The changing skill mix in nursing: Considerations for and against different levels of nurse

Journal article


Beth Jacob, Lisa McKenna and Angelo D'Amore. (2015). The changing skill mix in nursing: Considerations for and against different levels of nurse. Journal of Nursing Management. 23(4), pp. 421-426. https://doi.org/10.1111/jonm.12162
AuthorsBeth Jacob, Lisa McKenna and Angelo D'Amore
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 complications.

Keywordseconomic factors; levels of nurse; scope of practise; skill mix; workforce
Year2015
JournalJournal of Nursing Management
Journal citation23 (4), pp. 421-426
PublisherBlackwell Publishing Ltd
ISSN0966-0429
Digital Object Identifier (DOI)https://doi.org/10.1111/jonm.12162
Scopus EID2-s2.0-84929028786
Publisher's version
File Access Level
Controlled
Publication process dates
Deposited26 Apr 2021
Permalink -

https://acuresearchbank.acu.edu.au/item/8vy16/the-changing-skill-mix-in-nursing-considerations-for-and-against-different-levels-of-nurse

Restricted files

Publisher's version

  • 228
    total views
  • 0
    total downloads
  • 0
    views this month
  • 0
    downloads this month
These values are for the period from 19th October 2020, when this repository was created.

Export as

Related outputs

Drawing blood from a peripheral intravenous cannula and its effect on cannula dwell time, phlebitis, and bloodstream infection : A randomised controlled study
Davies, Hugh, Jacob, Alycia M., Aboo, Lea, Coventry, Linda L. and Jacob, Elisabeth. (2024). Drawing blood from a peripheral intravenous cannula and its effect on cannula dwell time, phlebitis, and bloodstream infection : A randomised controlled study. Collegian: The Australian Journal of Nursing Practice, Scholarship and Research. 31(4), pp. 181-187. https://doi.org/10.1016/j.colegn.2024.04.001
A Follow-Up Study on the Clinical Impact of Pre-Registration Extended Immersive Ward-Based Simulation
Davies, Hugh, Robertson, Sue, Sundin, Deborah and Jacob, Elisabeth. (2024). A Follow-Up Study on the Clinical Impact of Pre-Registration Extended Immersive Ward-Based Simulation. Clinical Simulation in Nursing. 91, pp. 1-8. https://doi.org/10.1016/j.ecns.2024.101540
What are the facilitators and barriers experienced by sessional academics during the process of onboarding : A scoping review
Brouwer, Hendrika Jacoba, Griffiths, Semra, Jacob, Alycia, Ricks, Thomas Aaron, Schulz, Paula, Lavell, Sharni, Lam, Louisa and Jacob, Elisabeth. (2024). What are the facilitators and barriers experienced by sessional academics during the process of onboarding : A scoping review. Journal of Higher Education Policy and Management. pp. 1-18. https://doi.org/10.1080/1360080X.2024.2340987
Factors impacting nursing assistants to accept a delegation in the acute care settings : A mixed method study
Crevacore, Carol, Coventry, Linda L., Duffield, Christine and Jacob, Elisabeth. (2024). Factors impacting nursing assistants to accept a delegation in the acute care settings : A mixed method study. Journal of Clinical Nursing. 33(6), pp. 2153-2164. https://doi.org/10.1111/jocn.17127
The perspectives of internationally qualified nurses regarding their specialty skill transition to Australia : A cross-sectional survey
Kurup, Chanchal, Burston, Adam Scott, Betihavas, Vasiliki and Jacob, Elisabeth. (2024). The perspectives of internationally qualified nurses regarding their specialty skill transition to Australia : A cross-sectional survey. Journal of Advanced Nursing. 80(5), pp. 1-14. https://doi.org/10.1111/jan.15952
What are the facilitators and barriers experienced by sessional academics during the process of onboarding: a scoping review
Brouwer, H., Griffiths, S., Jacob, A., Ricks, T., Schulz, P., Lam, L. and Jacob, E.. (2024). What are the facilitators and barriers experienced by sessional academics during the process of onboarding: a scoping review. Journal of Higher Education Policy and Management. pp. 1-18. https://doi.org/10.1080/1360080X.2024.2340987
