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[Skill mix of nurses and primary health care professionals: a systematic review]
Silvia Helena De Bortoli Cassiani1, Maria Neyrian de Fátima Fernandes2, Ludovic Reveiz1
1Organização Pan-Americana da Saúde Washington, D.C. Estados Unidos de América Organização Pan-Americana da Saúde, Washington, D.C., Estados Unidos de América.
Objective:
To evaluate the effectiveness of the strategy of skill mix of nurses and other health care professionals in primary health care.
Methods:
Systematic review of the literature aligned with the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), including observational and intervention studies. No restrictions were established for period or country of publication; studies published in Spanish, English and Portuguese were included. The search was carried out in MEDLINE, CINAHL, LILACS, EMBASE and Web of Science electronic databases.
Results:
Eighteen studies were analyzed, including 6 from the United States; 3 from the Netherlands; 2 from the United Kingdom; 1 each from Australia, South Africa, South Korea, Scotland, Haiti and Japan; and 1 study with a prospective observational design from 8 countries. The studies reported that the skill mix among health professionals enables a better use of material resources; optimizes time spent on care; improves adhesion to treatment, quality of care and commitment and satisfaction with the work; and reduces the level of psychological distress in nursing professionals.
Conclusions:
The expansion of tasks of nurses and other health care professionals, and the skill mix as well as the development of interprofessional teams, are strategies that help to face a scarcity and poor distribution of human resources in urban and non-urban areas with improvement of the health care of the population and satisfaction of professionals and clients.
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