Marga Hoogendoorn

137 is possible, but the impact on the objective and perceived nursing workload has not been studied yet. Further research should also focus on the potential new role of certified ICU nurses supervising other nurses working in the ICU. 7. 6 CONCLUS I ON Measuring nursing workload is important for daily and strategic planning. Among the existing nursing workload scoring systems we found NAS most reliable although we also showed that further and continuous validation and recalibration is needed as nursing care develops over time. We demonstrated that besides the use of the NAS for measuring nursing workload and the planning of nursing staff, patient factors like severity of illness and nursing factors like being a student nurse also affect the perceived nursing workload. Both a too high and too low workload will lead to dissatisfaction of the nurse regarding workload. During the COVID-pandemic ICUs were confronted with a high workload. Our research has shown that this was caused by a combination of a higher NAS per patient and an increase of number of patients per nurse. However, the COVID-period also showed that deployment of other nurses on the ICU is possible. It is important to define the optimal nursing workload per nurse that takes multiple dimensions of good employership and quality of care into account.