This literature synthesis strengthens our understanding of the elements that influence staff mix decision-making, including patient, provider and organizational factors. In addition, it provides further evidence to support the evaluation framework (CNA et al., 2005) that is broadly structured using those three components. While some progress has been made toward the development and implementation of tools and processes to inform staff mix decision-making, substantial gaps in this area remain. In effect, this represents the ‘uptake’ or ‘utilization’ of the research linking nursing staff mix to clinical outcomes.
Overall, the evaluation framework provides one organizing model that settings can use to apply staffing research to practice environments. While researchers continue to produce literature in this field that contains variable findings, the results can be used to broadly inform decisions around nurse staffing. As such, administrators and researchers must continue to measure outcomes in a meaningful and consistent manner to enhance evidence regarding safe and effective nurse staffing practices.
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