Introduction For decades, high nurse workload levels have plagued healthcare systems, harming nurse well-being, compromising care quality, and contributing to staff shortages. Many nurse workload assessment tools rely on self-reported estimates or professional judgment instead of validated, objective, and quantitative approaches. Computer simulation offers one such quantitative approach and has increasingly been used to measure nurse workload and test work design and policy scenarios.Aim This review consolidates studies using computer simulation to model, measure, and analyze nurse workload across healthcare settings, addressing gaps in prior reviews that focused either on workload measurement broadly, simulation in healthcare generally, or specific settings such as emergency departments.Method Following PRISMA® guidelines, English-language peer-reviewed studies published before May 1, 2025, were considered. The Better Work Better Care framework was used to analyze the final review set.Findings Of 2,268 identified studies, 43 were included. Common focus areas included staffing, care demands, and patient outcomes. Understudied areas included cost factors, psychosocial and emotional workload, individual off-shift characteristics, and long-term care and home care settings. Limited model validation and insufficient attention to operational uptake were also noted, highlighting important priorities for future research if nurse workload simulation is to serve as a practical management decision-support tool.
Hanratty et al. (2026) studied this question.