Nursing Workforce Data Research Articles

How is ‘shortage’ defined? Exploring Nursing Workforce Data across Canada 2015-2022: An Ecological Study

RationaleDetermining the ability of a country’s nursing workforce to meet the health care needs of the population is essential for optimal health outcomes. ‘Nursing shortage’ is frequently heralded as an issue, yet it is unclear how ‘shortage’ is defined and calculated. The purpose of this study was to collect and link publicly available Canadian data to describe and compare trends in nursing workforce capacity. MethodsPrimary data sources included linking Statistics Canada and Canadian Institutes of Health Information (CIHI) data from 2015 to 2022. Statistics Canada tracks provincial population data and job vacancy rates. CIHI receives data from provincial nursing organizations on demographics, roles, and employment status. To estimate a sufficient workforce, job vacancy rates (a proxy for provincial need) were cross tabulated with the number of registered nurses (RNs) and registered psychiatric nurses (RPNs) per year. ResultsThe number of RNs and RPNs in Canada has increased by 8.6% between 2015 and 2022, to a total of 322,226. Job vacancies, as a percent of total nursing supply, shows a rising trend (2.3% to 8.7%) between 2015 and 2022 across Canada. In 2022, 84.9% of Canadian RNs and RPNs in direct patient care across Canada and 86.1% were in urban settings. Conclusion & LimitationsThis project examines Canadian nursing workforce data encompassing potential effects of the COVID-19 pandemic. The trends are limited to annual due to aggregated data. Data on a country’s nursing workforce measured monthly and consistently across provinces would yield clearer information.

Effects of a disincentive policy on behavioral changes by South Korean medical institutions that do not submit official nursing grade data.

This study aimed to determine whether the policy of imposing deductions on medical institutions in South Korea led to increased submission of nursing grade data. In Korea, medical institutions are required to report data on their nursing workforce; however, many institutions did not comply with this regulation, making it difficult to gauge their level of nurse staffing. Therefore, in 2020, a nursing fee deduction policy was introduced that penalizes medical institutions financially for failing to submit nursing workforce data. We prospectively collected data on the characteristics, nursing grade, and data submission status of 1,200 hospitals in South Korea from 2015 to 2021. We analyzed the submission rate of data related to nursing grades according to the characteristics of the medical institutions and evaluated the effect of policy change on data submission status using multiple logistic regression. The submission rate of data increased from 50.2% in 2015 to 93.3% in 2021, and 39.3% of medical institutions that had not previously submitted data did so after the policy was introduced. The submission rate of medical institutions unaffected by the policy also increased after its introduction. Compared with 2015, the likelihood of medical institutions submitting data increased by 23.69 times in 2020 and 20.47 times in 2021. The appropriate use of disincentive policies, such as financial deductions for medical institutions showing inappropriate behavior, was found to be effective in inducing desirable changes in the behavior of medical institutions. Properly planned and implemented policies can contribute to improved quality of medical services and patient safety through effective administrative control.

Analysis of England's incident and mental health nursing workforce data 2015-2022.

INTRODUCTION: There is a paucity of empirical data examining incidents and mental health nurses and the relationship between the two remains uncertain. Comparison of English national data for incidents and nursing workforce to examine recent trends. Descriptive analysis of two national datasets of incidents and workforce data for England between 2015 and 2022. A 46% increase in incidents was found; the leading causes are self-harm and aggressive behaviour. Despite the rise in adverse incident reporting, a 6% increase in mental health nurses was found, with more nurses in community settings than hospitals. Current services are incident reporting at greater concentrations than in previous years. Patient-related behaviour continues to be most prominently reported, rather than possible antecedent health services issues that may contribute to reporting. Whilst staffing has increased, this does not seem to have kept pace with the implied workload evident in the increase in incident reports. Greater emphasis should be placed on health service behaviour in reporting mechanisms. Self-harm and aggression should continue to be considered adverse outcomes, but causal health service factors, such as missed care, should be present in pooled reporting to help reduce the occurrence of adverse outcomes.

