Alice F' Kuehn, Ph'D'

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Office of Missouri Nursing Workforce Analysis
O M N W A

• Alice F. Kuehn, Ph.D.
• Executive Director/Associate Professor, Emeritus
• Sinclair School of Nursing
• University of Missouri Columbia
• Presented to the Missouri Nursing Coalition
• March 11, 2003

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So What Exactly Is the Office of Missouri
Nursing Workforce Analysis (OMNWA)?
OMNWA
DATABASECENTER
PRACTICE/EDUCATION RESEARCH CENTER
MoNF
Vision Create Nursing as Community Create a
community of nurses who appropriately educate and
manage a nursing workforce to serve the health
care needs of Missouris population within an
ever expanding environment . It will emerge as we
transition from a set of multiple isolated roles
into a world community of providers and those we
serve. Initially funded by the RWJF-CIC grant
1996-2002
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So What Exactly Is the OMNWA Missouri Nursing
Forum (MoNF)?
OMNWA
DATABASECENTER
PRACTICE/EDUCATION RESEARCH CENTER
MoNF
Mission StatementProvides a forum to discuss
education, preparation and management of the
Missouri nursing workforce leading to quality and
cost-effective health care for Missouris
citizens.
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So What Exactly Does the OMNWA Missouri Nursing
Forum Do?
OMNWA
DATABASECENTER
PRACTICE/EDUCATION RESEARCH CENTER
MoNF

• The Mission of MoNF is accomplished through
• VIRTUAL CONSORTIUM using web site-monitored by
  stakeholders in the trenches.
• PARTNERSHIPS with existing organizations (AHEC,
  MONA) to facilitate meetings and conferences.

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So What Exactly Does the OMNWA Missouri Nursing
Forum Do?
OMNWA
DATABASECENTER
PRACTICE/EDUCATION RESEARCH CENTER
MoNF

• The Mission of MoNF is accomplished through
• LEADERSHIP using existing stakeholders in each
  designated AHEC region.
• CONTENT DRIVEN BY CURRENT TOPICS affecting
  nurses serving the population
• MoNF serves as a statewide advisory resource to
  assist OMNWA in database and research missions.

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So What Exactly Is the OMNWA Database Center?
OMNWA
DATABASECENTER
PRACTICE/EDUCATION RESEARCH CENTER
MoNF

• Mission of the Database Center
• Provide Missourians with information on the
  status of the nursing workforce providing health
  care for rural Missouri.

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So What Exactly Is the OMNWA Database Center?
OMNWA
DATABASECENTER
PRACTICE/EDUCATION RESEARCH CENTER
MoNF

• The Database Center will provide
• DATA TABLES created from existing databases and
  OMNWA generated research
• DATA ANALYSIS provided by expert faculty and
  staff
• GENERATED REPORTS available on the web site
• WORKFORCE FORECAST REPORTS available on the web
  site

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Missouri Database Center Development/Support
Technical Advisory Committee on the Quality of
Patient Care and Nursing Practices
(MoDHSS) Missouri Nursing Coalition Missouri
Rural Nursing Consortium (ruralnursing.org) Rober
t Wood Johnson Colleagues in Caring
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Examples of Database Sources

• Providers by setting
• Hospital (hospital profiles)
• Nursing home (nursing home profiles)
• Home health (secondary data Primary surveys)
• School nurses (primary survey)
• Public health nurses (primary survey)
• Enrollment/graduation rates/pass-fail rates
  (state board Primary surveys)
• Providers by licensure
• Licensure supply (DHSS)

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Database Center Activities

• Collect supply/demand/needs and trend data from
  multiple state and national sources for
  assessment and analysis.
• Data drawn from both practice and education
  resources.
• Conduct primary data surveys when no secondary
  database exist.
• Use data to provide public, professionals, and
  policy makers with strategic planning and/or
  policy decision making.

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Fast Facts - USA

• There are 126,000 nursing positions currently
  unfilled in hospitals across America.
• 56 of hospitals report they are using agency or
  traveling nurses at great expense to fill these
  vacancies.
• 90 of LTC organizations lack sufficient nurse
  staff to provide even the most basic of care.

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Fast Facts - USA

• There are roughly 21,000 fewer nursing students
  today than in 1995.
• One study found that in 1999, 5 of female
  college freshman and less than .05 of men
  identified nursing as being among their top
  career choice.
• Nursing schools turned away 5,000 qualified
  baccalaureate program applicants in 2001 because
  of faculty shortages.

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Fast Facts - Missouri

• There are currently 57,912 registered nurses
  actively working in MO. This number includes
  1,007 newly licensed nurses. (Database includes
  APNs, RNs, LPNs by county within Missouri).
• Current graduating LPN students represent 49.11
  of the starting class while RNs across the
  educational venues represent 46.33 of the
  starting numbers.

