Gordon, S., Buchanan, J., & Bretherton, T. (2008). Safety in Numbers: Nurse-to-Patient Ratios and the Future of Health Care (pp. 1-2). Ithaca, NY: Cornell University Press.
This book is a comprehensive look at mandatory legislated ratios and how effective they are in the localities where they have been enacted. It takes into account the pro-ratio arguments, the anti-ratio arguments, discusses the events leading up to the enactment of this legislation, and discusses the results and the research used in evaluating ratio legislation. The strengths of this source are that it’s comprehensive and credible source (it was published by an academic publisher). One of the weaknesses of this source is that the book is very long, and some of the subtopics are not as well indexed as I would have liked.
Hodge, M. B., Romano, P. S., Harvey, D., Samuels, S. J., Olson, V. A., Sauve, M., & Kravitz, R. K. (2004). Licensed Caregiver Characteristics and Staffing in California Acute Care Hospital Units [Electronic version]. The Journal of Nursing Administration, 34(3), 125-133.
This article is a comprehensive look at staffing on hospital units. It used a survey to look at characteristics of how the units were staffed – not just ratio, but the experience and education level of the nurses. It evaluated several different categories of hospital facilities – public versus private, academic medical centers versus HMO-affiliated medical centers, and city versus rural. It is a good source because it shows what some of the staffing levels were before the status quo of the ratio legislation passed in California. It’s main limitation as a source is that it doesn’t supply any information about patient outcomes.
DeVandry, S., & Cooper, J. (2009). Mandating Nursing Staffing in Pennsylvania: More than a Numbers Game [Electronic version]. The Journal of Nursing Administration, 39(11), 470-478.
This article is one I plan to use as an opposing viewpoint. It was written after the California ratio legislation went into effect, and it attempts to argue that legislated ratios don’t allow enough flexibility to adjust to changes in patient acuity. It advocates for a system enacted in Pennsylvania, which relies on committees to decide staffing levels. The committees have to include at least 50 percent practicing nurses. The strengths of this source are that it is very detailed in discussing the alternatives it is advocating for, and presents convincing arguments. However, the weakness is that it doesn’t have any further info evaluating how effective this system is when compared to mandatory ratio legislation – when looking at patient outcomes.
Hugonnet, S., Chevrolet, J., & Pittet, D. (2007). The Effect of Workload on Infection Risk in Critically Ill Patients [Electronic version]. Critical Care Medicine, 35(1), 76-81.
This article establishes that there are many differences in patient outcomes based on nurse-patient ratio in ICUs, looking at infection control in...