Policy Statement on Mandated Staffing Ratios

The American Organization of Nurse Executives (AONE) recognizes the need for adequate nurse-staffing levels to ensure the quality of patient care delivered in hospitals and health systems throughout our nation. The number of patients for which a nurse can provide safe, competent and quality care is dependent upon multiple factors. Studies have concluded that nurse-staffing levels are a critical determinant of patient outcomes, patient satisfaction, and nurse satisfaction. Recent research found a significant relationship between nurse-staffing ratios and preventable patient deaths (Aiken, et al. 2002). However, the researchers concluded, the "results do not directly indicate how many nurses are needed to care for patients or whether there is some maximum ratio of patients per nurse above which hospitals should not venture" (Aiken, et al., 2002, p.1990). It is the view of Dr. Peter Buerhaus, the Valerie Potter Professor of Nursing and Senior Associate Dean for Research at Vanderbilt University School of Nursing, and a leading researcher who has studied the relationship between nurse staffing and patient outcomes, that legislation to mandate fixed ratios carries a high potential of leading to the economic and political devaluation of the nursing profession and fails to effectively deal with the issues surrounding nurse staffing.