Nursing workforce deployment and intensive care unit strain during the COVID-19 pandemic in Victoria, Australia

BackgroundThe COVID-19 pandemic demanded intensive care units (ICUs) globally to expand to meet increasing patient numbers requiring critical care. Critical care nurses were a finite resource in this challenge to meet growing patient numbers, necessitating redeployment of nursing staff to work in ICUs. ObjectiveOur aim was to describe the extent and manner by which the increased demand for ICU care during the COVID-19 pandemic was met by ICU nursing workforce expansion in the late 2021 and early 2022 in Victoria, Australia. MethodsThis is a retrospective cohort study of Victorian ICUs who contributed nursing data to the Critical Health Information System from 1 December 2021 to 11 April 2022. Bedside nursing workforce data, in categories as defined by Safer Care Victoria’s pandemic response guidelines, were analysed. The primary outcome was ‘insufficient ICU skill mix’—whenever a site had more patients needing 1:1 critical care nursing care than the mean daily number of experienced critical care nursing staff. ResultsOverall, data from 24 of the 47 Victorian ICUs were eligible for analysis. Insufficient ICU skill mix occurred on 10.3% (280/2725) days at 66.7% (16/24) of ICUs, most commonly during the peak phase from December to mid-February. The insufficient ICU skill mix was more likely to occur when there were more additional ICU beds open over the ‘business-as-usual’ number. Counterfactual analysis suggested that had there been no redeployment of staff to the ICU, reduced nursing ratios, with inability to provide 1:1 care, would have occurred on 15.2% (415/2725) days at 91.7% (22/24) ICUs. ConclusionThe redeployment of nurses into the ICU was necessary. However, despite this, at times, some ICUs had insufficient staff to cope with the number and acuity of patients. Further research is needed to examine the impact of ICU nursing models of care on patient outcomes and on nurse outcomes.

State and national data on the Georgia nursing workforce

BackgroundThe enduring absence of robust nursing workforce data creates gaps to support evidence-based workforce planning and policy development. PurposeThe purpose of this study was to examine Georgia nursing workforce data available through state and national agencies to determine if significance differences exist among data sources. MethodsA cross-sectional, descriptive analysis of 2017 Georgia nursing workforce data was used to examine and compare workforce characteristics available from five data sources. The advantages and limitations of each data source were reviewed. FindingsSignificant differences were noted in the quality and quantity of data collected on the Georgia nursing workforce as reported by state and national agencies. None of the datasets include in our analysis had comprehensive and timely data on the Georgia nursing workforce. DiscussionNursing workforce stakeholders must work collaboratively to require and implement a comprehensive re-licensure survey. It is only though a standardized national minimum dataset that we can ensure an adequate nursing workforce.

Show Me the Nursing Shortage: Location Matters in Missouri Nursing Shortage

<h3>Background</h3> Across the United States, data show that nursing shortages exist in many parts of the country. <h3>Purpose</h3> This descriptive research study seeks to identify nursing shortage and nurse age differences by county in Missouri and aims to determine whether the distribution of nurses is even across rural and urban areas. <h3>Methods</h3> Using nursing workforce data based on licensed nurses, geographic mapping was performed to show nurse distribution and age cohorts at the county level in Missouri. The number of nurses per 10,000 residents was the ratio used to show nursing population density by county. <h3>Results</h3> Eleven metropolitan, 4 micropolitan, and 12 rural counties had the lowest ratio of nurses to 10,000 population at 18 to 49. By comparison, 2 metropolitan, 2 micropolitan, and 0 rural areas had the highest ratio at 198 to 327. There were several counties in which 42% to 58% of nurses were older than 54 years. <h3>Conclusion</h3> There is a disparity in both the number of nurses and the age of nurses in metropolitan, micropolitan, and rural areas. Understanding the factors that contribute to differential nurse practice patterns by geographic regions in states such as Missouri is essential to inform nursing policy and craft workforce solutions.

Impact of COVID-19 on acute isolation bed capacity and nursing workforce requirements: A retrospective review.

