Jacob Elisabeth R, McKenna Lisa, D'Amore Angelo
School of Nursing and Midwifery, Monash University, Gippsland, Victoria, Australia.
J Nurs Manag. 2015 May;23(4):421-6. doi: 10.1111/jonm.12162. Epub 2013 Sep 23.
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.
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.
Research literature was used to determine the current use of skill mix and its impact on patient care and health-care costs.
The use of a higher proportion of registered nurses is associated with better health outcomes, shorter length of stay and reduced patient morbidity.
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.
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 complications.
研究当前文献，以了解技能组合，其被操控的原因以及它如何影响患者护理和医疗成本。
由于劳动力短缺、经济限制以及患者病情日益严重，雇主们正在寻找在控制成本的同时提供患者护理的方法。注册护士占医疗保健预算的很大比例。技能组合的操控（即可用于患者护理的注册护士的百分比）被视为在控制成本增加的同时仍确保患者护理的一种方法。
研究文献用于确定技能组合的当前使用情况及其对患者护理和医疗成本的影响。
使用更高比例的注册护士与更好的健康结果、更短的住院时间和更低的患者发病率相关。
用其他医疗专业人员替代注册护士所节省的经济成本可能会被患者住院时间延长和患者死亡率增加所抵消。
在评估护理技能组合时，更高比例的注册护士可能通过缩短住院时间和减少患者并发症而节省医疗保健机构的成本。
