5-20: a model of minimum nurse-to-patient ratios in Victoria, Australia

J Nurs Manag. 2007 Jan;15(1):64-71. doi: 10.1111/j.1365-2934.2006.00657.x.


Aim: This study presents a critique of a new model of minimum nurse-to-patient ratio and considers its utility alongside established Patient Dependency Systems.

Background: Since 2001 legislation mandating minimum nurse-to-patient ratios has been enacted throughout large public hospitals in the state of Victoria, Australia. The Victorian model mandates minimum staffing of five nurses to 20 patients in acute medical and surgical wards. In conjunction with this approach, Patient Dependency Systems are employed to anticipate short-term resource needs.

Key issues: Although this legislation has been successful in attracting nurses back into the public sector workforce, no published empirical evidence exists to support specific ratios. In addition, neither ratio nor Patient Dependency Systems approaches account for the critical influence of skill mix on hospital, employee, or patient outcomes.

Conclusion: There is an urgent need for further research that specifically examines relationships between models of staffing, skill mix and quality outcomes.

Publication types

  • Review

MeSH terms

  • Activities of Daily Living
  • Acute Disease / nursing
  • Clinical Competence
  • Cost Savings
  • Diagnosis-Related Groups
  • Evidence-Based Medicine
  • Guidelines as Topic
  • Health Services Needs and Demand
  • Health Services Research
  • Hospitals, Public / organization & administration
  • Humans
  • Models, Nursing*
  • National Health Programs / organization & administration
  • Nursing Administration Research
  • Nursing Staff, Hospital / organization & administration*
  • Outcome Assessment, Health Care
  • Personnel Staffing and Scheduling / organization & administration*
  • Quality of Health Care / organization & administration
  • Quality of Life
  • Severity of Illness Index
  • Victoria
  • Workload* / legislation & jurisprudence
  • Workload* / statistics & numerical data