AimTo understand the impact of COVID‐19 on isolation bed capacity requirements, nursing workforce requirements and nurse:patient ratios.BackgroundCOVID‐19 created an increased demand for isolation beds and nursing workforce globally.MethodsThis was a retrospective review of bed capacity, bed occupancy and nursing workforce data from the isolation units of a tertiary hospital in Singapore from 23 January 2020 to 31 May 2020. R v4.0.1 and Tidyverse 1.3.0 library were used for data cleaning and plotly 4.9.2.1 library for data visualization.ResultsIn January to March 2020, isolation bed capacity was low (=<203 beds). A sharp increase in bed capacity was seen from 195 to 487 beds during 25 March to 29 April 2020, after which it plateaued. Bed occupancy remained lower than bed capacity throughout January to May 2020. After 16 April 2020, we experienced a shortage of 1.1 to 70.2 nurses in isolation wards. Due to low occupancy rates, nurse:patient ratio remained acceptable (minimum nurse:patient ratio = 0.26).ConclusionCOVID‐19 caused drastic changes in isolation bed capacity and nursing workforce requirements.Implications for Nursing ManagementBuilding a model to predict nursing workforce requirements during pandemic surges may be helpful for planning and adequate staffing.

Innovation Leaders:: Networking Across Practice and Regulatory Agencies for Better Data and Clinical Efficiency

Innovative leaders in health care are especially poised to impact patient safety, use of resources, and workforce planning through networked partnerships. Opportunities exist for nurse leaders to address internal needs through collaboration with external partners. In particular, partnerships with regulatory agencies can result in increased value for both partners. This article presents 2 exemplars in which nurse leaders worked with nurse regulators to improve nursing workforce data and student clinical placements for obstetric learning. 1

Nursing Education in Saudi Arabia: History and Development.

Nursing education in Saudi Arabia commenced in 1948 with the introduction of a nursing diploma program for males. Numerous bodies have worked as nursing education providers since then, leading to an unsteady growth of the field due to the lack of a unified curriculum coupled with an absence of regulating bodies. The absence of nursing leaders and the lack of reliable nursing workforce data during the past few decades have contributed to a lack of maturity and growth of the Saudi nursing landscape compared to the international nursing trends. This review explores the history of nursing education and its development within the context of Saudi Arabia.

Building Bridges: The Journey of Alabama's Health Action Coalition.

The Alabama Health Action Coalition is a state coalition whose purpose is to enable access to high-quality, safe, and patient-centered health care for all Alabamians by leading change in nursing and health care. The Alabama Health Action Coalition has four focus areas: advancing nursing education, improving nursing workforce data, promoting diversity among nursing and health care professionals, and fostering a culture of health. From 2012 to 2014, the Advancing Education Taskforce and Health Workforce Committee initiated processes to maximize resources, track changes in workforce data, and provide support for goal achievement. Outcomes included an increase in the number of nurses with a BSN and higher degrees from 35 percent to 50 percent, nearing national averages. Tracking of trends continues with 2016 data. This growth is particularly important in a state with a large, underserved population and high percentage of rural areas.

Developing a Process Infrastructure to Capture Supply, Education, and Demand Data for Indiana’s Nursing Workforce

The primary purpose of this project was to develop an infrastructure that established guidelines for the collection, analyses, and reporting of data utilizing the National Minimum Data sets (MDS) on the supply, education, and demand data for Indiana's nursing workforce. The initiative was undertaken as part of the Indiana Center for Nursing's (ICN) strategic initiative to create the centralized repository for Indiana's nursing workforce data and to ensure a seamless transition of the data to the future national workforce data repository. The infrastructure guidelines were created using recommendations from the Future of Nursing: Campaign for Action, the National Forum of State Nursing Workforce Centers, and the Indiana Board of Nursing. The standardized infrastructure guidelines promote timely and accurate collection, analyses, and reporting from the MDS documents not only regarding nursing supply and education, but also nursing demand, a data set that was not collected by the ICN before this project.

