Archive: Spring 2006 | Fall 2007 | Winter 2007

Newsletter, January 2007 (download pdf file)

From the Executive Director

The Center, established in 2003 and operational since 2005, is fully staffed with an Executive Director, an Associate Director of Research and an Administrative Assistant. The work of the Center continues to be accomplished by workforce collaboratives, which include nurses from throughout the state. These collaboratives develop specific initiatives that fulfill the functions of the Center. The Advisory Board provides active oversight and guidance in the accomplishment of the Center’s goals.

Here are some of the highlights of the year:

1. A partnership between the HMSA Foundation and the Center was one of ten in the nation to be awarded a Robert Wood Johnson/Northwest Health Foundation, Partners in Nursing Grant. The project is focused on recruitment and retention of nurses in the long term care setting.

2. A Summit on Education and Practice was held in March, 2006, and brought together nurses from all islands to focus on integration, collaboration, innovation and community partnerships. Two recommendations have resulted in new initiatives. A residency/internship model is being developed to assist in the transition of new graduate nurses and a formalized plan to integrate nursing education with the practice sector is being finalized.

3. Projections on the supply and demand for the nursing workforce in Hawai’i have been developed to provide estimates that reflect the State’s nursing shortage. A Fact Sheet and a detailed paper on current projections are being provided to all stakeholders.

4. A report on the 2004-05 educational capacity of 100% of the schools of nursing in Hawai’i was completed and distributed to stakeholders. This report is based on a survey of all schools of nursing and will be completed annually. The survey for the 2005-06 school year is being conducted.

5. A 5-year longitudinal study of new graduate registered nurses has been implemented. This study will examine new graduate transition into practice, turnover and best practices in retention.

6. As part of a coalition of nursing and healthcare organizations, the Center co-sponsored the AONE Conference entitled ”Saving Lives through Investments in Nursing” with Dr. LindaAiken, one of the premier nurse researchers nationwide, with a focus on nurse staffing, education and patient outcomes.

7. The Center facilitated a Staffing Task Force to address the recommendations in Senate Concurrent Resolution 76, S.D.1. A report has been distributed to stakeholders.

It has been an exciting and challenging year! We have involved many nurses from throughout our state and the response continues to be very gratifying! We are looking forward to bringing even more nurses into our collaborative workgroups to work on our current projects including leadership training for charge nurses….…please join with us and with others to strengthen our profession and deal with the many issues of the nursing shortage!

Barbara P. Mathews, MS, APRN, CNAA
Executive Director
Hawai’i State Center for Nursing

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HAWAI’I PARTNERS IN NURSING ADDRESSING RECRUITMENT AND RETENTION IN LONG TERM CARE

The HMSA Foundation was established in 1986 by the Hawai’i Medical Service Association (Blue Cross Blue Shield Plan of Hawai’i) to stimulate the research of issues that confront Hawai’i’s healthcare industry. The Foundation is a private organization dedicated to improving health in Hawai’i through grant making, strategic initiatives, publications and community-wide programs. The key initiatives are implemented through partnerships with community and government organizations and are focused in four priority areas: health promotion and disease prevention; health care delivery system; access to health care; general social welfare and healthy communities.

The Partners Investing in Nursing’s Future (PIN), an initiative of the Robert Wood Johnson Foundation and the Northwest Health Foundation, shares many of the same goals and objectives of the HMSA Foundation. Together, we are looking for ways to improve the healthcare delivered to the people of Hawai’i. For the Hawai’i Partners in Nursing, the HMSA Foundation and the Hawai’i State Center for Nursing have partnered to provide leadership for the project.

The purpose of the Hawai’i Partners in Nursing project is to build strong partnerships which lead to statewide education and practice initiatives that facilitate positive change in the initial and continuing education and training of nurses in long term care (LTC). In addition, partnerships will lead to improvements in the recruitment and retention of nurses in the geriatric specialty and in the long term care sector.

