Overview of APRN’s in Georgia

Dr. Lisa Wright EichelbergerCo-Lead, GNLC

Dean, College of HealthClayton State University

September 21st, 2015

The Data

Health Status of GA

Health Status in Georgia• Overall Rank of 38th

• No Change in Rank: America’s Health Rankings 2014– United Health Foundation

• Strengths– Low prevalence of binge drinking– Low occupational fatalities– Infant mortality decreased 48% since

1990– Low rate of drug deaths

Challenges in Georgia

• Rank 48th in high school graduation• Ranks 46th in low birthweight/insurance

coverage• Rank 45th in availability of dentists• Rank 42nd in Air Pollution• Rank 39th in High BP• Rank 38th in CV deaths• Rank 37th in Diabetes• Rank 36th in Primary Care Physicians• Rank 33rd in obesity rate

Leading Causes of Death*, Georgia Number of Deaths 2007-2011

Septicemia

Flu/Pneumonia

Kidney Dx

Diabetes

Alzheimer's

CHronic Resp Dx

Cancers

Heart Disease

0 10,000 20,000 30,000 40,000 50,000 60,000 70,000 80,000

Series 1 Column1 Column2

Health of Georgians• Dealing with Multi-Factorial Issues• Air pollution, Public Health Funding,

Graduation Rates - all impacting health

• Focus on Primary Care – APRN practice

• Who delivers Primary Care?• What is it?

Definition of Primary Care• “The provision of integrated,

accessible health services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community.” IOM Committee on Future of Primary Care

• PCP = General, Family Medicine, Ped, Internal Med. Geriatrics, FNP, PA

PCP/Primary Care Doctors• Measured by the number of PCD per

100,000• Range from 200.8/100,000 in Massachusetts

to 80.1/100,000 in Idaho. National average is 123.5/100,000

• GA ranks 36th with 105.4/100,000• AAMC ranked GA 39th 2010 up from 40th

in 2008 – 6 counties without Family physicians,

• Work life not as long

Physician’s Assistants• In 2015, 91,921 PAs in US• In 2010, 27,700 PAs active in primary care • 1/3 PAs practice in primary care - projected

forward 8,000 in 2020 • 173 accredited PA programs in 2013• In GA, one public PA program, three private• GA is ranked 35th in number of PAs per 100,000• 49 counties do not have PA, 3/10 work in

Primary Care• 3,536 PAs in 2015 Kaiser Foundation

National Overview of APRN’s• CRNA’s graduates – grew from 1,159

to 2,447 2001 to 2011 • CNM graduates – decreased from 422

to 392 in 2001 to 2011• NP graduates – grew from 7,261 to

12,273 2001- 2011 • Nationally 174, 826 NP’s licensed

Overview of NP’s • Number of active NP’s (110,800) has doubled from

2002 to 2012 NSSRN 2010

• In 2014, there were more than 205,000 nurse practitioners (NPs) licensed in the U.S.

• 8,752 licensed NP’s in GA• Average age 49 yo• Half of NP’s (55,400) are in primary care in 2010.• AACN data indicates graduating more NP’s each year– 12,273 - 2011, 14,400 - 2012, 15,000 - 2013– ? Graduating in GA – Incomplete AACN data

Overview of APRN’s in GA as of Sept 21st 2015• CRNA - 1,863• CNM – 498• NP – 7,537• CNS/PMH – 271• CNS – 132• RN’s – 124, 508• Licensed Undergraduate Nurse – 5• Sos.ga.gov/cgi-bin/activelicenses.asp

AACN Georgia 2014 APRN Enrollments

• 3,593 studying to be APRN’s including

• 3,499 in Nurse Practitioner programs, • 79 in CRNA programs, • 11 in Clinical Nurse Specialists, and • 4 Certified Nurse-Midwife programs.

