Administrators are currently being challenged to maintain high quality patient care in the face of shrinking health care resources. The introduction of different skill mix ratios has been suggested as one way to help manage health care costs. This paper briefly reviews the literature and research data on skill mix, discussing the relevant issues and identifying the positive and negative implications of this approach. It concludes with suggestions for further research.
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References
1.
ManuelPAlsterK. Unlicensed personnel — No cure for an ailing health care system. Nursing and Health Care1994; 15(1): 18–21.
2.
HayesE. Matching demands and resources in an intensive care environment. Intensive Care Nursing1991; 7: 206–213.
3.
ShermanRO. Team nursing revisited. Journal of Nursing Administration1990; 11: 43–46.
4.
EstaughSR. Hospital nursing technical efficiency: Nurse extenders and enhanced productivity. Hospital and Health Services Administration1990; 35(4): 561–573.
GardnerDL. Issues related to the use of nurse extenders. Journal of Nursing Administration1991; 21(10): 40–45.
7.
MorrisM. Nurses must face skill-mix reality. British Journal of Nursing1992; 1(14): 695.
8.
GibbsIMcCaughanDGriffithsM. Skill mix in nursing: A selective review of the literature. Journal of Advanced Nursing1991; 16: 242–249.
9.
HesterlySCRobinsonM. Alternative caregivers: Cost-effective utilization of RNs. Nursing Administration Quarterly1990; 14(3): 18–23.
10.
KennerlySM. Implications of the use of unlicensed personnel: A nursing perspective. Focus On Critical Care1989; 16(5): 364–368.
11.
KirbyKKGarfinkCM. The University Hospital nurse extender model — Part 1, An overview and conceptual framework. Journal of Nursing Administration1991; 21(1): 25–30.
12.
NotterJ. Skill mix is not grade mix. British Journal of Nursing1993; 2(7): 351.
13.
SheehanA. Skill mix does not work. British Journal of Nursing1993; 2(5): 256.
14.
TownsendMB. Defining value added. Nursing Economic$1993; 11(6): 382.
15.
MallisonMB. Cadillac or Chevrolet nursing? Look under the hood. American Journal of Nursing1992; 92(1): 7.
16.
WrayNPAshtonCMKuykendallDHPetersenNJSouchekJHollingsworthJC. Selecting disease-outcome pairs for monitoring the quality of hospital care. Medical Care1995; 33(1): 75–89.
17.
MarckP. The problem with good nursing care. Alberta Association of Registered Nurses Newsletter1994; 50(5): 10–11.
18.
JohnsonC. Humana model for nurse skill mix sets standards for cost-effective staffing. Healthcare Productivity Report1990; 3: 9–12.
19.
ShuklaRK. All RN model of nursing care delivery: A cost-benefit evaluation. Inquiry1993; 20: 173–184.
20.
BartonNKunkleRTuckerARobinsonBailey D. Redesigning care delivery: Another definition of managed care. Nursing Administration Quarterly1993; Summer: 30–37.
21.
FritzDCheesemanS. Blueprint for integrating nurse extenders in critical care. Nursing Economic$1994; 12(6): 327–331.
22.
BrettJL LuckenbillTongesM Crabtree. Restructured patient care delivery: Evaluation of the ProACT Model. Nursing Economic$1990; 8(1): 36–44.
23.
BostromJZimmermanJ. Restructuring nursing for a competitive health care environment. Nursing Economic$1993; 11(1): 35–41.
24.
TownsendMB. Twenty-four hour care teams. Nursing Management1994; 25(6): 62–64.
25.
JohnsonJHOlesinskiN. Program evaluation: Key to success. Journal of Nursing Administration1995; 25(1): 53–60.
26.
BrootenDNaylorMD. Nurses' effect on changing patient outcomes. Image1995; 27(2): 95–99.
27.
McManusSPearsonJV. Nursing at a crossroads: Managing without facts. Health Care Management Review1993; 18(1): 79–90.
28.
HeathI. Skill mix in primary care. British Medical Journal1994; 308: 993–994.