The Skill Mix Model

Abstract

: This study revealed that nurses working in skill mix model environments need more authority to delegate and educate NAs and to supervise and integrate nursing care. Study results may serve as a reference for hospital nursing practice in Taiwan.

Evaluating Skill-Mix Models of Care

“…Additional increases in RN satisfaction upon UAP implementation included statistically significant increases in teamwork among coworkers, appropriate delegation, sense of accomplishment in their work, enjoyment coming to work, satisfaction with the workload, and satisfaction with the job 22 . McGillis Hall 19 found a statistically significant positive relationship between job satisfaction and employment on units with a regulated and UAP mix, whereas 2 studies found improved, but not significant increase in RN job satisfaction upon UAP implementation 17,18 . Contrastingly, Dzikowicz et al 16 found that RNs significantly preferred to work on the all-RN staffed unit, reporting it to be more professionally satisfying with improved time management.…”

“…Seven of 10 articles that met the inclusion criteria were from English-speaking countries (Table 2). Locations of study included Canada (n = 4), 15,19-21 the United States (n = 3), 14,16,22 and Taiwan (n = 3) 17,18,23 . Dates of publication ranged from 1999 to 2023.…”

“…Six studies examined nurse satisfaction upon skill-mix change implementation and found generally positive responses 14,16-19,22 . RNs reported improved satisfaction, but not significant, in UAP performance of delegated responsibilities and communication of pertinent information 14 ; these findings were reciprocated in the UAP satisfaction survey.…”

“…Two studies examined nurse perceptions of role changes after implementation of a skill-mix model change 17,19 . Huang et al, 17 who added UAPs to units, found that 63% of nurses perceived an increase in their role function as an educator of UAPs, and more than 50% of nurses perceived an increase in their role function as a consultant, an educator for patients and families, as supervisors and managers for patient care, and as evaluators for nursing care outcomes and nursing team implementation leaders.…”

“…Two studies examined nurse perceptions of role changes after implementation of a skill-mix model change 17,19 . Huang et al, 17 who added UAPs to units, found that 63% of nurses perceived an increase in their role function as an educator of UAPs, and more than 50% of nurses perceived an increase in their role function as a consultant, an educator for patients and families, as supervisors and managers for patient care, and as evaluators for nursing care outcomes and nursing team implementation leaders. Approximately 42% of nurses perceived no change in their level of patient monitoring and reporting patient conditions when working with UAPs, and more than 50% of the nurses perceived no change as coordinator, consultant, or patient advocate of the healthcare team 17 .…”