A Massive Open Online Course Delivered Just-in-Time : A Cohort Study
Leathwick, Sandra Marie, El Ali, Mandy, Jacob, Alycia M. and Jacob, Elisabeth. (2023). A Massive Open Online Course Delivered Just-in-Time : A Cohort Study. Journal of Continuing Education in Nursing. 54(10), pp. 472-479. https://doi.org/10.3928/00220124-20230829-01
Role of nurse-surgeons in global surgical care : A scoping review
Grota, Tenber, Betihavas, Vasiliki, Burston, Adam and Jacob, Elisabeth. (2023). Role of nurse-surgeons in global surgical care : A scoping review. Journal of Advanced Nursing. pp. 1-31. https://doi.org/10.1111/jan.15906
Strategies employed by developed countries to facilitate the transition of internationally qualified nurses specialty skills into clinical practice : An integrative review
Kurup, Chanchal, Betihavas, Vasiliki, Burston, Adam Scott and Jacob, Elisabeth. (2023). Strategies employed by developed countries to facilitate the transition of internationally qualified nurses specialty skills into clinical practice : An integrative review. Nursing Open. 10(12), pp. 7528-7543. https://doi.org/10.1002/nop2.2023
Graduate enrolled nurse readiness to practice : A scoping review
Akhter, Zainab, Malik, Gulzar, Jacob, Elisabeth and McDonald, Ewan. (2023). Graduate enrolled nurse readiness to practice : A scoping review. Nurse Education Today. 131, p. Article 105973. https://doi.org/10.1016/j.nedt.2023.105973
Integrative review : Factors impacting effective delegation practices by registered nurses to assistants in nursing
Crevacore, Carol, Jacob, Elisabeth, Coventry, Linda L. and Duffield, Christine. (2023). Integrative review : Factors impacting effective delegation practices by registered nurses to assistants in nursing. Journal of Advanced Nursing. 79(3), pp. 885-895. https://doi.org/10.1111/jan.15430
Factors impacting delegation decision making by registered nurses to assistants in nursing in the acute care setting: A mixed method study
Crevacore, Carol, Coventry, Linda, Duffield, Christine and Jacob, Elisabeth. (2022). Factors impacting delegation decision making by registered nurses to assistants in nursing in the acute care setting: A mixed method study. International Journal of Nursing Studies. 136, p. Article 104366. https://doi.org/10.1016/j.ijnurstu.2022.104366
Impact of pre-registration extended immersive ward-based simulation on student learning in preparation for clinical placement
Davies, Hugh, Robertson, Sue, Sundin, Deb and Jacob, Elisabeth. (2022). Impact of pre-registration extended immersive ward-based simulation on student learning in preparation for clinical placement. Nurse Education Today. 119, p. Article 105575. https://doi.org/10.1016/j.nedt.2022.105575
Impact of nurse-surgeons on patient-centred outcomes : A systematic review
Grota, Tenber, Betihavas, Vasiliki, Burston, Adam and Jacob, Elisabeth. (2022). Impact of nurse-surgeons on patient-centred outcomes : A systematic review. International Journal of Nursing Studies Advances. 4, p. Article 100086. https://doi.org/10.1016/j.ijnsa.2022.100086
Extended immersive simulation to develop nontechnical skills : Content analysis of students' views
Jacob, Elisabeth R., Sundin, Deb, Robertson, Sue and Davies, Hugh. (2022). Extended immersive simulation to develop nontechnical skills : Content analysis of students' views. Collegian. 29(3), pp. 350-356. https://doi.org/10.1016/j.colegn.2021.09.009
A translational research framework for nurse practitioners
Ryder, Mary and Jacob, Elisabeth. (2022). A translational research framework for nurse practitioners. Journal of Nursing Management. 30(2), pp. 421-427. https://doi.org/10.1111/jonm.13496
Clinical readiness
Jacob, Elisabeth and Davies, Hugh. (2021). Clinical readiness. In In Harrison, Helena, Birks, Melanie and Mills, Jane (Ed.). Transition to nursing practice : From student to professional pp. 185-202 Oxford University Press.
The impact of blood sampling technique, including the use of peripheral intravenous cannula, on haemolysis rates : A cohort study