Settings GA APRN Employment17 CNMs CNSs CRNAs NPsHospital 173 617 980 1470Ambulatory Care 69 116 205 1289Public Health 8 64 3 154Occupational Health 0 17 1 58Insurance Claims/Benefits 2 26 2 22Nurs Home/Extended Care/Assisted Living

2 49 6 115

Home Health 9 66 6 124Academic Setting 33 71 14 234Correctional Facility 1 14 2 67School Health Service 2 15 1 56Other 68 155 45 923Community Health 16 45 1 304Policy/Planning/Regulatory Agency

0 3 0 3

Total 383 1,258 1,266 4,819 = 7,726

Race/Ethnicity of GA APRN’sCNSWhite – 65%Black – 26%Hispanic – 2%Asian – 5%Alaska Native/American Indian - <1%Native Hawaiian/Other Pacific Islander - <1%Other 3%

NPWhite - 76%Black – 18%Hispanic – 2%Asian – 3%Alaska Native/American Indian - <1%Native Hawaiian/Other Pacific Islander - <1%Other – 2%

CNM

White – 77%Black – 14%Hispanic – 2%Asian – 5%Alaska Native/American Indian <1%Native Hawaiian/Other Pacific Islander - 0Other – 3%

CRNAWhite – 83%Black – 12%Hispanic – 2%Asian – 3%Alaska Native/American Indian - <1%Native Hawaiian/Other Pacific Islander - <1%Other – 2%

Gender/Age of GA APRN’s• Gender – GA • CNM: Female - 98%, Male – 2%• CNS: Female – 91%, Male – 9%• CRNA: Female – 63%, Male. – 37%• NP: Female – 93%, Male – 7%• Total: Female – 88%, Male – 12% Nationally, 9% Male•  • Avg. Age - GA Avg. Age Nationally of all nurses • CNM: 47 Total: 47 • CNS: 52• CRNA: 47• NP: 46• Total: 47

Conclusion• Redesign of survey question• Type of NP practice• Continue to learn and refine process

Thank you!

References for Advocacy• Policy & Politics in Nursing and Health Care, 6th Edition• Diana J. Mason, RN, PhD, FAAN; Judith K. Leavitt, RN, MEd, FAAN; and

Mary W. Chaffee, RN, PhD, FAAN February 2011 • Approx. 848 pp., 90 illus. • ISBN: 978-1-4377-1416-6

•  • http://campaignforaction.org/sites/default/files/IOM%20Report%20Chap

ter%205%20Leadership.pdf Chapter 5, Transforming Leadership. The Future of Nursing: Leading Change, Advancing Health Copyright © National Academy of Sciences. 2010

•  • Abood, S. (January 31, 2007). "Influencing Health Care in the

Legislative Arena". OJIN: The Online Journal of Issues in Nursing. Vol. 12 No. 1, Manuscript 2.

• Tomajan, K., (January 31, 2012) "Advocating for Nurses and Nursing" OJIN: The Online Journal of Issues in Nursing Vol. 17, No. 1, Manuscript 4.

Settings GA APRN Employment17 CNMs CNSs CRNAs NPsHospital 173 617 27.2%Ambulatory Care Setting

18.0% 9.2% 16.2% 23.8%Public Health 2.1% 5.1% 0.2% 2.8%Occupational Health 0.0% 1.4% 0.1% 1.1%Insurance Claims/Benefits 0.5% 2.1% 0.2% 0.4%Nursing Home/Extended Care/Assisted Living Facility

0.5% 4.0% 0.5% 2.1%

Home Health 2.3% 5.2% 0.7% 2.3%Academic Setting 8.6% 5.6% 1.1% 4.3%Correctional Facility 0.2% 1.1% 0.2% 1.2%School Health Service 0.5% 1.2% 0.1% 1.0%Other 17.8% 1.2% 0.1% 17.1% Community Health 4.2% 3.6% 3.6% 5.6%Policy/Planning/Regulatory/Licensing Agency

0.0% 0.2% 0.1% 0.1%