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Background: The measurement of the nursing workload (NWL) and its association with patient mortality contributes to the understanding of nursing practices and to the decision making process in the delivery of safe, high quality and effective care. Aim: ?o study the association between NWL and the mortality of patients in intensive care units (ICU). Method: Documentation was researched using the electronic databases Medline and Cinahl, and a narrative review was conducted. ?he following key-words were used: mortality, in-hospital mortality, 30 days mortality, nurse staffing, nurse manpower, workload, intensive care units. Papers published in English and Greek during the period 1990-2009 were used as the source material to investigate the association between NWL and mortality of adult ICU patients. Results: Patient mortality is the parameter most commonly studied in the context of the quality and safety of nursing care. Adequate ICU nurse staffing, which avoids patient exposure to a high NWL, appears to be associated with high quality care characterized by decreased mortality, although several researchers found no association between NWL and patient mortality. Conclusions: The necessity of cost-effective intensive care demands the measurement of NWL and its correlation with health care outcomes. The multiplicity of different methods employed for estimating NWL and studying its association with mortality, along with the heterogeneity of the study populations and the severity of ICU patients make comparisons difficult and indicate the need for further research in the area. [ABSTRACT FROM AUTHOR]