The project brings together partners from education and practice (academic sites paired with long term care facilities) to develop and implement an integrated model of education and practice in long term care using demonstration projects. The partners include: The University of Hawai’i School of Nursing and Dental Hygiene with Maunalani Nursing and Rehabilitation Center; Hawai’i Pacific University with the Hi’olani Care Center at Kahalu Nui; Kapiolani Community College with Leahi Hospital and Maui Community College with Hale Makua.

The first arm of the demonstration project involves nursing student clinical placement in each of four LTC facilities which are partnered with a school of nursing. The partnerships represent both baccalaureate nursing programs and associate degree nursing programs. The facilities represent both the public and private sectors.

The second arm of the project involves faculty from the schools of nursing who will provide in-service education or clinical skill upgrades to the staff of the LTC facilities. The focus of the clinical skill upgrades will be linked to each facility’s quality data as reported in the Minimum Data Set (MDS).

The third arm of the project involves preceptor training which is being developed in collaboration with the long term care partners by Lois Greenwood, PhD from VITEC at Maui Community College. Preceptor training will be provided to staff in each facility using a “train-the-trainer” model.

The aim of the demonstration project is to encourage sustainable change within each facility and within each school of nursing as well as to influence local policy development.

The project began in August, 2006 with the first baseline measures taken from each of the four long term care facilities and the implementation of student clinical rotations. LTC baseline measures examining HR factors, MDS Quality indicators, and perceptions of nursing staff as well as pre-clinical placement questionnaires of students have been completed. Faculty and LTC leadership are finalizing plans for the in-service education. Preceptor training is in development and will be conducted in May, 2007.

All partners have been actively involved in planning and implementing the project and have formed a cohesive group with a commitment to learning from each other. We are very pleased and proud to be a part of a significant initiative with our nationwide partners and are committed to sharing the learning with nurses and healthcare leaders in Hawai’i.

Projected Registered Nurse Workforce in Hawai’i 2005 - 2020

Investigator: S.A. LeVasseur, PhD, Associate Director, Research, Hawai’i State Center for Nursing

In order to plan future workforce needs, workforce demand requirements and supply availability need to be adequately estimated, and workforce shortages or oversupply conditions need to be predicted. Forecasting requires that past and current trends in the demand for and supply of nursing workforce are carefully assessed. Predictors of levels and trends in demand and supply must be identified and models created that weigh these factors and use them to project future demand and supply.

One of the goals of the Hawai’i State Center for Nursing is to establish “an ongoing system that assists in estimating the future registered nursing workforce supply and demand needs in Hawai’i.” Long range forecasting is described as ‘an estimate or prediction of the future’. Forecast data are a best estimate of likely trends and are an essential component of nursing workforce planning. In order to plan future workforce needs, workforce demand requirements and supply availability need to be adequately estimated, and workforce shortages or oversupply conditions need to be predicted.

In this study, the National Center for Health Workforce Analysis (NCHWA) models are used to forecast the supply and demand of registered nurses (RN) in Hawai’i from 2005 - 2020. Preliminary estimates suggest that demand will grow from a current need for about 8,411 FTE RNs to more than 10,955 over the next 15 years. However, supply is projected to increase from an estimated 7,553 FTE RNs in 2005 to an estimated 8,286 by 2020. The models indicate that by the year 2020, Hawai’i will have a shortage of approximately 2,669 FTE RNs, or about 24 percent demand shortfall.

Both immediate and long-term policy development is required to address this growing nursing shortage. We need to address the limited educational capacity issues faced by our nursing programs; to attract and ensure educational opportunities for people to the nursing profession. The advantage of such policies is that they add new nurses year after year. Thus, while the increase in any one year may be modest, the cumulative effect can be significant. Other factors such as reducing net annual out-migration and turnover rates; and attracting more people to nursing will have an accumulative effect.

Policies that affect participation within the existing pool of nurses may have a limited long-term impact while increasing the supply of nurses in the short term. Delaying time until retirement, reducing career changes and increasing the percentage of nurses working full time as opposed to part time are examples of such policies.

Full report located at: http://hinursing.org/abstract04.htm