Nursing Education Challenges and Opportunities in Colorado
Explore the evolving landscape of nursing education in Colorado, highlighting key statistics, shortages, and the need for increased NP and PA supply. Learn about the impact of ACA, retirement trends, and the demand for primary care providers in rural areas.
Uploaded on | 0 Views
Download Presentation
Please find below an Image/Link to download the presentation.
The content on the website is provided AS IS for your information and personal use only. It may not be sold, licensed, or shared on other websites without obtaining consent from the author. If you encounter any issues during the download, it is possible that the publisher has removed the file from their server.
You are allowed to download the files provided on this website for personal or commercial use, subject to the condition that they are used lawfully. All files are the property of their respective owners.
The content on the website is provided AS IS for your information and personal use only. It may not be sold, licensed, or shared on other websites without obtaining consent from the author.
E N D
Presentation Transcript
Linda Flynn, PhD, RN, FAAN Associate Dean & Professor University of Colorado College of Nursing College of Nursing
Michael Yedidia, PhD Rutgers Center for State Health Policy Principal Investigator Project Director, Evaluating Innovations in Nursing Education College of Nursing
Increase of 16-34 million people insured (34 million by 2016) (Congressional Budget Office, 2012) By 2019 increase of 15-25 million primary care visits per year (Hofer, Abraham, & Moscovice, 2011) Shortage of approximately 12,000 41,000 primary care physicians by 2025 (AAMC) College of Nursing
According to HRSA 2012.NO. HRSA estimates that supply of NP will increase 30% by 2020 and PA supply will increase by 58% by 2020. The increase in NP and PA supply will reduce PCP shortage from 20,000 PCPs to 6,000 PCPs. College of Nursing
In Colorado.. State graduates 125 new NPs per year A total of 140 NPs retire each year .(CCNE). Supply not keeping up with demand from retirement NOT counting population growth nor impact of ACA. College of Nursing
Only 18% of NPs practice in rural areas (American Academy of Nurse Practitioners) Yet, 20-25% of residents live in rural areas An additional 4,000 primary care providers needed in rural areas (National Conference of State Legislators). College of Nursing
BLS estimates RN demand up 26% (1 million RN increase) by 2020. 1/3 of increase in RN demand will come from ACA (333,333 RNs). RNs needed in home health care will increase 55% between 2010-2020. RNs needed for Primary Care Practices / Medical Homes = more training / education. College of Nursing
Increase in NP demand expected, especially for rural areas. Demand for RNs will increase, particularly in outpatient settings and home health care. RNs increasingly need skills as care coordinators, case managers, patient educators, and chronic care specialists. Increased pressure on educational pipeline. College of Nursing
Total of 78,089 qualified applicants turned away in 2013. Total of 1,358 existing faculty positions unfilled in 2013; an additional 98 new positions needed. Faculty vacancy rates of over 8% nationwide. Wave of faculty retirements expected. College of Nursing
Inadequate doctoral-prepared pool and pipeline. Non-competitive salaries. Aging faculty workforce. Attrition of existing faculty for other than retirement (Fang & Bednash, 2014). College of Nursing
Practice Environment Resource Adequacy RN/MD Relationships Foundations for Quality Input Into Affairs Supportive Manager Facility Characteristics Nurse Outcomes Nurse Staffing Patient Outcomes Processes of Care Surveillance (Aiken, et al., 1998; 2001)
Nurse Burnout Aiken, Clarke, Sloane (2002); Aiken et al. (2008); Lang et al. (2012); Flynn, Thomas-Hawkins, Clarke, 2009 Van Bogaert et al. (2010). Job Satisfaction / Intent-to-Leave / Attrition Choi, Flynn, Aiken (2011); Flynn (2007); Flynn, Thomas-Hawkins, Clarke (2009); Van Bogaert, et al. (2010). Poor Patient Outcomes Kutney-Lee, et al. (2009); Flynn, et al., (2012); Flynn, Liang, Dickson, & Aiken, 2010; Jarrin, Flynn, Lake, Aiken (2014). College of Nursing
What are the modifiable aspects of work-life that are associated with burnout and intent-to-leave among nurse faculty? College of Nursing
Stratified random sample of full-time faculty. Sample proportionately representative of all US programs by prelicensure offered (BS, AD); urban/rural; research intensity. Total of 3,975 faculty invited to participate in survey; 78.5% response rate! Final Sample = 3,120 faculty from 269 schools of nursing. College of Nursing
