The skill mix model

Background: Nursing shortage is a critical problem worldwide. Using nurse aides (NAs) within a skill mix model has been applied in the healthcare delivery system as a strategy to improve nursing workforce shortages. Purpose: The purpose of this study was to investigate changes in nurse perceptions of their role functions under the skill mix model in Taiwan. Methods: This was a cross-sectional designed study that employed a structured questionnaire. Participants included 38 registered nurses from three medical wards in three hospitals that had implemented the skill mix model for 6 months. The questionnaire gathered data on participant demographics, perceptions on the role functions, role and job satisfaction of nurses, and patient care quality. Nurses' role functions were grouped into independent, dependent, and interdependent categories. Results: Results demonstrate that nurses' perceptions of independent and interdependent role function have changed since the implementation of the skill mix model. The most significant role changes in the independent function category included the nurse as educator of NAs, supervisor for patient care, and evaluator for nursing care outcomes. The most significant role changes in the interdependent function category included the nurse as integrator of nursing work and coordinator of the healthcare team. Nurses' perceived changes increase in repetitive confirmation of patient conditions and patient care quality. Conclusions: 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.