The Future of Nursing

THE FUTURE OF NURSING NURSING SHORTAGE I CURRENT SUPPLY THERE IS CURRENTLY A SURPLUS OF OLDER NURSES IN THE WORKFORCE The nursing workforce grew substantially in the 2000s About 1/3 of the nursing workforce is OLDER THAN 50 GROWING BY MORE THAN: 50+ 500,000 (24.1%) 90,000 The average age of nurses has increased over the past decade by almost 2 YEARS for RNs and 175 years for LPNS (15.5%) 24.1% 500,000 2,074.688 Both RNs and LPNS are experiencing a trend where 15.5% older nurses, particularly those OLDER THAN 60, 90,000 580,645 are WORKING MORE HOURS NOW than they did in 2000 - Possibly due to the economic downturn and lack of retirement RNs LPNS I FUTURE SHORTAGE DECREASE IN THE NUMBER OF LPNS AGED 31 TO 50 21-30 50+ 2010 - 2015: 31-50 118,000 nurses will stop working full time THIS GAP WILL LEAD TO: OVER THE NEXT 10 TO 15 YEARS • A loss of experiential knowledge loss of vital leadership, including faculty and teaching • A taxing increase in work for younger nurses due to the gap created by retirees and an overall lack of nurses • Additional issues for the aging U.S. population at large (more patients/less nurses) RNs LPN of the current workforce will 1/3 reach retirement age I ADDRESSING THE SHORTAGE More nurses are needed to both replace the retiring workforce and address the needs of the aging patient population Nurses need to be trained with skills and leadership abilities to replenish the loss of experiential knowledge and continue to educate the younger workforce HEALTHCARE REFORM GOVERNMENT POLICY HITECH ACT Health Information Technology for ACA Affordable Care Act Economic and Clinical Health Act The ACA's reforms in healthcare will give millions of new people access to the healthcare system while also pushing to improve the quality of care while both pieces of legislation call for the implementation of advanced health technology I IMPACT OF REFORM ON NURSING CHANGING THE LIMITATIONS and regulations of what nurses are allowed to do - enabling nurse practitioners to practice to the full extent of their licenses MORE PRIMARY CARE ROLE • Fill in the gap created by the increase of millions of newly insured patients due to the healthcare reform • Fill in the gap created by the ANTICIPATED PHYSICIAN SHORTAGE (an estimated dearth of 150,00o doctors within 15 years) • Continue to SERVE RURAL AND REMOTE AREAS where patient visits are bigger obstacles and primary care providers are mostly nurse practitioners (27.8%) rather than family physicians (22.5%) or pediatricians (8.8%) • Improve the quality of care ultimately sought for in healthcare reform with increased patient engagement and accurate records TECHNOLOGY The HITECH ACT and ACA are intended to accelerate the implementation and adoption of HEALTH IT I ELECTRONIC HEALTH RECORDS (EHR) In 2009, only EHR SYSTEMS enable nurses the ability to document the care they provide, creating efficiencies with the use of TEMPLATES and BEDSIDE MEDICAL DEVICE INTERFACES, such as a 1.5% of U.S. hospitals had a comprehensive EHR SYSTEM (present in all clinical units), 7.6% had a basic system (present in at least one clinical unit) wall-mounted computer or laptop or table As of 2010, only JOHN DOE 15.1% of acute care non-Federal hospitals had instituted at least a basic EHR SYSTEM I COMPUTERIZED PROVIDER ORDER ENTRY (CPOE) Transcription tasks are normally labor-intensive and CPOE can not only REPLACE THEM but also IMPROVE QUALITY of care and patient safety by preventing common prescribing errors MEDICATION ERRORS are the most common cause or preventable injuries and deaths in hospitals In 2000, deaths resulting from medical error: 98,000 (deaths annually) In 2009, only 17% of U.S. hospitals had CPOE SYSTEMS in place for The implementation of CPOE SYSTEMS is associated with a reduction in medication errors of medication orders 55% BAR CODE MEDICATION ADMINISTRATION This technology allows medication to be SCANNED BEFORE ADMINISTRATION, checking that the medication is correct, for the right patient, in the right dosage, etc. And helps to DECREASE MEDICATION ERROR fulmal CLINICAL DECISION SUPPORT RULES Many HEALTH IT systems include these customizable rules providing warnings and reminders that assist nurses in keeping track of important tasks OK Cancel EDUCATION NEED FOR MORE EDUCATION The IOM and Robert Wood Johnson Foundation (RWJF) 2010 Future of Nursing Report assesses that nurses with BACHELOR'S DEGREES should increase to 80% and nurses with DOCTORAL DEGREES SHOULD 38.7% 37.6% 10% 0.4% DOUBLE Doctorate degree by 2020 in order to accommodate for the healthcare reform changes Associate's Bachelor's Master's degree degree degree I NEED FOR HIGHER EDUCATION To achieve both IOM goals, at least 760,000 additional nurses must earn at least a BSN (or BS). The IOM reports that easier education pathways with increased incentives to pursue higher education are needed An additional 24,147 DOCTORATE by 2020 must earn a NEED FOR NURSING FACULTY THE LACK OF QUALIFIED NURSING FACULTY IS ATTRIBUTED TO: The number of applications to entry-level baccalaureate programs increased by more than • The lack of adequate education pathways and fewer nurses with a graduate education • The nursing shortage - and loss of experienced, older nurses to retirement 70% between 2004 and 2009 • Disparities in salary and other benefits - which the ACA seeks to help offset with provided loan repayments and scholarships Unfortunately, thousands of qualified applicants have been turned away due to limitations imposed by the lack of qualified nursing faculty and Among other factors, having a more highly educated nursing workforce will increase the number of nursing faculty available - thus providing for the next generation of nurses CAPACITY OF NURSING SCHOOLS In order to enable nurses to step into primary care positions and make up for the experiential knowledge & leadership loss due to the nurse shortage, the nursing workforce as a whole requires more educated nurses PRODUCED BY: NORWICH UNIVERSITY* 1819 Online SOURCES: http://www.thefutureofnursing.org/lOM-Report http://www.nursing.pitt.edu/pitt_nurse/archive/pittnurse_spring2011.pdf http://www.rwjf.org/content/dam/farm/reports/issue_briefs/2011/rwjf70968 http://www.rwjf.org/content/dam/files/rwjf-web-files/Resources/2/cnf2012081o.pdf http://bhpr.hrsa.gov/healthworkforce/reports/nursingworkforce/nursingworkforcefullreport,.pdf http://journals.lww.com/ajnonline/Fulltext/2012/08000/Health_Information_Technology_and_Nursing.22.aspx http://www.bloomberg.com/news/2012-03-21/nursing-shortage-in-u-s-is-over-temporarily-researchers-find.html http://www.nursingworld.org/MainMenuCategories/ThePracticeofProfessionalNursing/workforce/NursingShortage http://www.whitehouse.senate.gov/imo/media/doc/Health%20- Care%20Delivery%20System%20Reform%20and%20The%20Affordable%20Care%20Act%20FINAL2.pdf