Nurse Staffing Ratios

Click to see a map of state legislative action on this topic

Staff nurses time and again point to safe nurse-patient ratios as a critical solution to making sure that there are enough nurses to adequately care for patients.  A 2002 study by Linda Aiken found that fewer nurses means more medical errors and poorer patient outcomes.   While Congress debates federal legislation to make a safe ratio the law of the land, states are moving forward.

California is the only state to enact specific nurse-to-ratios.  The Safe Staffing Law, AB 394, was signed into law in 1999 by former Gov. Gray Davis.  This legislation sets minimum nurse-to-patient ratios on all hospital units. The ratios range from one nurse per patient [1:1] to one nurse for eight patients [1:8], depending on the unit. Some units, such as the intensive care unit, have had minimum ratios for years. But in areas of the hospital where most patients are treated—medical/surgical and the emergency department, for instance—ratios are being newly enforced.  Other states are watching California's experiment. As of 2005, at least 14 states were considering some kind of hospital nurse staffing legislation.  These states were CO, HI, IL, IA, MO, MA, NJ, NV, NY, PA, RI, VT and FL.   As of yet, none of the bills have passed. 

Click on the links below to learn more about which states are acting on these key issues (data is current to the end of the most recent state legislative cycle, which concluded in 2005 for most states):

• Nurse staffing ratios
• Nurse staffing plans
• Mandatory overtime ban
• Safe patient handling and movement
• Whistleblower protection
• Universal health care