Hospitals in England should be wary about having nurses care for more than eight patients each on wards during the day, draft NHS guidance suggests.
The National Institute for Health and Care Excellence (NICE) says there is more risk of harm if there is a lower ratio of nurses to patients.
But it stopped short of stipulating one to eight was an absolute minimum, saying flexibility might be required.
The Department of Health said the number of front-line staff had risen.
NICE said while flexibility was needed, hospitals should be able to justify a situation where the recommended ratio of nurses to patients was breached.
It said this was because there could be cases where patients' illnesses and needs were less serious than normal, and, therefore, it would be wrong to set strict thresholds.
But the guidance recommends nurses raise the alarm - or a "red flag" - when care is being compromised, no matter what the ratio.
That could include situations where there are not enough staff to help patients use the toilet, monitor their vital signs or administer medication.
Safety checkNICE deputy chief executive Prof Gillian Leng said: "There is no floor or ceiling number on the required number of nursing staff that can be applied across the whole of the NHS."
She added decisions about the number of nursing staff should "allow flexibility on a day-to-day or shift-by-shift basis".
End QuoteRegardless of the careful wording, this threshold is bound to be interpreted as a line in the sand"
The guidance, which is now being consulted on before the final recommendations are made in the summer, applies to general acute wards.
Specialist areas such as maternity, paediatrics, and accident and emergency will get their own guidance at a later stage.
NICE was asked to look at the issue by ministers who promised to explore safe staffing levels following the public inquiry into the Stafford Hospital scandal.
Many hospitals have already started paying close attention to nurse numbers; for example, a number publicly display actual staffing levels on wards along with what they should be.
NHS England wants this to become routine across the health service, while later this year hospitals will have to submit their staffing levels each month so they can be displayed on the NHS Choices website.
'Sensible' guidanceRoyal College of Nursing general secretary Peter Carter said: "For any patient to receive substandard care is unacceptable.
"Nurses will be hoping that once the full set of guidelines is completed, the NHS will never again be so vulnerable to short-term financially-driven decisions about patient care."
A spokesman for the Foundation Trust Network, which represents hospitals, said the guidance was "sensible" and supported what many trusts were already doing.
"Local nursing and clinical teams are best placed to make the judgement on what is best for their patients," he added.
The guidance also applies to Wales, although it will now be up to ministers there whether it will be applied.
In Scotland, hospitals are already routinely monitoring and publishing staffing levels - although there are no recommended minimums.
Health Secretary Jeremy Hunt said: "NICE's work on staffing is a major step forward - for the first time in its history, the NHS will have the evidence it needs to make sure that nurses are able to spend enough time with their patients."
A Department of Health spokesman said the number of admin staff and managers in hospitals had been cut since 2010 but there were 5,100 more nurses working on wards.
"We have increased the NHS budget in real terms and are clear that hospitals must balance their books whilst ensuring compassionate, quality care for all. We know this can and is being done," he said.
What is your reaction to these guidelines? Do you work in the NHS? Send an email to haveyoursay@bbc.co.uk with 'nursing' in the subject line.
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