Marga Hoogendoorn

45 Intensive Care is changed due to a changing patient population, development of new techniques and organisational changes. However, the first system developed in 1974, the TISS, including the translation of points into a Nurse:Patient-ratio, is still used in current practice. Therefore, it is important to update or validate systems, if still in use after such a period of time. Because the limitation to articles in English, German or Dutch, we did exclude a relatively high number of articles for further analysis (n=57). Among these excluded articles are a substantial number of articles on the NAS which were written in the Portuguese or Spanish language. Despite this high number of excluded NAS studies, the NAS is still well represented in the results of our review (n=12). Therefore, we believe that the most important systems are represented in our review. CONCLUS I ON Scoring systems for measuring nursing workload and calculating the needed nursing staff on an Intensive Care received a lot of attention over the years. A range of systems has been developed and is still in use in daily practice of Intensive Care management. Overall, NAS performed best; it is the only system with good content-validity and Multi Moment Recordings showed that 81% of total time spent by nurses could actually be explained. The results of this review showed that the NAS is the most used system for measuring nursing workload. However, the intra- and inter-rater reliability evaluation of NAS showed a need for improvement. Given the insufficient evaluationmethods and results regarding the validity and reliability of most scoring systems we conclude that the value of these systems to plan nursing capacity in practice is debatable. Due to the important role of workload scoring systems for Intensive Care management, further research is needed to improve the reliability of scoring and the accuracy of the translation of the scores into the actual needed nursing time.