Jacob, Elisabeth, Jacob, Alycia, Davies, Hugh, Jacob, Darren, Jenkins, Mark, Husain, Margaret and Coventry, Linda. (2021). The impact of blood sampling technique, including the use of peripheral intravenous cannula, on haemolysis rates : A cohort study. Journal of Clinical Nursing. 30(13-14), pp. 1916-1926. https://doi.org/10.1111/jocn.15744
Current methods of nurse-surgeon training and education : Systematic review
Grota, Tenber, Betihavas, Vasiliki, Burston, Adam and Jacob, Elisabeth. (2021). Current methods of nurse-surgeon training and education : Systematic review. International Journal of Nursing Studies Advances. 3, p. Article 100048. https://doi.org/10.1016/j.ijnsa.2021.100048
Peripheral intravenous cannulas for blood drawing : Nurses' views through content analysis
Jacob, Elisabeth R., Jacob, Alycia M., Davies, Hugh T., Stoneman, Laurita J. and Coventry, Linda. (2021). Peripheral intravenous cannulas for blood drawing : Nurses' views through content analysis. Collegian. 28(4), pp. 408-414. https://doi.org/10.1016/j.colegn.2020.12.002
Measuring attitudes of those caring for people living with dementia : A quantitative survey
Vafeas, Caroline, Jacob, Elisabeth and Jacob, Alycia. (2021). Measuring attitudes of those caring for people living with dementia : A quantitative survey. Contemporary Nurse. 56(5-6), pp. 491-504. https://doi.org/10.1080/10376178.2021.1894958
Does participation in extended immersive ward-based simulation improve the preparedness of undergraduate bachelor’s degree nursing students to be ready for clinical practice as a registered nurse? An integrative literature review
Davies, Hugh, Sundin, Deborah, Robinson, Suzanne and Jacob, Elisabeth. (2021). Does participation in extended immersive ward-based simulation improve the preparedness of undergraduate bachelor’s degree nursing students to be ready for clinical practice as a registered nurse? An integrative literature review. Journal of Clinical Nursing. 30(19-20), pp. 2897-2911. https://doi.org/10.1111/jocn.15796
Experiences of Western Australian rural nursing graduates : A mixed method analysis
Graf, Amanda C., Nattabi, Barbara, Jacob, Elisabeth and Twigg, Di. (2021). Experiences of Western Australian rural nursing graduates : A mixed method analysis. Journal of Clinical Nursing. 30(23-24), pp. 3466-3480. https://doi.org/10.1111/jocn.15849
Rural dialysis nurses’ experiences with challenging patients : a thematic qualitative analysis
Jacob, Alycia M., Vafeas, Caroline, Stoneman, Laurita and Jacob, Elisabeth. (2020). Rural dialysis nurses’ experiences with challenging patients : a thematic qualitative analysis. Renal Society of Australasia Journal. 16(1), pp. 13-19. https://doi.org/10.33235/rsaj.16.1.13-19
Contemporary nursing graduates’ transition to practice : A critical review of transition models
Graf, Amanda C., Jacob, Elisabeth, Twigg, Diane and Nattabi, Barbara. (2020). Contemporary nursing graduates’ transition to practice : A critical review of transition models. Journal of Clinical Nursing. 29(15-16), pp. 3097-3107. https://doi.org/10.1111/jocn.15234
Are current clinical guidelines on the use of Peripheral Intravenous Cannula for blood draws supported by evidence? An organizational case study
Jacob, Alycia, Coventry, Linda, Davies, Hugh and Jacob, Elisabeth. (2020). Are current clinical guidelines on the use of Peripheral Intravenous Cannula for blood draws supported by evidence? An organizational case study. Nursing Open. 7(6), pp. 1746-1754. https://doi.org/10.1002/nop2.559
An integrative review to identify evidence of nurse practitioner-led changes to health-care delivery and the outcomes of such changes
Ryder, Mary, Jacob, Elisabeth and Hendricks, Joyce. (2020). An integrative review to identify evidence of nurse practitioner-led changes to health-care delivery and the outcomes of such changes. International Journal of Nursing Practice. 26(6), p. e12901. https://doi.org/10.1111/ijn.12901
A survey identifying leadership and research activities among nurse practitioners
