title: Exploring nursing skill mix: a review.
abstract: OBJECTIVE
  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.
  
  
  BACKGROUND
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: School of Nursing, Midwifery and Community Health, Glasgow Caledonian University, UK. f.crossan@gcal.ac.uk
authors.forename: Frank
authors.initials: F
authors.lastname: Crossan
authors.forename: Dorothy
authors.initials: D
authors.lastname: Ferguson
mesh_terms: D002322:Career Mobility; D002983:Clinical Competence; D003362:Cost-Benefit Analysis; D003659:Decision Making, Organizational; D019317:Evidence-Based Medicine; D006801:Humans; D008008:Licensure, Nursing; D024802:Nurse's Role; D015401:Nursing Administration Research; D009728:Nursing Assistants / Q000193:education / Q000600:supply & distribution; D015404:Nursing Methodology Research; D009740:Nursing Staff / Q000193:education / Q000600:supply & distribution; D009745:Nursing, Supervisory / Q000458:organization & administration; D009746:Nursing, Team / Q000458:organization & administration; D032024:Personnel Delegation / Q000458:organization & administration; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration*; D011787:Quality of Health Care / Q000592:standards; D012107:Research Design; D016526:Workload