Study of Nursing Workload Using the Nursing Activities Score in Level 2 and Level 3 ICUs in Latvia: A 3-Month Observation
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This study presents a three-month prospective observational analysis of nursing workload in Intensive Care Units (ICUs) in Latvia using the Nursing Activities Score (NAS). The objective was to implement the NAS instrument in three hospitals representing different levels of care (level II and III) and to assess inter-institutional differences in workload. Data were collected from 3420 nursing care episodes across day and night shifts between February and May 2025. Descriptive and inferential statistics revealed statistically significant differences in NAS scores between the hospitals, with the highest workload observed in the level III facility. No significant difference was found between day and night shifts in overall NAS per nurse, but a significantly higher nurse shortage was identified during night shifts. Strong correlations were observed between NAS total scores, required nursing staff, and actual staffing levels, highlighting critical disparities. Several extreme overload cases were identified, exceeding the safe workload threshold of 100 NAS points per nurse per shift. The findings underscore the need for structured NAS-based workforce planning in Latvian ICUs, particularly in higher-level hospitals. The study demonstrates the NAS instrument's practical applicability for workload monitoring and suggests that its broader implementation can enhance patient safety and staff well-being.
