210 Pittsboro Street
Campus Box 6210
Chapel Hill, NC 27599-6210

T 919-962-2091
F 919-962-2279

Research brief

For immediate use

Jan. 17, 2007

Researchers study impact of laws
requiring minimum nurse staffing

The UNC School of Nursing will lead a team investigating the impact of California's minimum nurse staffing law on nurse-to-patient ratios, hospital financial performance, quality of care and nurse wages.

The $1.2 million study is funded by a grant from the Agency for Healthcare Research and Quality to Dr. Barbara Mark, Sarah Frances Russell distinguished professor of nursing systems at UNC-Chapel Hill and the study's lead investigator.

Mark's team will examine whether the law was effective in increasing the nurse staffing in California hospitals and whether fewer patients died or suffered complications after the legislation was implemented. Because nurse wages may have increased in response to the legislation - affecting hospital cost and profit margins - the team will also study whether hospitals reacted to the changes by reducing the amount of care provided to patients who are unable to pay, and lowering the number of student nurses and physicians in training.

"Nurses make important contributions to ensuring hospital patients receive high quality care, but it is not clear whether legislating minimum levels of nurse staffing, as has been done in California, will really assure the best care for patients," Mark said.

In 2005, 19 states introduced nurse staffing legislation and nine states passed some kind of staffing measure according to the American Nurses Association. However, California remains the only state to have implemented minimum staffing legislation. Federal legislation was introduced, but not acted upon.

Mark's co-investigators include Drs. George Pink and Kristin Reiter from the UNC School of Public Health's department of health policy and administration; Dr. David Harless, of the department of economics at Virginia Commonwealth University; Dr. Joanne Spetz, at the University of California at San Francisco; and Dr. Wallace Berman, in the department of pediatrics at Duke University.

- 30 -

Note: Dr. Barbara Mark can be reached at

School of Nursing contact: Amanda P. Meyers, (919) 966-4619,