The nursing workforce plays a central role in our present health care system, and will likely have an even greater role in the future. Nurses already provide the vast majority of care to patients in hospitals, and so it should come as no surprise that the quality of nursing care affects patient outcomes.
In 2004, California became the first state to implement minimum nurse-to-patient staffing requirements inacute care hospitals. It remains the only state to enact such requirements, although at least 18 states have introduced nurse staffing legislation. The goals of the legislation were to reduce nurse workloads, improve recruitment and retention of nurses, and improve quality of care. This Issue Brief summarizes the first comprehensive evaluation of the California mandate in achieving these goals.