Overview of California's Nurse-to-Patient Ratio Mandate

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Background California became the first state to mandate nurse-to-patient ratios, in 2005. The California law has a relatively brief history, starting with the passing of AB 394 in 1999, when the state established the idea of nurse-to-patient ratios before working out the details of implementation or the actual ratio parameters. The actual nurse-to-patient ratios were agreed upon in 2003, and cooperation was mandated during a five-year phase in starting in 2004. Overview Nurse-to-patient ratios simply mean a "maximum number of patients that may be assigned to an RN during one shift," (Kasprak, 2004). It is a "floor, not a ceiling," ("Implementation Of Nurse-to-Patient Ratios In California Is Successful, Says American Society Of Registered Nurses," (2008). The objective of the law was to improve quality of care, reduce errors, reduce lengths of hospital stay, improve patient satisfaction, and lower mortality rates (Clark, 2010). According to National Nurses United (2012), the legislation also requires hospitals to maintain patient acuity systems. The ratios were also intended to have benefits on the nursing profession itself by reducing turnover rates, retaining staff, raising morale, and reducing burnout (Clark, 2010). Actual ratios established by the California law are as follows. One-to-one ratios are mandated in an operating room setting. One-to-two in various types of intensive care units including labor and delivery. One-to-three patient ratio is called for in

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