The levels and related factors of mental workload among nurses: A systematic review and meta‐analysis.

Aim: The aim was to determine the overall levels and related factors of mental workload assessed using the NASA‐TLX tool among nurses. Background: Mental workload is a key element that affects nursing performance. However, there exists no review regarding mental workload assessed using the NASA‐TLX tool, focusing on nurses. Design: A systematic review and meta‐analysis. Data Sources: PubMed, MEDLINE, Web of Science, EMBASE, PsycINFO, Scopus, CINAHL, CNKI, CBM, Weipu and WanFang databases were searched from 1 January 1998 to 30 February 2022. Review Methods: Following the PRISMA statement recommendations, review methods resulted in 31 quantitative studies retained for inclusion which were evaluated with the evaluation criteria for observational studies as recommended by the Agency for Healthcare Research and Quality. The data were pooled and a random‐effects meta‐analysis conducted. Results: Findings showed the pooled mental workload score was 65.24, and the pooled prevalence of high mental workload was 54%. Subgroup analysis indicated nurses in developing countries and emergency departments experienced higher mental workloads, and the mental workloads of front‐line nurses increased significantly during the COVID‐19 pandemic. Conclusion: These findings highlight that nurses experience high mental workloads as assessed using the NASA‐TLX tool and there is an urgent need to explore interventions to decrease their mental workloads. Summary statement: What is already known about the topic? Mental workload is a key element that can affect nursing performance and patient safety outcomes.Nursing is a stressful occupation, and nurses are at risk for high levels of mental workload. What this paper adds? The review, which involved 31 studies and 16,189 nurses around the world, found that nurses experienced high mental workloads, and identified several factors that contributed to their mental workload.This meta‐analysis identified trends indicating that that nurses from developing countries and those working in emergency departments may suffer higher mental workloads. The implications of this paper: Systematic evaluation of nurses' mental workload is important because it significantly affects nurses' work performance.Due to high heterogeneity, the findings should be considered with caution, and more high‐quality studies are needed. [ABSTRACT FROM AUTHOR]