Crossan Frank, Ferguson Dorothy
School of Nursing, Midwifery and Community Health, Glasgow Caledonian University, UK.
J Nurs Manag. 2005 Jul;13(4):356-62. doi: 10.1111/j.1365-2934.2005.00530.x.
The overall aims of the paper are to provide an overview of the subject, illustrate the need for further research and to raise awareness of the ongoing limitations of existing knowledge and present these to those involved in skill mix decision making.
Over the last 20 years health care organizations across the globe have seen an increase in the pace of change. The continuing drive towards cost-effectiveness, quality of care and the clinical governance agenda are causing more and more managers to examine closely the mix of staff skills. This paper demonstrates that, despite 20 years of research and skill mix management in practice, there continues to be a tension between the use of qualified and unqualified staff, particularly, the cost and quality dimensions.
The evidence which currently exists offers some limited support for the suggestion that redistribution of certain tasks in nursing could be possible and could contribute to strategies for meeting the demands of changes within health care delivery. Any reallocation of task, and substitution of qualified by unqualified staff, should be based on sound evidence and not merely on staff availability, service demand or apparent costs.
本文的总体目标是对该主题进行概述,阐明进一步研究的必要性,并提高对现有知识持续存在的局限性的认识,并将这些呈现给参与技能组合决策的人员。
在过去20年里,全球各地的医疗保健机构变革步伐加快。对成本效益、护理质量和临床治理议程的持续推动,促使越来越多的管理人员密切审视员工技能组合。本文表明,尽管在实践中进行了20年的研究和技能组合管理,但在使用合格和不合格员工之间,尤其是在成本和质量方面,仍然存在矛盾。
目前存在的证据为以下建议提供了一些有限的支持,即护理中的某些任务重新分配是可能的,并且有助于满足医疗保健服务变革需求的策略。任何任务的重新分配以及用不合格员工替代合格员工,都应基于可靠的证据,而不仅仅基于员工可用性、服务需求或表面成本。