Staffing Standards for Patient Care

This position statement was updated on 11/7/2012.


  • Stratification of patients, including determination of the average and outliers in a patient population, is important for determining appropriate patient location, provider skill mix, and other resources required for appropriate patient care.
  • The health care community is responsible for the provision of adequate staffing resources to support the provision of high quality patient care.
  • Patient care assignments should be made based on the medical-surgical nurse's ability to meet needs of individual patients rather than predetermined or fixedpatient-to-nurse ratios.
  • Medical-surgical nurses should be involved in ongoing research and open discussions concerning staffing principles as a practice issue.


Hospital nurse staffing is a major concern because of its impact on patient safety and quality of care. According to research funded by the Agency for Healthcare Research and Quality (AHRQ, 2004) and others, hospitals with low nurse staffing levels are likely to have higher rates of nursing-sensitive, negative patient outcomes, including pneumonia, shock, cardiac arrest, and urinary tract infections. Providing a safe environment for both the patient and nurse is a paramount concern. The patient should receive resources according to need, and the medical-surgical nurse must be able to provide the resources based on his or her licensure, education, and role. An immediate demand for staffing guidelines comes not only from the nursing profession, but also from consumers and policy makers seeking parameters for safe, quality patient care.

The Nurse Staffing Standards for Patient Safety and Quality Care Act of 2009 (H.R. 2273) was introduced in the U.S. House of Representatives in May 2009 and referred to committee. The bill seeks to amend the Public Health Service Act to "require hospitals to implement staffing plans that meet specified ratios for direct care registered nurse-to-patient staffing levels for each unit" (, 2009, ¶ 2).


AMSN supports provision of the highest quality patient care through appropriate use of health care resources.


Agency for Healthcare Research and Quality. (2004). Hospital nurse staffing and quality of care. Retrieved October 12, 2009, from (2009). H.R. 2273: Nurse Staffing Standards for Patient Safety and Quality Care Act of 2009. Retrieved October 12, 2009, from