The above links will take you to the Center for the Health Professions site.

Minimum Nurse-to-Patient Ratios
in California Hospitals

In 1999, California's government adopted historic legislation requiring that specific minimum nurse-to-patient ratios be established for all units in acute care hospitals in the state. The Department of Health Services established regulations in concordance with this legislation, and the ratios were implemented on January 1, 2004. The Center for California Health Workforce Studies has been tracking the establishment of the ratios since the legislation was passed, and has published several reports on potential and early effects of the ratios. Our latest project, funded by the California HealthCare Foundation, examines the effects of the ratios on different types of hospitals. CCHWS staff also are supporting research efforts led by Linda Aiken at the University of Pennsylvania and Barbara Mark at the University of North Carolina.

Reports:
Minimum Nurse Staffing Ratios in California Acute Care Hospitals (2001)

Estimates of the Impact of Governor Davis's Proposed Ratios (2002)

Journal Articles:
Coffman J, Spetz J, Seago JA. (2002) Minimum Nurse-to-Patient Ratios in Acute Care Hospitals. Health Affairs, 21 (5): 53-64.

Seago JA. (2002) The California Experiment: Minimum Nurse to Patient Ratios: Are there Alternatives? Journal of Nursing Administration, 32(1): 48-58.

Seago JA, Spetz J, Coffman J, Rosenoff E, & O'Neil E. 2003. Minimum Nurse to Patient Ratios: The California Workforce Initiative Survey. Nursing Economics, 21(2), 65-70.

Spetz J. (2001) What Should We Expect from California's Minimum Nurse Staffing Legislation? The Journal of Nursing Administration, 31(3), 132-140.

Spetz J. (2005) Public Policy and Nurse Staffing: What Approach is Best?
Journal of Nursing Administration. 35 (1):14-16.

Spetz J. (2004) California's Minimum Nurse-to-Patient Ratios: The First
Few Months. Journal of Nursing Administration. 34 (12):571-578. Abstract

Spetz J. (in press) Can Mandated Nurse Staffing Ratios Work? The Goals and Effects of Ratios in California. In Policy and Politics in Nursing and Health Care, 5th edition, ed. Diana Mason. Philadelphia, PA: W.B. Saunders Company.
Order the book here

Presentations:
Joanne Spetz, California's Minimum Nurse to Patient Ratios: What's Happening? What's Next? Presented at the University of Illinois, Institute for Government and Public Affairs, June 17, 2004.

Joanne Spetz, The California Hospital Staffing Mandate: How Will It Affect Nursing? Presented at the University of Pennsylvania, June 2002.

Jean Ann Seago, Minimum Nurse Patient Staffing Ratios in California Acute Care Hospitals. Presented at the California HealthCare Foundation, December 2001.

Joanne Spetz, Nurse Staffing in California: What Can the Data Tell Us? Presented at the California HealthCare Foundation, December 2001.

Joanne Spetz, Legislating Solutions for Nursing Workforce Supply, presented at Critical Linkages: Patient Safety, Nurse Staffing, and Leadership Solutions, sponsored by the Joint Commission on Accreditation of Healthcare Organizations, Washington DC, September 2004.

Contact: Joanne Spetz, PhD