title: California's nurse-to-patient ratios, part 3: eight years later, what do we know about patient level outcomes?
abstract: OBJECTIVE
  The objective of this study was to describe the impact of California's nurse-to-patient ratios on patient-level outcomes from a comprehensive literature review.
  
  
  BACKGROUND
  While implemented in 2004, questions remain about the effects the ratios have had on patients.
  
  
  METHODS
  A comprehensive literature review was conducted.
  
  
  RESULTS
  Patient outcome results are mixed in the 8 identified studies, with 3 studies finding both positive and negative outcomes and 5 studies reporting no significant changes in patient outcomes.
  
  
  CONCLUSIONS
  Findings from this review suggest some improvements have resulted from the implementation of staffing ratios, but the positives have not been as significant and widespread as predicted. Further studies are needed to explore the relationship between patient outcomes and mandated staffing levels in this state and other settings.
authors.affiliation: Author Affiliation: Assistant Professor, Orvis School of Nursing, University of Nevada, Reno.
authors.forename: Teresa
authors.initials: T
authors.lastname: Serratt
mesh_terms: D002140:California; D006801:Humans; D009741:Nursing Staff, Hospital / Q000600:supply & distribution*; D017063:Outcome Assessment, Health Care; D061214:Patient Safety; D017060:Patient Satisfaction; D010561:Personnel Staffing and Scheduling / Q000706:statistics & numerical data*; D011787:Quality of Health Care