Aim

To explore predictors of perceived nursing workload in relation to patients, nurses, and workflow.

Background

Nursing workload is important to healthcare organizations. It determines nurses’ well-being and quality of care. Nevertheless, its predictors are barely studied.

Methods

Cross-sectional prospective design based on the Complex Adaptive Systems theory was used. An online survey asked nurses to describe perceived workload at the end of every shift. Data were gathered from five medical-surgical wards over three consecutive weeks. We received 205 completed surveys and tested multivariate regression models.

Results

Patient acuity, staffing resources, patient transfers, documentation, patient isolation, unscheduled activities, and patient specialties were significant in predicting perceived workload. Nurse-to-patient ratio proved not to be a predictor of workload.

Conclusions

This study significantly contributed to literature by identifying some workload predictors. Complexity of patient care, staffing adequacy and some workflow aspects were prominent in determining the shift workload among nurses.

Implications for Nursing Management

Our findings provide valuable information for top and middle hospital management, as well as for policymakers. Identification of predictors and measurement of workload are essential for optimizing staff resources, workflow processes, and work environment. Future research should focus on the appraisal of more determinants.