The quantification of nursing workload in Intensive Care Units

An average of 50% of an Intensive Care Units (ICU) budget is spend on nursing staff. From an economical point of view, it is therefore important to understand how many nurses are minimally required to perform care of good quality. Excessive budgetary cuts targeted to reduce the nursing staff are likely to increase the nursing workload This will have a negative impact on patient safety and survival chances. Moreover, reducing the number of nursing staff may also negatively impact the nurses well-being if the workload becomes too high. Without an accurate workload measurement method, ICUs are at risk of under- or overstaffing nurses. Additionally, the lack of a validated measurement method hampers the development of a national standard for the allocation of nurses per ICU bed. In order to take the capacity planning of nurses beyond rough estimates and assumptions, an accurate method for measuring nursing workload is essential.
This thesis anticipates on these topics by assessing different nursing workload models and their validity and reliability, with special attention for the NAS, by assessing the association between nursing workload and in-hospital mortality, by developing a new nursing workload model, and finally, by providing an overview of differences in nursing workload over different patient- and contextual groups.