Aim: To explore predictors of perceived nursing workload in relation to patients, nurses and workflow.Background: Nursing workload is important to health care organisations. It determines nurses' well-being and quality of care. Nevertheless, its predictors are barely studied.Methods: A 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.

Introduction: Work contexts can affect nurses’ work and work outcomes. Work context factors of nurses, patients, or workflow can modulate nurses’ organization of work and determine increased workloads. Aim: The aim of this research was to analyze relationships between factors regarding the patient, the nurse, workflow, and nurses’ work organization, to investigate whether work organization is related to physical, mental, and emotional workloads, and to explore whether one dimension of workload influences the other dimensions. Methods: We used a cross-sectional design based on the Job Demand-Resources theory. We asked registered nurses, working in nine medical-surgical wards across three hospitals in Italy, to self-report on work organization and workloads regarding randomized shifts over three consecutive weeks. Four scales from the QEEW 2.0 questionnaire were used on an online survey for data collection. multivariable linear regressions with structural equation modelling were tested. The study was approved by the three local Ethics Committees. Results: We received 334 questionnaires regarding 125 shifts worked. Patient complexity (β = 0.347), patient specialties (β = 0.127), adequacy of staffing (β = −0.204), collaboration with colleagues (β = −0.155), unscheduled activities (β = 0.213), supply search (β = 0.141), and documentation (β = 0.221) significantly influenced nurses’ work organization. Nurses’ work organization was significantly related to physical, mental, and emotional nursing workloads. Conclusions: the patient, the nurse, and workflow aspects influence nurses’ work organization and workloads. Healthcare organizations, managers, and nurses should explore work settings to identify work turbulences early and implement strategies to improve nursing work conditions and workloads.

Aim This study aimed to identify determinants of physical, mental and emotional nursing workloads. Background Workload has a physical, mental and emotional dimension. It influences employees' well‐being and quality of care. Nevertheless, studies of specific predictors for each dimension of nurses' workload are scarce. Methods We used a cross‐sectional prospective design based on the Job Demand‐Resources theory. We asked nurses to describe workload perceived at the end of every shift over three consecutive weeks. Data were gathered from two academic hospitals, in seven medical–surgical wards. We received 259 responses and tested 2 multivariate regression models. Results Physical workload was predicted from all variables tested; mental workload was determined by patient complexity or isolation, adequacy of nurse staffing and skill‐mix, and unscheduled activities; and emotional workload was predicted by all variables except adequacy of staffing and other people's education. Conclusions Patient, nurse and workflow aspects influenced nurse's shift workload differently for each specific dimension. Implications for Nursing Management Measurement and definition of predictors of workload in the work environment are essential. Recognizing the determinants of specific dimensions of workload facilitates identification of the most appropriate interventions to improve nurses' well‐being in health care settings.

Introduction: The Münchausen Syndrome by Proxy (MsbP) is a condition in which the caring figure, usually the mother, causes or simulates a physical and psychological damage to her own child, in order to call upon herself the attentions of the people with whom she relates through the baby. This resulting psychological damage on the victims is devasting and it can even lead to death. From the Scientific Literature emerges the difficulty in diagnosing the Syndrome, therefore an adequate training of the healthcare personnel, is necessary. Purpose: To assess the level of knowledge of the Münchausen Syndrome by Proxy among professionals working in the Emergency Department. Material and methods: An observational and multicenter study was conducted in four hospitals located in the South of Italy. The tool used is the questionnaire of Hochhauser, was delivered in a sealed envelope to the Directors of the first Aid Operating Units and to the coordinators of the various departments and later distributed to the Medical and Nursing Staff. Results: The sample consists of 137 health professionals, which includes doctors and nurses Only 22.6% (n = 31) said they knew about the MSbP. 86.1% (n = 118) say they have never treated MSbP. 53.3% (n = 73) suspected or could now retrospectively suspect this syndrome. 41.6% (n = 57) found parents who exaggerated the child’s symptoms or attributed serious pathological meanings to modest symptomatological diseases. 93.4% (n = 128) asserted that training courses would be useful and necessary to deepen this syndrome. Conclusions: The results of the study indicate that only a minority of the analyzed professionals know the Münchausen Syndrome by proxy and only some of them would know how to manage and deal with such a situation. The need to increase professional training courses is highlighted on this issue, with the aim of improving the health professional’s awareness about the importance of recognition, diagnosis and treatment of this form of abuse.