Ryder, Mary, Jacob, Elisabeth and Hendricks, Joyce. (2020). A survey identifying leadership and research activities among nurse practitioners. Contemporary Nurse. 56(5-6), pp. 441-454. https://doi.org/10.1080/10376178.2020.1835508
A younger onset dementia toolkit: Innovative practice
Vafeas, Caroline, Jacob, Elisabeth and Jacob, Alycia M. (2020). A younger onset dementia toolkit: Innovative practice. Dementia. 19(4), pp. 1299 - 1307. https://doi.org/10.1177/1471301217738402
‘Ward for the day’: A case study of extended immersive ward-based simulation
Davies, Hugh, Schultz, Rebecca, Sundin, Deborah and Jacob, Elisabeth. (2020). ‘Ward for the day’: A case study of extended immersive ward-based simulation. Nurse Education Today. 90, pp. 1 - 8. https://doi.org/10.1016/j.nedt.2020.104430
Estimation of body fluid status by fluid balance and body weight in critically ill adult patients : A systematic review
Davies, Hugh, Leslie, Gavin, Jacob, Elisabeth and Morgan, David. (2019). Estimation of body fluid status by fluid balance and body weight in critically ill adult patients : A systematic review. Worldviews on Evidence-Based Nursing. 16(6), pp. 470-477. https://doi.org/10.1111/wvn.12394
Blood sampling through peripheral intravenous cannulas: A look at current practice in Australia
Davies, Hugh, Coventry, Linda L., Jacob, Alycia M., Stoneman, Laurita and Jacob, Elisabeth. (2019). Blood sampling through peripheral intravenous cannulas: A look at current practice in Australia. Collegian. 27(2), pp. 219 - 225. https://doi.org/10.1016/j.colegn.2019.07.010
A quantitative systematic review of the association between nurse skill mix and nursing-sensitive patient outcomes in the acute care setting
Twigg, Diane E., Kutzer, Yvonne, Jacob, Elisabeth and Seaman, Karla. (2019). A quantitative systematic review of the association between nurse skill mix and nursing-sensitive patient outcomes in the acute care setting. Journal of Advanced Nursing. 75(12), pp. 3404 - 3423. https://doi.org/10.1111/jan.14194
An inductive qualitative approach to explore nurse practitioners views on leadership and research: An international perspective
Ryder, Mary, Jacob, Elisabeth and Hendricks, Joyce. (2019). An inductive qualitative approach to explore nurse practitioners views on leadership and research: An international perspective. Journal of Clinical Nursing. 28(13-14), pp. 2644 - 2658. https://doi.org/10.1111/jocn.14853
The role of the family in supporting the self-management of chronic conditions : A qualitative systematic review
Whitehead, Lisa, Jacob, Elisabeth, Towell, Amanda, Abu-qamar, Ma'en and Cole-Heath, Amanda. (2018). The role of the family in supporting the self-management of chronic conditions : A qualitative systematic review. Journal of Clinical Nursing. 27(1-2), pp. 22-30. https://doi.org/10.1111/jocn.13775
Intentional rounding in acute adult healthcare settings : A systematic mixed-method review
Christiansen, Angela, Coventry, Linda, Graham, Renée, Jacob, Elisabeth, Twigg, Di and Whitehead, Lisa. (2018). Intentional rounding in acute adult healthcare settings : A systematic mixed-method review. Journal of Clinical Nursing. 27(9-10), pp. 1759-1792. https://doi.org/10.1111/jocn.14370
An integrative review of rural and remote nursing graduate programmes and experiences of nursing graduates
Fowler, Amanda C., Twigg, Diane, Jacob, Elisabeth and Nattabi, Barbara. (2018). An integrative review of rural and remote nursing graduate programmes and experiences of nursing graduates. Journal of Clinical Nursing. 27(5-6), pp. e753-e766. https://doi.org/10.1111/jocn.14211
Is it time to consider a four year Nursing Bachelor Degree in Australia? A discussion paper
Angela Christiansen, Elisabeth Jacob and Di Twigg. (2018). Is it time to consider a four year Nursing Bachelor Degree in Australia? A discussion paper. Collegian. 25(5), pp. 567-571. https://doi.org/10.1016/j.colegn.2018.01.004
Influence of perceptions and stereotypes of the nursing role on career choice in secondary students: A regional perspective
