The IOM Recommendations & An Update on the Wisconsin Nursing Workforce
The Need to Advance Education in Nursing
CNO (Insert your name & organization here)
WCN Mission
•Assure an adequate, well-prepared and diverse nurse workforce to meet the needs of the people of Wisconsin
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)
Trends impacting nursing workforce
• Growing elderly populations • Increased diversity of population • Aging healthcare workforce• Faculty shortage & age• Potential impact of healthcare
reform (ACA)• Economy
RN workforce per 100,000 population Source: The U.S. Nursing Workforce: Trends in Supply and Education (HRSA, 2013).
Table 1. Wisconsin Projected Population by Age Group, 2000-2035
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 13.018-24 520,629 553,530 577,800 11.025-44 1,581,724 1,547,380 1,570,350 -0.745-64 1,190,053 1,638,250 1,572,050 32.165 & over 702,553 900,170 1,485,570 111.565-84 606,928 764,710 1,263,020 108.185 & over 95,625 135,460 222,550 132.7
Source: Egan-Robertson, D., Harrier, D. & Wells, P. (2008).
Wisconsin projected population growth 2000-2035
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.
Employment Status & Location2012 RNs: • 53.6% hospitals• 17.3% ambulatory care• 10.7 % nursing home/extended care• 5.7% home health• Average age: 48 • Average experience: 15 years2013 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
Median RN age: 48Average 15 years of experience
RNs 55 & older by work setting
LPNs 55 & older by work setting
Gender in Wisconsin NursesAssembly 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 2010-2012-2013 Wisconsin Nurse Survey Summaries
Race/Ethnicity In Wisconsin NursesSource: 2012 RN & 2011 WI LPN At-a-Glance
Caucasian African American Hispanic Other
WI RN 93.5 2.0 1.4 3.0WI LPN 91.0 6.3 1.9 3.8WI Population 85.0 6.0 6.0 3.0
US Population 78.1 13.1 16.7 6.4
RN Plans to Leave Direct Patient Care
LPNs – Plan to Leave Direct Patient CareSource: 2013 Wisconsin LPN Survey
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
New Graduate RN Pipeline
Add your hospital nursing data here
DWD Forecasting Tool• Developed by economists• Projections include a variety of scenarios • Potential gap: 34- 36% by 2035• Potential gap of 15-20,000
direct care nurses
Source: Walsh, T., Udalova, V. & Winters, D. (2011). Wisconsin Registered Nurse Supply and Demand Forecasting: Results Report 2010-2035. Wisconsin Department of Workforce Development, Office of Economic Advisors. Retrieved from http://worknet.wisconsin.gov/worknet_info/projects/rn_forecasting/results_report_printer_friendly.pdf
Projections by Work Setting 2010 Wisconsin RNs and Projected Demand Change by Work Setting
2010 RNs % Change 2010-2035
Nursing Home/Extended Care
7,291 88
Home Health 3,008 82Inpatient 21,484 41Emergency 3,068 16Surgery 5,700 36Ambulatory 8,939 30Public Health 2,963 17Other 8,664 17Nurse Educators 1,844 38Total 62,962 41Source: 2010 OEA RN Forecasting Model
Closing the RN Gap
New Graduates needed annually to close the projected demand
2010 Observation 2,7002015 Scenario Estimate 4,5002020 Scenario Estimate 7,5002025 Scenario Estimate 11,3002030 Scenario Estimate 14,1002035 Scenario Estimate 15,500
Source: DWD, OEA, 2010 RN Forecasting Model, Broad Nursing Workforce - Head Count
Goal 80% BSN by 2020
Add your hospital nursing data here
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
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
2013 Strategic Workforce Report• The Wisconsin Nursing Workforce: Status &
Recommendations• Landmark, historical report; framed w/ IOM report• Executive Summary & Full Report• http://
www.wisconsincenterfornursing.org/workforce_report.html
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
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
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
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
2020. 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
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
Websites
•Wisconsin Center for Nursingwww.wicenterfornursing.org
• Future of Nursing™ Campaign for Actionwww.campaignforaction.org