Case Study
Arbeitsgestaltung für eine Krankenschwester in einem Krankenhaus


The employer is a healthcare company with approximately 3400 employees. The company includes several hospitals, which u. a. also serve as an academic teaching hospital.

Disability and functional restriction of the employee:

The woman has a hearing impairment and despite the supply of new hearing aids in certain situations, such. B. noise / noise and telephoning, only limited capable of acoustic information, such. B. speech and signals to perceive. Due to disability, therefore, audible information on perception must be amplified or specifically filtered or converted (tactile, visual or direct transmission into the hearing aids). The woman was equated by the Employment Agency with people with severe disabilities and has a GdB (degree of disability) of 40.

Training and job:

The woman works as a nurse on a part-time basis (30 hours per week) in shifts at the Children's Cancer ward.

Work organization:

The staff at the children's cancer ward work according to their roster, with at least three nurses working in the morning shift and two in the late night and night shifts. In addition, ward doctors and caregivers are present. The nurses divide the children to be treated in the room so that there is a daily assignment of responsibilities in the care.

Workplace and work duties:

The nurse is working at the Children's Cancer ward with 12 rooms and 21 beds in a building with old solid structure. Despite the high-quality new hearing aids, the nurse has problems with the acoustic signals of the infusoria for the infusions and monitoring monitors for the body functions and the ward telephone. With regard to the station telephone (cordless telephone), in addition, communication or telephoning with the hearing aids used in conjunction with a conventional acoustic handset output is insufficiently possible. For medical devices, the reason lies in the too low volume of the acoustic signal, which is emitted by the devices. The devices are not connected to the central monitoring monitor in the nurses' room. Moreover, when the doors to the children's rooms are closed, the signal in the nurses' room or in other rooms is barely audible. There are more people present at the children's ward compared to other wards by visiting parents and teachers. As a result, the noise level is higher due to background noise, which makes it even more difficult for the nurse to recognize the important and quiet signals and to understand the phone. So far, the nurse solves this problem by going to the rooms to be looked after by her at short intervals to see if, for B. has passed an infusion, in a device is an error message or another technical problem. For them, especially in the late and night shift with reduced staffing, this means a considerable additional burden in addition to their nursing activities. The monitoring monitors could be connected via their signal output to the existing nurse call system. The signals from the monitoring monitors can thus be displayed on the central display in the nurses' room and in the corridors. The implementation was carried out by technicians of the hospital. Since this was not possible with the infusomats, a radio signal system was used whose microphone transmitter is attached directly to the housing of the infusomat. The acoustic signals are recorded via the microphone and transmitted by radio with the help of the transmitter to the recipient, who carries the nurse on the body. It displays the signal by vibrating and flashing differently colored LED displays that can be used for certain possible events and incidents (alarm, paging, telephone). To determine the required equipment performance and types and to provide the operational safety of the system, a measurement of the radio ranges was made by an employee of the manufacturing and distributing company of the aid. For a sufficient signal strength, especially in the side corridor, additional repeaters were used, since the building absorbs the radio waves to a considerable extent. For a safe function, the repeaters are supplied via the power network of the station. The necessary electrical installations were made by clinicians own technicians. As an additional backup was a connection of the displays located in the corridors for nurses or person calls from the rooms to the recipient of the nurse. The nurse gets two receivers for increased safety - one stationary for the nurses' room and one mobile for the smock bag. Both show the signals. This ensures the highest level of functional reliability of the signaling system. With regard to the use of the station telephone, a new cordless telephone, which is compatible with the in-house telephone system, was used after successful testing. The phone has a volume control, vibration and flasher (light signal) and a Bluetooth connection. The cordless phone recognizes when removing the Bluetooth receiver in the hearing aids of the nurse and automatically establishes a radio connection. The phone call is switched directly to the nurse's hearing aids, improving hearing quality, eliminating noise and avoiding volume loss. If the Schurlostelefon is not in the nurse's coat (eg in the charging station), incoming calls are transmitted via a station connected to the station to the recipient carried on the nurse's body. This signal via vibration an event that can be assigned using the LED display for the phone. The tools used allow the nurse to continue practicing her profession in communication and the perception of important information.

Assistive devices used:

Behind-the-ear hearing aids signalling devices

Keywords and Further Information

Funding and participation:

The hearing aids were funded with a fixed amount from the statutory health insurance. The excess amount for the required hearing aids was borne by the pension insurance in the day-to-day work because of the present conditions. Disability-friendly work design was promoted by the Integration and Inclusion Office. The consultation on disability-friendly design was carried out by the Technical Advisory Service of the Integration and Inclusion Office and in relation to the hearing aids by a specialist shop for hearing acoustics.

ICF Items

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Last Update: 11 Dec 2019