Marga Hoogendoorn

24 We also checked the Cochrane-database for published reviews on this topic. The search strategy included MeSH terms and keywords for ‘nursing’, ‘Intensive Care’, ‘scoring system’, ‘classification’ and ‘workload’. The exact search queries are presented in appendix 1. The results were first independently assessed by two reviewers (MH and CM) based on title and abstract. If there was no abstract available, but the title indicated potential relevance, the article was selected for full-text reading. The full text of the selected articles was independently judged by the same two reviewers on the inclusion criteria. Differences in selection of articles were solved by discussion and in case of disagreement resolved by a third reviewer (NdK). We used a PRISMA flow chart for reporting the results of the search (www.equator-network.org/reporting-guidelines/prisma/ ) 88 . Selection criteria Papers were selected when they adhered to all of the following inclusion criteria: • It concerned an original study on either: - the development of a new scoring system to measure nursing workload or - the update of an existing scoring system to measure nursing workload or - the validation or evaluation of an existing scoring system to measure nursing workload • The scoring system quantified the workload into the needed amount of nursing time based on points, classes, levels of care or absolute amount of time • The setting was an adult Intensive Care Unit • The language of the articles was English, German or Dutch We excluded articles about scoring systems without a quantification of the nursing time needed. We also excluded articles with Intensive Care Units situated in a burn centre because the nursing care in a burn centre is not comparable with other Intensive Care Units. References from reviews and included articles were checked on relevance and included if they met the inclusion criteria. Data extraction f rom selected articles The two reviewers (MH and CM) extracted all relevant information from the selected articles by filling in a data extraction form. This form contained the following items: name of the scoring system, study aim, country, setting and number of participants (Intensive Care Units, patients and nurses), kind of nursing interventions or activities measured by the scoring system, methods used to select nursing interventions or activities in case