Nursing workload in Latvian intensive care units: a 3-month observation

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 statistical analyses revealed statistically significant differences in NAS scores between hospitals, with the highest workload observed in the level II facility. No significant difference were 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 workload cases were identified, exceeding the safe workload threshold of 100 NAS points per nurse per shift. The findings highlight the need for structured NAS-based workforce planning in Latvian ICUs, particularly in higher-level hospitals.