Adaptation of the Nursing Activities Score in Latvia

This study focuses on the adaptation and validation of the Nursing Activities Score (NAS) for use in Latvian intensive care units (ICUs) to measure nursing workload. The NAS, widely used internationally, was selected for its comprehensive ability to reflect 81% of ICU nursing activities, making it a suitable tool for assessing nursing workload in the Latvian healthcare context. The study followed a two-phase methodology: (1) expert validation using the Content Validity Index (CVI) and (2) a pilot study to assess the psychometric properties of the adapted tool. In the first phase, 10 ICU nursing experts assessed the translated NAS items, resulting in revisions to three specific paragraphs (4a, 14, and 20) based on low CVI scores. After refinement, CVIs improved from 0.6 to 0.8 for paragraphs 4a and 14, and from 0.5 to 0.9 for paragraph 20. The final CVI for all items reached 0.909. In the second phase, a pilot study was conducted in a Latvian ICU with 42 patients and 226 NAS assessments. The psychometric evaluation showed strong reliability and validity, confirming the NAS's suitability for measuring nursing workload in this context. Cronbach's alpha for the scale was 0.973. The adapted NAS provides a standardised method for workload assessment in Latvian ICUs, offering potential improvements in nurse resource management and patient care.