1. CNO (Insert your name & organization here)
The IOM Recommendations & An Update on the Wisconsin Nursing Workforce The Need to Advance Education in Nursing
CNO (Insert your name & organization here)

2. WCN Mission
Assure an adequate, well-prepared and diverse nurse workforce to meet the needs of the people of Wisconsin

3. Data Driven Process Three surveys: RN, LPN, & Educational
Survey designs; based on National Minimum Dataset: Supply, Demand & Education from National Forum of State Nursing Workforce Centers
DSPS - Distribution of surveys
DWD – Data security & initial analysis
WCN – analyses by nursing researchers & dissemination with recommendations
Benchmark data from national reports (HRSA)

4. Trends impacting nursing workforce
Growing elderly populations
Increased diversity of population
Aging healthcare workforce
Faculty shortage & age
Potential impact of healthcare reform (ACA)
Economy

5. RN workforce per 100,000 population Source: The U. S
RN workforce per 100,000 population Source: The U.S. Nursing Workforce: Trends in Supply and Education (HRSA, 2013).

6. Wisconsin projected population growth 2000-2035
Table 1. Wisconsin Projected Population by Age Group,
Age
Group
Census 2000
Projected
2015
Projected 2035
Percent Change
0-17
1,368,756
1,349,090
1,448,200
5.8
18-64
3,292,406
3,739,160
3,720,200
13.0
18-24
520,629
553,530
577,800
11.0
25-44
1,581,724
1,547,380
1,570,350
-0.7
45-64
1,190,053
1,638,250
1,572,050
32.1
65 & over
702,553
900,170
1,485,570
111.5
65-84
606,928
764,710
1,263,020
108.1
85 & over
95,625
135,460
222,550
132.7
Source: Egan-Robertson, D., Harrier, D. & Wells, P. (2008).

7. 2012 Wisconsin RN Survey Findings
83.9% actively working as nurse in healthcare
3.1% working in healthcare non-nurse
1.8% working in another field
50,315 working in direct patient care (75% who answered the question)
5,664 Advanced Practice with Masters or higher
5.7% APRNs vs 8.7% nationally; lowest per population in the nation.
78,159 online and 3000 manual

8. Employment Status & Location
2012 RNs:
53.6% hospitals
17.3% ambulatory care
10.7 % nursing home/extended care
5.7% home health
Average age: 48
Average experience: 15 years
2013 LPNs:
10.7% hospitals
29.1 % ambulatory care
42.1% nursing home/extended care
6.8% home health
Average age: 50
Average experience: 20 years

9. Median RN age: 48 Average 15 years of experience
Median LPN age almost 50

10. RNs 55 & older by work setting

11. LPNs 55 & older by work setting

12. Gender in Wisconsin Nurses
Assembly of Men in Nursing Goal: 20% Men by 2020
Wisconsin Nurses by Gender
% Female
% Male
WI 2010 RN
93.2
6.8
WI 2012 RN
93.1
6.9
WI 2011 LPN
95.4
4.6
WI 2013 LPN
95.6
4.4
Source: WCN DWD Wisconsin Nurse Survey Summaries

13. Race/Ethnicity In Wisconsin Nurses Source: 2012 RN & 2011 WI LPN At-a-Glance
Caucasian
African American
Hispanic
Other
WI RN
93.5
2.0
1.4
3.0
WI LPN
91.0
6.3
1.9
3.8
WI Population
85.0
6.0
US Population
78.1
13.1
16.7
6.4

14. RN Plans to Leave Direct Patient Care

15. LPNs – Plan to Leave Direct Patient Care Source: 2013 Wisconsin LPN Survey

16. RN/LPN Intent to Leave
Within 9 years 59.5% LPN’s leave the workforce (Northern region-63.3%)
Next 2 years- 3,000 RN will leave
Next 4 years 9,622 holding DCP will leave (retirement, job stress, physical demands)
Within 5-9 years another 22.3% of RN DCP providers expressed intent to leave
Significant shortages projected at same time as physician shortages & other health professionals

17. New Graduate RN Pipeline
Approximately 3100 RN and 1000 LPN’s a year.

18. Add your hospital nursing data here

19. DWD Forecasting Tool Developed by economists
Projections include a variety of scenarios
Potential gap: % by 2035
Potential gap of 15-20, direct care nurses
Source: Walsh, T., Udalova, V. & Winters, D. (2011). Wisconsin Registered Nurse Supply and Demand Forecasting: Results Report Wisconsin Department of Workforce Development, Office of Economic Advisors. Retrieved from

