What is the national benchmark when it comes to nurse-patient staff ratios? Maintaining appropriate nurse staffing levels does not just promote better care, in most cases, it's the law. But pinning down a specific number is hard to do, given the legal vagaries from state to state.
Federal regulation 42CFR 482.23(b) requires hospitals certified to participate in Medicare to “have adequate numbers of licensed registered nurses, licensed practical nurses, and other personnel to provide nursing care to all patients as needed. There must be supervisory and staff personnel for each department or nursing unit to ensure, when needed, the immediate availability of a registered nurse for bedside care of any patient.”
Without giving a clear figure, it is left up to each state to determine how to ensure that staffing is appropriate to patients’ needs.
The right ratio
The American Nurses Association (ANA) supports a legislative model in which nurses are empowered to create staffing plans specific to each unit. This method allows hospitals to establish staffing levels that are flexible and account for changes including the intensity of patients’ needs, the number of admissions, discharges and transfers during a shift, level of experience of nursing staff, layout of the unit, and availability of resources, such as ancillary staff and technology.
California is the only state that has legally defined required minimum nurse-to-patient ratios to be maintained at all times by unit. For example, the nurse-to-patient ratio in a critical care unit must be 1:2 or fewer at all times, and the nurse-to-patient ratio in an emergency department must be 1:4 or fewer at all times that patients are receiving treatment, the law states.