In reviewing key evidence from the United States of America and Canada, this paper highlights
three critical gaps in the nursing skill mix literature when examined in the context of Singapore’s nursing
workforce. Issues related to the interface between local and foreign nurses, the impact of speciality education, and
the possible effects that work roles and distribution may have on quality of care need to be further examined. This
knowledge should provide a robust evidence base with which to inform national policy on skill mix and maximize
nursing resources in order to achieve optimal outcomes