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Open Access
CC BY 4.0 · Appl Clin Inform 2025; 16(05): 1828-1836
DOI: 10.1055/a-2753-9439
Research Article

Acceptance and Usability of a Web Application for Patient Care Level Classification in German Clinical Nursing Care: A Pilot Study

Authors

  • David Powering

    1   Department of Industrial Engineering and Health, Institute of Medical Engineering, Technical University Amberg-Weiden, Weiden, Germany

  • Nico Humig

    1   Department of Industrial Engineering and Health, Institute of Medical Engineering, Technical University Amberg-Weiden, Weiden, Germany

  • Eva Rothgang

    1   Department of Industrial Engineering and Health, Institute of Medical Engineering, Technical University Amberg-Weiden, Weiden, Germany
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Abstract

Background

The German Federal Ministry of Health introduced the Pflegepersonalregelung 2.0 (PPR 2.0) to address the nursing staffing crisis. It establishes a framework to determine personnel requirements, ensuring adequate staffing. However, the required daily classification of patient care levels imposes a significant administrative burden on nursing staff. Digitizing this process may reduce documentation time and enhance efficiency, but effectiveness depends on usability and acceptance.

Objectives

This study evaluates the acceptance and usability of a direct digitization of the analog PPR 2.0 classification catalog into a digital user interface—the PPR 2.0 Calculator.

Methods

A mixed-methods approach was used, combining quantitative assessment using the Technology Acceptance Model 3 (TAM 3) and the System Usability Scale (SUS), with qualitative insights from a semistructured interview. Fifteen nursing staff members from a pediatric rheumatology clinic in Germany participated.

Results

The PPR 2.0 Calculator was rated highly usable, with strong scores for Perceived Ease of Use (4.00) and Computer Self-Efficacy (4.09). Participants required minimal technical support, indicating an intuitive interface. However, Perceived Usefulness (2.82) and Job Relevance (2.53) scores were lower, suggesting limited value in daily workflows. The SUS score (65.50) was slightly below the benchmark of 68, indicating good usability with moderate room for improvement.

Conclusion

Digitizing the analog PPR 2.0 catalog resulted in good usability, but significant challenges regarding practical relevance and workflow integration remained. Directly adopting the catalog content negatively affected perceived usefulness and job relevance, revealing limitations in the classification framework itself. Refinement of the PPR 2.0 framework is needed to reflect real-world clinical nursing tasks. Seamless integration with existing infrastructures and structured documentation is also critical. Future improvements should go beyond simple digitization and explore automated classification features.

Keywords

evaluation - mixed methods - Technology Acceptance Model - System Usability Scale - nursing documentation - PPR 2.0 - web application

Protection of Human and Animal Subjects

This study involved voluntary participation of nursing staff in a questionnaire and a semistructured interview. No patients or sensitive health data were involved, and participants were not exposed to any physical or psychological risks. All participants were informed about the purpose and scope of the study and provided written informed consent prior to participation. According to the applicable national regulations and institutional policies, formal ethics committee approval was not required for this type of non-interventional research.


Supplementary Material



Publication History

Received: 10 April 2025

Accepted: 12 October 2025

Article published online:
11 December 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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