Minimum Nurse Staffing Ratios in California Acute Care Hospitals


Joanne Spetz, Jean Ann Seago, Janet Coffman, Emily Rosenoff, Ed O'Neil

December 1, 2000

As California implements its minimum staffing legislation, it becomes increasingly important that researchers continue to examine the relationship between RN staffing and quality of care. Research does not support the general assumption that more RN staffing is always better; policymakers and hospital executives need to learn whether there are thresholds below which quality of care is unacceptable or above which there can be little improvement. This report provides objective research and analysis to inform the California Department of Health Services (DHS) in the development of minimum nurse staffing ratios. The authors examined the existing literature and conducted original research in a number of areas to shed light on the impact that nurse staffing ratios may have on patient care, nurses' working environment, hospitals, and the size and cost of the nursing workforce.