Professional Association of Paediatricians and Adolescent Doctors (BVKJ) for North Rhine, speaks of a difficult situation that also has its origins in the remuneration for paediatrics: "It often happens that I can only find a free bed for my patients in Mechernich or Cologne. Ultimately, this is also due to the fact that the treatment of children is paid less by the health insurance companies than that of adults". (Original text: Philipp Königs / Translation: Mareike Graepel)