{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T05:49:53Z","timestamp":1791352193393,"version":"4.3.1"},"reference-count":29,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Clinical Nursing"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To evaluate whether the National Early Warning Score is associated with patient\u2010level nursing care demand in acute hospital wards.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Multicentre observational study with prospective 24\u2010h patient\u2010level recording.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Adult patients admitted to 10 acute care wards across five hospitals in the Autonomous Province of Bolzano were enrolled on predefined study days. The unit of analysis was the individual patient observed over 24\u2009h. Nursing activities and time spent were recorded in real time using a structured form. Nursing care demand was measured as nursing care time, number of nursing activities, and patient\u2010level workload overload, defined as care time above the seventy\u2010fifth percentile.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 392 patients were included. Median nursing care time increased from 139\u2009min in patients scoring 0\u20134 to 184\u2009min in those scoring 5\u20136 and 246\u2009min in those scoring 7 or higher. The median number of nursing activities increased from 24 to 27 and 36. In adjusted analyses, higher National Early Warning Score values remained associated with greater nursing care time, more activities, and higher likelihood of patient\u2010level workload overload.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The National Early Warning Score was associated with patient\u2010level nursing care demand across heterogeneous acute hospital wards.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for the Profession and\/or Patient Care<\/jats:title>\n                    <jats:p>Routinely available acuity information may help nurses and managers identify patients requiring greater care time and support responsive workload assessment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Impact<\/jats:title>\n                    <jats:p>This study addresses the need for pragmatic indicators of nursing care demand in acute wards. Findings may inform patient assignment, workload monitoring, and clinical nursing practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Reporting Method<\/jats:title>\n                    <jats:p>The study was reported according to the Strengthening the Reporting of Observational Studies in Epidemiology statement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>No Patient or Public Contribution<\/jats:title>\n                    <jats:p>Patients and the public were not involved.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jocn.70588","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T04:50:07Z","timestamp":1791348607000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association Between the National Early Warning Score and Nursing Workload in Acute Hospital Wards: A Multicentre Observational Study"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4204-8884","authenticated-orcid":false,"given":"Arian","family":"Zaboli","sequence":"first","affiliation":[{"name":"Health Professions Management South Tyrolean Health Authority (SABES\u2010ASDAA)|  Bolzano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pasquale","family":"Solazzo","sequence":"additional","affiliation":[{"name":"Health Professions Management Hospital of Merano  Merano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Ziller","sequence":"additional","affiliation":[{"name":"Emergency Department Hospital of Merano (SABES\u2010ASDAA)  Bolzano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland","family":"Lioni","sequence":"additional","affiliation":[{"name":"Health Professions Management South Tyrolean Health Authority (SABES\u2010ASDAA)|  Bolzano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne","family":"Siller","sequence":"additional","affiliation":[{"name":"Health Professions Management South Tyrolean Health Authority (SABES\u2010ASDAA)|  Bolzano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianni","family":"Turcato","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Intermediate Care Unit Hospital Alto Vicentino (AULSS\u20107)  Santorso Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,6]]},"reference":[{"key":"e_1_2_13_2_1","unstructured":"Agenzia Nazionale per i Servizi Sanitari Regionali (AGENAS)2022.https:\/\/www.agenas.gov.it\/images\/agenas\/In%20primo%20piano\/personale\/personale_ssn_2022.pdf."},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.288.16.1987"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1891\/1061\u20103749.27.1.E34"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/nuf.12594"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD007019.pub3"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/0021\u20109681(87)90171\u20108"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2022.104311"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/CNQ.0000000000000388"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/00140139.2019.1690674"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2019.103487"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.3310\/ZBAR9152"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365\u20102702.2002.00584.x"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.7812\/tpp\/08\u2010021"},{"key":"e_1_2_13_15_1","unstructured":"Ingram A. 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