11 Safe Staffing Ratios
Ratios 101
AB 394 — the California Nurses Association (CNA)-sponsored safe staffing law — has multiple provisions
designed to remedy unsafe staffing in acute-care facilities. California's safe staffing standards are based
on individual patient acuity, of which the RN ratio is the minimum.
NNU FIGHTS FOR SAFE STAFFING RATIOS WITH THE FOLLOWING ELEMENTS:
Mandates Minimum, Specific Numerical Ratios
Establishes minimum, specific numerical
nurse to patient ratios for acute-care, acute
psychiatric, and specialty hospitals.
Requires a Patient Classification System that
Provides for Additional RNs Based on
Individualized Patient Need
RNs must be added to the minimum ratio based
upon a documented patient classification sys-
tem that measures patient needs and nursing
care, including severity of illness, complexity of
clinical judgment, and the need for specialized
technology.
Regulates Use of Unlicensed Staff
Hospitals may not assign unlicensed assistive
personnel to perform nursing functions in lieu of
an RN and may not allow unlicensed personnel
under the direct supervision of an RN to perform
functions that require a substantial amount of sci-
entific knowledge and technical skills.
Restricts Unsafe "Floating" of Nursing Staff
Requires orientation and demonstrated current
competence before assigning a nurse to a clinical
area. Temporary personnel must receive the same
orientation and competency determination as
permanent staff.
