Aim: The aim of this review was to explore literature from January 2017 to December 2021 for specific aspects of care ethics related to nursing workload in the acute care setting.Background: High nursing workload is associated with adverse outcomes for nurses as well as patients. Nursing workload goes beyond patient-to-nurse ratios and encompasses patient, nurse and organizational factors.Evaluation: This qualitative systematic review was conducted according to the Joanna Briggs Institute Manual for Evidence Synthesis. The four features of care ethics related to nursing workload guided the review of qualitative studies in MEDLINE, CINAHL and PsycINFO, and synthesized findings were presented in the four phases of caring.

The purpose of this integrative review was to evaluate the literature from January 2013 to April 2020 and to explore critical care nurses’ perspectives of and intent to use recommended Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption (PADIS) patient assessment tools in adult critical care units. A literature search was performed with a total of 47 studies included in the final analysis for this review. The studies’ data were organized and further reduced based on The Reasoned Action Approach behavioral theory to reflect the extent to which a nurse plans to use a PADIS assessment tool. Extracted themes were related to behavioral beliefs in patient-centered care and critical thinking; normative beliefs about communication and prioritization; and control beliefs concerning autonomy and confidence. Contextualizing the international phenomenon of variation in PADIS assessment tool use by critical care nurses provides a deeper understanding of its complexity for use in the clinical setting.