Raymond, Anita, James, Ainsley, Jacob, Elisabeth and Lyons, Judith. (2018). Influence of perceptions and stereotypes of the nursing role on career choice in secondary students: A regional perspective. Nurse Education Today. 62, pp. 150 - 157. https://doi.org/10.1016/j.nedt.2017.12.028
Development of an Australian nursing critical thinking tool using a Delphi process
Jacob, Elisabeth, Duffield, Christine and Jacob, Darren. (2018). Development of an Australian nursing critical thinking tool using a Delphi process. Journal of Advanced Nursing. 74(9), pp. 2241 - 2247. https://doi.org/10.1111/jan.13732
A protocol for the development of a critical thinking assessment tool for nurses using a Delphi technique
Jacob, Elisabeth, Christine Duffield and Darren Jacob. (2017). A protocol for the development of a critical thinking assessment tool for nurses using a Delphi technique. Journal of Advanced Nursing. 73(8), pp. 1982-1988. https://doi.org/10.1111/jan.13306
Peer learning a pedagogical approach to enhance online learning: A qualitative exploration
Raymond, Anita, Jacob, Elisabeth, Jacob, Darren and Lyons, Judith. (2016). Peer learning a pedagogical approach to enhance online learning: A qualitative exploration. Nurse Education Today. 44, pp. 165 - 169. https://doi.org/10.1016/j.nedt.2016.05.016
Cultural desire need not improve with cultural knowledge: A cross-sectional study of student nurses
Isaacs, Anton Neville, Raymond, Anita, Jacob, Elisabeth, Jones, Janet, McGrail, Matthew and Drysdale, Marlene. (2016). Cultural desire need not improve with cultural knowledge: A cross-sectional study of student nurses. Nurse Education in Practice. 19, pp. 91 - 96. https://doi.org/10.1016/j.nepr.2016.05.009
Exploration of nursing degree students’ content expectations of a dedicated Indigenous health unit
Jacob, Elisabeth, Raymond, Anita, Jones, Janet, Jacob, Alycia M., Drysdale, Marlene and Isaacs, Anton Neville. (2016). Exploration of nursing degree students’ content expectations of a dedicated Indigenous health unit. Collegian. 23(3), pp. 313 - 319. https://doi.org/10.1016/j.colegn.2015.06.001
Infection control : It's not just what you wear -it's how you take it off
Mata, Gina, Oliver, Kim, Geale, Sara and Jacob, Elisabeth. (2015). Infection control : It's not just what you wear -it's how you take it off. Australian Nursing and Midwifery Journal. 23(3), p. 39.
Senior nurse role expectations of graduate registered and enrolled nurses on commencement to practice
Jacob, Elisabeth R., McKenna, Lisa and D’Amore, Angelo. (2014). Senior nurse role expectations of graduate registered and enrolled nurses on commencement to practice. Australian Health Review. 38(4), pp. 432-439. https://doi.org/10.1071/AH13216
Senior nurse role expectations of graduate registered and enrolled nurses in Australia : Content analysis of open-ended survey questions
Jacob, Elisabeth R., McKenna, Lisa and D’Amore, Angelo. (2014). Senior nurse role expectations of graduate registered and enrolled nurses in Australia : Content analysis of open-ended survey questions. Contemporary Nurse. 48(2), pp. 212-218. https://doi.org/10.1080/10376178.2014.11081943
Comparisons of the educational preparation of registered and enrolled nurses in Australia : The educators' perspectives
Jacob, Elisabeth R., McKenna, Lisa and D'Amore, Angelo. (2014). Comparisons of the educational preparation of registered and enrolled nurses in Australia : The educators' perspectives. Nurse Education in Practice. 14(6), pp. 648-653. https://doi.org/10.1016/j.nepr.2014.07.005
Similarities and differences in educational preparation of registered and enrolled nurses in Australia: An examination of curricula content
Elisabeth Jacob, Lisa McKenna and Angelo D'Amore. (2014). Similarities and differences in educational preparation of registered and enrolled nurses in Australia: An examination of curricula content. Contemporary Nurse. 48(2), pp. 199-211. https://doi.org/10.1080/10376178.2014.11081942