The changing skill mix in nursing: considerations for and against different levels of nurse
- 23 September 2013
- journal article
- review article
- Published by Wiley in Journal of Nursing Management
- Vol. 23 (4), 421-426
- https://doi.org/10.1111/jonm.12162
Abstract
Aim: To investigate the current literature to gain an understanding of skill mix, why it is being manipulated and how it affects patient care and health-care costs. Background: Due to workforce shortages, economic constraints and increasing patient acuity, employers are looking at methods of providing patient care whilst maintaining costs. Registered nurses make up a large percentage of the health-care budget. The manipulation of skill mix (i.e. the percentage of registered nurses available for patient care) is seen as one method of managing the increasing cost whilst still ensuring patient care. Evaluation: Research literature was used to determine the current use of skill mix and its impact on patient care and health-care costs. Key issue: The use of a higher proportion of registered nurses is associated with better health outcomes, shorter length of stay and reduced patient morbidity. Conclusion: Economic savings from substituting registered nurses with other health professionals may be offset by increased patient length of stay in hospital and increased patient mortality. Implications for nursing management: When evaluating nursing skill mix, a higher percentage of registered nurses may result in health-care facility cost savings by providing a shorter length of stay and decreased patient complicationsKeywords
This publication has 29 references indexed in Scilit:
- Nurse staffing and skill mix patterns: Are there differences in outcomes?Journal of Healthcare Risk Management, 2012
- Nurse staffing levels revisited: a consideration of key issues in nurse staffing levels and skill mix researchJournal of Nursing Management, 2009
- A comparison of activities undertaken by enrolled and registered nurses on medical wards in Australia: An observational studyInternational Journal of Nursing Studies, 2008
- EditorialContemporary Nurse, 2007
- Nursing skill mix and outcomes: a Singapore perspectiveInternational Nursing Review, 2007
- The Critical Elements Within a Journey Towards the Achievement of Quality Use of MedicinesCollegian, 2007
- Impact of California’s Licensed Nurse-Patient Ratios on Unit-Level Nurse Staffing and Patient OutcomesPolicy, politics & nursing practice, 2005
- Hospital Nurse Staffing and Patient Mortality, Nurse Burnout, and Job DissatisfactionJama-Journal Of The American Medical Association, 2002
- Role determination in nursing–implications for service provisionJournal of Nursing Management, 1995
- Enrolled nurses: where do they go from here?Journal of Nursing Management, 1994