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Fast Facts - Missouri

• MONA salary data for 2000. Average full-time
  salary for RNs was 46,740 with an average of
  14.2 years of experience.
• The average age of an RN in the state of MO is
  44.7 years of age and the average LPN age is
  46.9.
• 51 of all RNs and 58 of all LPNs are over the
  age of 45.

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Missouri Nursing Summit April 2001 Office of
Missouri Nursing Workforce Analysis
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Missouri Nursing Coalition March 2003 Office of
Missouri Nursing Workforce Analysis
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Missouri Nursing Coalition March 2003 Office of
Missouri Nursing Workforce Analysis
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So What Exactly Is the ONMWA Practice /Education
Research Center ?
OMNWA
MoNF
DATABASECENTER
PRACTICE/EDUCATION RESEARCH CENTER
Mission of the Practice/Education Research
Center To create a model of nursing role
clarity for education and practice.
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So What Exactly Is the ONMWA Practice /Education
Research Center ?
OMNWA
MoNF
DATABASECENTER
PRACTICE/EDUCATION RESEARCH CENTER

• The mission of the practice/education research
  center is accomplished by
• Concept analyses of differentiated practice and
  role clarity
• Support/facilitate implementation of the concept
  of role clarity in hospital, long term care and
  public health settings.
• Support educational institutions in efforts to
  appropriately prepare nurses at all levels to
  interact with each other and to serve a dynamic
  population

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Current Model of Nurse Staffing Based on Role
TRENDS
NEEDS
Nurse Role
Nurse Role
APRIL 1999
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The Role Clarity Model
Role clarity is a conceptual model of nursing
practice and education that delineates scope of
responsibilities and accountability for actions
based on expected competencies of nurses.
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The Role Clarity Model
The theoretical framework of the model is
trimodalNursing theory, role theory, and the
concept of community Nursing theories offer a
beginning articulation of what nursing is and
what roles nurses play(Afaf Meleis, 1991)
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The Role Clarity Model
Role-the part one plays. The expected and
actual behaviors associated with a given position
within a given situation or context. The actions
of the individual cannot ever be truly
independent but are interconnected with the
actions of others and framed within the structure
of the organization.
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The Role Clarity Model
Role Identity-the interpretation of role
expectations by the individual assuming the given
role. Role redefinition and realignment are
ongoing processes related to expanding knowledge
and increasing consumer demands for access to
care.
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The Role Clarity Model
Community is not only a place but a powerful
social resourceof networks, relationships and
shared sense of purpose and responsibility.
Communities must be created and maintained
through focused human effort. (Hobbs, 1996
Koerner, 1996)
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A Nursing Forecast Model Pivoted upon Clarity
of Nurse Role using Differentiated Practice
TRENDS
NEEDS
Nurse Role
APRIL 1999
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Practice/Education Research Center Grant Support
Fund for the Improvement of Post-Secondary
Education (FIPSE) ADN/BSN/MSN students become
acquainted with each others roles in a teamwork
approach to education and practice FIPSE North
American Mobility Students and faculty explore
nurse role clarity and collaboration across the
borders of Canada, Mexico, and USA. HRSA Nursing
Education and Practice Improvement Act of 1998
Supports career mobility and leadership
development for the expanding role of public
health nurses. Studies the impact of education
upon the public health work environment.
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Practice/Education Research Accomplishments

• DIFFERENTIATED PRACTICE CONCEPT ANALYSIS
  developed by Dr. Louise Miller/Dr. Alice Kuehn
• FITZGIBBON HOSPITAL - Best Practices Model for
  DP, initiated development in 1997 currently
  developing model for LTC working on Magnet
  Status.
• PUBLIC HEALTH/SCHOOL NURSES- Enhancing education
  and resources to prepare them to assume new roles
  in population-based nursing.
• WEB SITE DEVELOPMENT Nursingfutures.org assisting
  nurses with updates, education, and discussion
  forums.

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So What Is the Future of OMNWA?

• Proposals
• National Library of Medicine (NLM) community
  nursing utilizing information in practice.
  (Submitted January,2003 Notification October,
  2003).
• CDC letter of intent environmental health
  conference(submitted February, 2003 Notification
  may, 2003)
• National Science Foundation an innovative
  nursing workforce stability model(to be submitted
  April, 2003 Notification October, 2003)

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So What Is the Future of OMNWA?

• Continue MoNF development
• Continue database center development
• Continue practice/research center
  development
• Facilitate development of role clarity/differentia
  ted practice and education.
• Facilitate hospitals, LTC settings to achieve
  magnet status
• Evolve to
• Missouri Center for Nursing Excellence (MoCNE)

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Office of Missouri Nursing Workforce Analysis
MoNF
DATABASECENTER
PRACTICE/EDUCATION RESEARCH CENTER
Missouri Center for Nursing Excellence
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The Phenomenon of Nursing Is One of an Ever
Increasing Complexity Within an Ever Expanding
Environment . (Kuehn, 2000 Koerner, Parpiuk,
1994)
Missouri Center for Nursing Excellence
NURSINGS FUTURE IS OURS TO SHAPE