SKILL MIX.
There are quite a number of health systems around the world that have reformed policies changed models in nursing to cope with nursing staffs shortages and control medical costs. However, research is yet to determine the nursing skill mix model that will be successful in achieving both quality of care and cost effectiveness (Pei-Hsuan et al, 2012). Managers and health experts are thus striving to recognize the most current skilfulness attainable by the staff within existing resources (Buchan, 2000).
According to Buchan & O’May (2000), skill mix is the mixture of diverse groups of workers with different skills that is working in any field of work. The 2000 World Health Report noted that one of the major challenges in healthcare is to determine and achieve the right skill of health personnel in an organization and health systems (WHO, 2000). The task in healthcare is to make sure value of care and the employees are not bargained in this shifting cost of organised atmosphere (Buchan, 2000). Many organizations are looking into skill mix as a probable explanation to healthcare problem. It should be the ratio of staff nurses to other care staff such as care assistants, and it plays a vital role in the efficiency of the organization and improving value of care (Buchan et al, 2000a).
The following factors must be considered when skill mixing. Defining the services that are current, such as the activities and the staffs, the needs of the patients, quality care, bed occupancy, patient’s safety and number of staff involved, and cost effectiveness should be the driving force behind any skill mix model (Buchan et al, 2000b). Getting the right staff with the right skills to care for our patients all the time is not something that can be mandated or secured nationally. Compassion in practice should be put in place as it is one of the needs for skill mixing (DH, 2012). Furthermore, cost is also associated with the skill mix. Also, the extent of control should be measured to the best solutions attainable. In checking the extent of control, the national pay arrangement, staffing norms, service regulations, independence, etc. (Hall et al, 2004), should be considered. Allocating the experienced assistants and freeing the RNs from duties can help in control of cash but can reduce the value of care given and the patient’s results and satisfaction (Roy Carr Hill, 2008), in the sense that it is related to the safety of the patients, rate of infection and mortality significantly (Su et al, 2010).
Also, one of the factors that cause negligence of patients is insufficient staff, thus leading to poor delivery of quality care. It has been known that the average proportion of registered nurses compared to unregistered healthcare assistants on day shifts was 56%, whereas it has been said by the CNO for England that the ratio of nurses to assistants should not fall below 60:40, but this varies from 43% to 68% between trusts (Shepherd, 2012). The manager need to bear in mind that the right number and skill level of care giver available should be