Characteristic Age Within 5 years of retirement Female White Education Master s Doctorate Research Institution Rank Professor Associate Professor Assistant Professor Instructor Characteristic Mean (SD) 51.4 (9.38) Mean (SD) Percent Percent 15.8% 95% 88% 70.6% 19.7% 25% 16.7% 19.4% 30.8% 28.8% College of Nursing
76% taught in Pre-Licensure Program 24% taught in Graduate Programs 46.2% taught in schools offering ADN 53.8% taught in schools offering BSN or > 21.4% taught in schools in rural areas 28.6% were tenured 20.8% on tenure track 24.4% NOT on tenure track 26.2% school does not offer tenure College of Nursing
Burnout (Emotional Exhaustion) Maslach Burnout Inventory EE Subscale Intent-to-Leave Academic Nursing How likely to leave in next 5 years (4-point scale) Demographics Age, gender, race/ethnicity, highest degree Health Status College of Nursing
Institutional Characteristics Degree Programs Offered Research Intensity Urban/Rural Locale Job Characteristics Years in current institution Rank Tenure Status / Tenure Track/ Non-Tenure Track / Tenure Opportunity Teaching post-BSN students College of Nursing
Administrative Responsibilities Salary Range Certified APRN College of Nursing
Hours spent per week on. Didactic Teaching / Prep Clinical Teaching / Prep Committees / Meetings Advising / Mentoring Students All Work Activities Developed 1 Course / 1 Major Course Revision Developed 2 Courses/ 2 Major Course Revisions Converted 1 or more courses to online format Published 1 or more articles in p-r journal Prepared 1 or more grant proposals College of Nursing
Conditions of Work Workload Salary Benefits Job Security Resource Availability Content of Work Flexibility to balance work/family Autonomy/Independence Relationship with Adm Relationships with Students Relationships with Colleagues Meaningfulness of Work Rewards for Innovations Visibility in Job College of Nursing
Mean hours worked = 48.3 hrs / week. 34.2% Major revision of 2 or more courses 19.8% Published 1 or more p-r articles 28.3% Submitted 1 or more grants 67.7% >61 plan to retire in 5 years 85% Very Somewhat Satisfied with their College of Nursing work
39% High Levels of Burnout! Higher than staff nurses in hospitals and nursing homes! 20% Younger faculty intended to leave Academic Nursing within 5 years 31% 51-60 yrs old intended to leave Academic Nursing within 5 years College of Nursing
Predictor Within 5 years of retirement age Highest Degree BSN Highest Degree Master s On Tenure Track but not Tenured Not on Tenure Track High Burnout (EE) Dissatisfied with Workload Dissatisfaction w/Teaching Support Dissatisfaction with Salary Dissatisfaction with Reward for Innovation Predictor OR 6.41 2.70 1.91 1.50 1.49 1.27 1.26 1.19 1.18 1.16 OR CI (4.77,8.62) (1.58,4.62) (1.42,2.56) (1.08,2.08) (1.02,2.16) (1.00,1.61) (1.08,1.47) (1.01,1.40) (1.02,1.35) (1.04,1.29) CI p p <.001 <.001 <.001 <.05 <.05 <.05 <.01 <.05 <.05 <.01 College of Nursing
Predictor Dissatisfaction with Workload >50% Administrative Role Dissatisfaction with Flexibility to Balance Work and Family Life Poor Health Dissatisfaction with Meaningfulness of Work Dissatisfaction with Direction of Department / School Hours Worked per Week* Race / Ethnicity Non-White *Increase from 40 hrs 50 hours of work per week associated with 22% higher odds of burnout. Predictor OR 1.82 1.73 1.58 OR CI (1.55,2.13) (1.32,2.27) (1.37,1.82) CI p p <.001 <.01 <.001 1.46 1.36 (1.28,1.67) (1.14,1.63) <.001 <.01 1.27 (1.09,1.48) <.01 1.02 0.68 (1.10,1.03) (0.49,0.93) <.001 <.05 College of Nursing
Constellation of Work-Life factors equal to retirement age in predicting intent-to-leave academic nursing! Burnout Workload / Hours per week worked Lack of flexibility to balance work / family life Dissatisfaction with Workload Dissatisfaction with Salary / Reward for Innovation Dissatisfaction with Teaching Support College of Nursing
Monitor faculty workload / perceptions Implement strategies to increase flexibility of schedules Implement strategies to increase teaching support College of Nursing
Explore needs of APRN faculty Explore needs of Non-Tenure Track Faculty Explore needs of Academic Leaders
Planning grant funded by RWJF Schools invited to join as Members Annual Faculty / Student Survey (electronic) for Member Schools / Outcome Driven Large Database of De-identified Data / Schools own their data Benchmarking Capabilities www. NNERN.org (Under Construction) College of Nursing
