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Observational and experimental study designs were included. Mix\u2010methods designs were included if the quantitative component met the criteria.<\/jats:p><\/jats:sec><jats:sec><jats:title>Review methods<\/jats:title><jats:p>The Systematic Review guidelines of the Joanna Briggs Institute and its critical appraisal instrument were used. An inverse association was determined when seventy\u2010five percent or more of studies with significant results found this association.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixty\u2010three articles were included. Twelve patient outcomes were inversely associated with nursing skill mix (i.e., higher nursing skill mix was significantly associated with improved patient outcomes). These were length of stay; ulcer, gastritis and upper gastrointestinal bleeds; acute myocardial infarction; restraint use; failure\u2010to\u2010rescue; pneumonia; sepsis; urinary tract infection; mortality\/30\u2010day mortality; pressure injury; infections and shock\/cardiac arrest\/heart failure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Nursing skill mix affected 12 patient outcomes. However, further investigation using experimental or longitudinal study designs are required to establish causal relationships. Consensus on the definition of skill mix is required to enable more robust evaluation of the impact of changes in skill mix on patient outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Impact<\/jats:title><jats:p>Skill mix is perhaps more important than the number of nurses in reducing adverse patient outcomes such as mortality and failure to rescue, albeit the optimal staffing profile remains elusive in workforce planning.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jan.14194","type":"journal-article","created":{"date-parts":[[2019,9,4]],"date-time":"2019-09-04T15:03:08Z","timestamp":1567609388000},"page":"3404-3423","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":91,"title":["A quantitative systematic review of the association between nurse skill mix and nursing\u2010sensitive patient outcomes in the acute care setting"],"prefix":"10.1111","volume":"75","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4694-4555","authenticated-orcid":false,"given":"Diane E.","family":"Twigg","sequence":"first","affiliation":[{"name":"School of Nursing and Midwifery Edith Cowan University Joondalup Western Australia Australia"},{"name":"Centre for Nursing Research Sir Charles Gairdner Hospital Nedlands Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3568-5030","authenticated-orcid":false,"given":"Yvonne","family":"Kutzer","sequence":"additional","affiliation":[{"name":"School of Nursing and Midwifery Edith Cowan University Joondalup Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3506-8422","authenticated-orcid":false,"given":"Elisabeth","family":"Jacob","sequence":"additional","affiliation":[{"name":"School of Nursing and Midwifery Edith Cowan University Joondalup Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4611-9616","authenticated-orcid":false,"given":"Karla","family":"Seaman","sequence":"additional","affiliation":[{"name":"School of Nursing and Midwifery Edith Cowan University Joondalup Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,10,3]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1067\/mno.2002.126696"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)62631-8"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs-2016-005567"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40520-016-0576-8"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.QMH.0000338552.13136.1e"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/NNA.0000000000000195"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/NCQ.0000000000000057"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2016.08.001"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2017.08.004"},{"issue":"1","key":"e_1_2_7_11_1","first-page":"27","article-title":"The relationship between nurse staffing models and patient outcomes: A descriptive study","volume":"6","author":"Barkell N. 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