20. Projections by Work Setting
2010 Wisconsin RNs and Projected Demand Change by Work Setting
2010 RNs
% Change
Nursing Home/Extended Care
7,291 88
Home Health
3,008 82
Inpatient
21,484 41
Emergency
3,068 16
Surgery
5,700 36
Ambulatory
8,939 30
Public Health
2,963 17
Other
8,664
Nurse Educators
1,844 38
Total
62,962
Source: 2010 OEA RN Forecasting Model

21. Closing the RN Gap
New Graduates needed annually to close the projected demand
2010 Observation
2,700
2015 Scenario Estimate
4,500
2020 Scenario Estimate
7,500
2025 Scenario Estimate
11,300
2030 Scenario Estimate
14,100
2035 Scenario Estimate
15,500
Source: DWD, OEA, 2010 RN Forecasting Model, Broad Nursing Workforce - Head Count

22. Goal 80% BSN by 2020

23. Add your hospital nursing data here

24. 2011 WI Education Survey Findings
79% response rate (43 programs)
20 ADN programs (70% return)
10 BSN (70%) ,13 graduate(100%) Online out-of-state programs not included
Preparing large numbers at undergrad & graduate level.
Barriers: limited clinical sites, insufficient resources, lack of funds to hire qualified faculty.
Faculty significantly older than nurses in general- expect increased retirements
Diversity-student demographics mirror population, ADN most diverse
Insufficient capacity in nursing in second degree programs resulted in 61% rejected
Once again, as with practicing nurses, we see impact of economy on nursing educators staying in the job market – for now. Takes time to prepare pipeline of future educators; “Degree a decade”. Need to streamline the process to get them prepared.

25. Wisconsin Challenges 53.4% BSN Approximately 30,000 ADNs to advance
Mean age for MSN completion is age 41; “degree a decade.”
67% RN’s had no immediate plans to return to school
0.6% Doctorates (includes PhDs & DNPs)
42.8% faculty are over age 55; average age 58
47.7% nurses plan to leave workforce in 10 years
Only 5% of nurses from underrepresented populations
APRNs are not completely independent

26. 2013 Strategic Workforce Report
The Wisconsin Nursing Workforce: Status & Recommendations
Landmark, historical report; framed w/ IOM report
Executive Summary & Full Report

27. Academic Progression - 80% BSN by 2020
Triple the number of ADNs returning to school for BSN or higher
Hiring practices & scheduling policies
Partnerships
Access in rural areas; innovative pilots
Remove barriers- funding, access & time
Dual track enrollment
Expansion of shared curriculum
Increase scholarships
Push-Pull models, flex programs
Outreach, support for under-represented groups
Cost and lost work time and larges issues identified in 2012 RN survey

28. Increase Doctoral Degrees
Increase faculty positions, mentorship programs
Recruit & increase diversity
Remove salary inequities to provide market compensation to recruit & retain
Enhance loan forgiveness programs

29. The WHY? Patient Safety & Outcomes Need for a more highly educated workforce
Research linking nursing education to Patient Outcomes
See AACN Fact sheet
Lower mortality rates, fewer adverse outcomes, decreases in readmissions
Every 10% increase in BSN decreases risk of death and failure to rescue by 5%- Aiken 2003
Support from IOM, Tri-Council, AONE, NLN, ACCA

30. Inquiries for your organization
Assessment of nursing workforce in your organization- age & education by unit?
Do you have a plan in place to get to 80% BSN or higher by Ongoing dashboard to measure?
Communication of issues to CEO, board, foundation, medical staff leadership?
Role of APRN’s
Scholarships in addition to tuition reimbursement?
School/Community partnerships
Enhanced residency programs
Innovations in redesign
Use of simulation
Enhancing interprofessional education & practice
Nursing presence on Board of Directors

31. Multi-prong approach Retention of the workforce w/ new models of care
Recruitment & successful transition of new nurses to double the pipeline-Expand residency programs
Recruitment and retention of faculty
Academic progression in partnership w/ employers & schools
Innovative partnerships w/adoption & spread of best practices

32. Websites Wisconsin Center for Nursing www.wicenterfornursing.org
Future of Nursing™ Campaign for Action