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Nursing staff mix models and outcomes.

Linda McGillis Hall¹

¹Canadian Institutes of Health Research. l.mcgillishall@utoronto.ca

Journal of Advanced Nursing

|October 3, 2003

Summary

Registered Nurses experienced high role conflict regardless of staff mix. While job satisfaction increased with unregulated workers, perceived quality of care decreased, indicating complex impacts of nursing workforce restructuring.

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Area of Science:

Nursing Workforce Management
Healthcare Quality Improvement
Organizational Psychology in Healthcare

Background:

Global trend of nursing workforce restructuring to enhance efficiency and cost-effectiveness.
Introduction of unregulated workers into support roles alongside Registered Nurses.
Lack of evaluation regarding the efficacy and impact of these workforce changes on nursing staff, patients, and healthcare systems.

Purpose of the Study:

To examine the relationship between different staff mix models (regulated vs. mixed regulated and unregulated staff) and nursing outcomes.
To determine the impact of staff mix on the perceived quality of patient care.
To assess the influence of staff mix on Registered Nurses' job satisfaction and role perceptions.

Main Methods:

Comparative correlational study design.
Inclusion of 30 adult, acute care patient units across eight Toronto hospitals.
Survey of Registered Nurses using validated instruments measuring role conflict, ambiguity, job satisfaction, and perceived care effectiveness and quality.

Main Results:

High levels of role conflict reported by Registered Nurses across all staff mix models.
Increased job satisfaction among Registered Nurses working with unregulated support staff.
Lower perceived quality of care by Registered Nurses on units employing unregulated workers.

Conclusions:

Staff mix significantly influences Registered Nurses' perceptions of patient care quality.
Other work environment variables may exert a greater influence on outcomes than the staff mix model alone.
Further research is needed to understand the multifaceted impacts of nursing workforce restructuring.

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