Nursing skill mix and patient outcomes

In hospitals, the nursing staff typically represent the largest single element of cost, and nursing is frequently treated as a cost centre rather than a core service line. Efforts to contain hospital costs often involve cutting nursing care, reducing the number of nurses or replacing some professional nursing staff with staff such as licensed practical nurses, nurses' aides and other assistive personnel.

Substantial evidence from studies in the USA, Europe and other countries relates lower nurse staffing and higher nurse workloads to adverse patient outcomes such as mortality, infections, falls and longer lengths of stay. Longer stays, which increase hospital costs, may result from increased adverse events lengthening admissions or delays in care due to nurses being unable to complete their work or prepare patients for discharge.1–13

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