Nursing staffing and skill mix in nursing homes in Italy: An observational cross-sectional study

Introduction/Objective: The relationship between staffing levels and skill mix in nursing homes is poorly documented in Italy. This study aimed to investigate nursing staffing levels and skill mix in Northern Italian nursing homes. Methods: A cross-sectional observational study was conducted using a questionnaire sent to several nursing homes. Results: Twenty-three nursing homes participated. Data were collected on organizational models, daily hours of support staff, and daily hours of care per resident, categorized by professional profile. The predominant models were "by sector or modular" and "Team nursing". Daily hours of nursing care were minimal; in most nursing homes, daily hours of support staff exceed those of nurses and healthcare assistants. Total daily hours of care per resident were 2.75, below international and recommended standards. Discussion: Organizational settings can be improved by adjusting staffing, particularly by rebalancing the ratio of nursing to support staff, to improve outcomes and prevent missed care. (c) 2025 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.