HAWAII STATE Center for Nursing

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HAWAII STATE
Center for Nursing
Hawaii State Rural Health Association 10th
Annual Conference October 26, 2007
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Legislative Mandate

• The Hawaii State Center for Nursing was
  established by the Hawaii
• State Legislature in 2003 to
• address nursing workforce issues
• ACT 198, HB 422

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Mission

• To assure that the State of Hawaii
• has the nursing resources necessary
• to meet the health care needs
• of its people.

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ACT 198, HB 422

• Structure
• Governor appointed Advisory Board
• Revenue from new and renewing RN licenses
• Functions
• Collect and analyze data regarding the current
  and future status and trends of the nursing
  workforce
• Develop a plan for recruitment and retention of
  nurses
• Conduct research on best practices and quality
  outcomes

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Nursing Workforce National Data

• Nurses are the largest number of health care
  providers (2.6 million nationwide)
• The majority of the current RN workforce is
  comprised of women born during the baby boom
  generation (between 1946 and 1960)
• Despite the recent increase in the RN workforce,
  the profession is not expected to replace all the
  RNs who will be retiring from the workforce over
  the next decade
• The resulting gap between demand and supply will
  grow to an estimated 340,000 RNs by 2020
• Shortage estimated to be three times larger than
  any shortage ever experienced in the US
• Source Auerbach, Buerhaus, Staiger Better
  Late than Never Implications of Later Entry
  into the Profession for the Future supply of
  Nurses, Health Affairs, January/February 2007

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RN SUPPLY SURVEY 2007RNs Registered with BON
compared to Respondents to RN Workforce Survey
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Nursing Workforce Hawaii Data

• In Hawaii there are 18,075 licensed registered
  nurses (2007)
• Nursing workforce is agingmean age of RNs living
  in Hawaii is 45.8 years
• 89 female and l0 male
• 88 working in a position requiring RN license or
  knowledge
• Nearly 61 of the nursing workforce is expected
  to retire by 2020

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Hawaii County
US Census Bureau, 2006
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Maui County
US Census Bureau, 2006
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Kaua'i County
US Census Bureau, 2006
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HONOLULU CITY COUNTY
US Census Bureau, 2006
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Ethnicity by Island
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Vets, Boomers, GenXM by Island
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RN Cohort by Island
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Nursing Workforce Demand

• Hawaiis population is aging faster than the
  rest of the countrybetween 2000 and 2020, the
  number of people age 60 and older will increase
  by almost 75
• Health care needs increase for older population
  and are more complex
• Baby boomers are expected to spend more on health
  care as they age

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Nursing Workforce Projections

• Projected shortfall of RNs in Hawaii
• 960 in 2006
• 2,220 in 2015
• 2,670 in 2020
• Between 2006 and 2020, demand the RNs is expected
  to grow by 28, while supply of RNs is expected
  to grow by 8.9

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Nursing Education

• Nursing faculty are aging
• Of full time faculty in Hawaii nursing programs,
  69 are 50 years or older
• 66 of all faculty are 50 years or older
• Resources
• 63 of programs report lack full time faculty
• Lack of capacity in public nursing programs
  faculty positions, infrastructure, facilities and
  technology
• Shortage of clinical sites is becoming a bigger
  challenge

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Nursing Education

• Increased interest in nursing as a career with
  applicant pools growing
• NLN reported increase in admissions of 20.6 in
  2005
• The Hawaii State Legislature has approved
  funding for increased educational capacity in
  public nursing programs during the past three
  years
• Highly qualified applicants are continuing to be
  turned away
• UH Schools of Nursing turned away 243 qualified
  applicants in Fall, 2003 and 542 in Fall, 2006
• The shortage of nursing faculty is becoming a
  critical component in addressing the nursing
  shortage
• Shrinking percentage of RNs in the pipeline for
  graduate degrees
• Lack of interest in faculty positions
• Increased diversity of opportunity for PhD
  prepared nurses
• Noncompetitive faculty salaries

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Growth in Capacity to Address Shortage
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Important Trends

• Short term surge in the nursing workforce
• Two-thirds are 50 years of age or older
• Focus on retention and the work environment
• Workforce conditions have improvedlong term
  commitment needed
• Generational factors strategies to retain the
  older nurse
• Shift to community based care
• Increase by 15 since 1983 in number of RNs
  working in non-hospital settings (Peter
  Buerhaus, Vanderbilt University)
• Need for nursing care delivery models for
  continuum of care for the elderly
• Use of data and evidence to improve practice and
  patient safety

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Important Trends

• Use of advanced practice nurses
• Independent roles within community based care
• Importance of adequate staffing and baccalaureate
  preparation
• Evidence of impact on patient outcomes in acute
  care (Linda Aiken, University of Pennsylvania)
• Need for leadership development at all levels
• Enhancement in the functioning of
  interdisciplinary teams
• Communication as essential to patient safety

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What Do We Need to Do?

• Develop innovative approaches in education
• Educational pathways
• Undergraduate to Masters
• Accelerated programs
• Distance learning, on-line programs
• Redesign curriculums to encourage BSN preparation
• Oregon model , UH Consortium,
• Maximize use of technology
• Simulation
• Distance learning
• Interdisciplinary approaches
• Address faculty shortage
• Encourage nurses to obtain advanced degrees
  earlier in their careers
• Address disparity in salaries
• Increase educational capacity

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What Do We Need to Do?

• Increase ethnic and gender diversity in the
  nursing workforce
• Increase efforts to retain nurses
• New graduate residency/transition programs
• Innovative approaches for the older nurse
• Provide opportunities for professional
  development including leadership training
• Continue to improve the work environment
• Magnet Hospital initiatives
• Ensure adequate staffing
• Increase partnerships and opportunities for
  collaboration

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Current Strategies to Address the Shortage

• Provide ongoing workforce data to inform policy
  and resource allocation
• Supply survey with Board of Nursing completed
  June, 07
• Annual survey of educational capacity
• Demand survey ongoing
• Partner with HMSA Foundation to address
  recruitment and retention in long term care ( PIN
  Project as funded by RWJ Foundation)
• Conduct leadership training programs for staff
  nurses
• Developing a new graduate RN residency program
• Conduct research to develop strategies and best
  practices
• RN turnover survey on generational differences

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Role of the Hawaii State Center for Nursing

• HSCFN is positioned to be a catalyst for change
• HSCFN can bring diverse organizations, agencies
  and stakeholders together to collaborate and to
  coordinate workforce initiatives
• Accurate and reliable data will ensure that
  efforts and resources are appropriately focused
  to make a difference

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Role of the Hawaii State Center for Nursing

• Innovations in education and practice will ensure
  that the educational capacity of our Schools of
  Nursing is increased
• Focused recruitment will ensure that we have a
  diverse nursing workforce to care for Hawaiis
  people
• Best practices in retention will result in higher
  job satisfaction, lower turnover and greater
  diversity in career pathways

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WE ALL BENEFITJOIN IN!GET INVOLVED!

• Hawaii State Center for Nursing

• Executive Director Barbara Mathews, MS, APRN,
  CNAA
• Associate Director, Research Sandra LeVasseur,
  PhD, RN, MS
• Nurse Researcher Debra Mark, PhD, RN
• Administrative Assistant Meredith Donnelly, BA
• Office Webster Hall 432, University of Hawaii
  at Manoa
• School of Nursing Dental Hygiene
• Phone [phone]
• Fax [phone]
• Email hscfn_at_hawaii.edu
• Website http//www.hinursing.org