Background/Objectives: In recent years, some hospitals have shifted from traditional to intensity-of-care-based organizational models, where patients allocation is based on the care they require. In this context, Nursing Patient Classification Systems (NPCSs) can lead to the identification of the appropriate nursing care setting based on patient nursing needs; this also applies to pediatrics. In this scenario, the concept of patient nursing complexity has emerged. This narrative literature review aims to provide an overview on validated NPCSs that assess the nursing complexity of pediatric patients. Methods: PubMed, CINAHL, and the Cochrane Library were searched, and inclusion and exclusion criteria were applied to the retrieved papers. Two authors independently screened n = 498 papers, of which n = 7 were read in full and subsequently excluded. Results: No paper met the inclusion criteria. However, papers read in full were analyzed, and their main characteristics were described. They were excluded because they did not concern validated NPCSs that assess pediatric patients’ nursing complexity or did not assess pediatric patients’ nursing complexity as defined in this literature review. Conclusions: This narrative literature review highlighted a critical gap in the field of validated NPCSs that assess the nursing complexity of pediatric patients. The lack of a shared definition of “nursing complexity of the patient” is the primary barrier identified. This constitutes a crucial take-home message. Therefore, future studies should prioritize in-depth exploration of the differences among all the published definitions and concepts related to “complexity” and harmonizing existing conceptual analysis to guide future research and the development of shared NPCSs.
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