The 2013 National Nursing Workforce Survey of Registered Nurses

The 2013 National Nursing Workforce Survey of Registered Nurses

Toward Standardization (Part 2)

With the passage of the Affordable Care Act and the development of a National Workforce Commission, multiple entities have increased their interest in collecting standardized health care workforce data at the state and national levels. In a tight budget environment, developing data sets which collect the minimum needed information that is necessary for workforce planning and supply/demand projections has become critically needed. This article represents the second of a two part series describing the work that the Forum of State Nursing Workforce Centers has undertaken during the last 3 years toward standardizing nursing workforce data. Part I described the initial steps that informed the development of national nursing workforce minimum data sets. Part II describes the consensus model used to develop the minimum data sets as well as an update on the implementation of the minimum data sets in individual states including challenges and barriers encountered.

Can New Zealand achieve self‐sufficiency in its nursing workforce?

This paper reviews impacts on the nursing workforce of health policy and reforms of the past two decades and suggests reasons for both current difficulties in retaining nurses in the workforce and measures to achieve short-term improvements. Difficulties in retaining nurses in the New Zealand workforce have contributed to nursing shortages, leading to a dependence on overseas recruitment. In a context of global shortages and having to compete in a global nursing labour market, an alternative to dependence on overseas nurses is self-sufficiency. Discursive paper. Analysis of nursing workforce data highlighted threats to self-sufficiency, including age structure, high rates of emigration of New Zealand nurses with reliance on overseas nurses and an annual output of nurses that is insufficient to replace both expected retiring nurses and emigrating nurses. A review of recent policy and other documents indicates that two decades of health reform and lack of a strategic focus on nursing has contributed to shortages. Recent strategic approaches to the nursing workforce have included workforce stocktakes, integrated health workforce development and nursing workforce projections, with a single authority now responsible for planning, education, training and development for all health professions and sectors. Current health and nursing workforce development strategies offer wide-ranging and ambitious approaches. An alternative approach is advocated: based on workforce data analysis, pressing threats to self-sufficiency and measures available are identified to achieve, in the short term, the maximum impact on retaining nurses. A human resources in health approach is recommended that focuses on employment conditions and professional nursing as well as recruitment and retention strategies. Nursing is identified as 'crucial' to meeting demands for health care. A shortage of nurses threatens delivery of health services and supports the case for self-sufficiency in the nursing workforce.

Toward Standardization (Part 1): Assessment of State and National Nursing Workforce Data Sources

Despite concerns expressed over the past 25 years, little progress has been made in improving the accuracy, availability, and timeliness of national data on the U.S. nursing workforce. In Part 1 of this two-part series, we review the current national data sources on nurse supply, demand, and education programs. We discuss the advantages that state-level data collection efforts enjoy in many states and propose that national data sets could be easily and cost-effectively built from state-level contributions-if states collected a standardized set of information. As part of a larger effort to standardize state-level data, from July to December 2008, we analyzed surveys and codebooks from 26 states collecting nurse workforce data. We present the results of this data assessment and conclude that data collection practices as of 2008 varied substantially from state to state. Creation and adoption of standardized minimum nursing workforce data sets is suggested to bring states into alignment.

Vision, Grit, and Collaboration: How the Wisconsin Center for Nursing Achieved Both Sustainable Funding and Established Itself as a State Health Care Workforce Leader

In 2001, a dedicated group of nurses from across Wisconsin came together to discuss how to create a state center of expertise on key nursing workforce issues. The result was the establishment of the Wisconsin Center for Nursing (WCN) in 2005. Since that time, through its statewide Board of Directors, WCN has clarified and targeted specific state workforce needs and identified gaps that exist in addressing those needs. During its five-year existence, WCN has received funding from a variety of sources, and volunteers have spent hundreds of hours working on behalf of the organization. Finding a sustainable base of funding for WCN has been a priority in order to ensure that the organization can hire permanent staff and invest in ongoing initiatives. In 2009, WCN was involved in developing a strategy that resolved both the issue of sustainability and the need to collect and analyze data on the nursing profession. A bill was passed by the Wisconsin legislature that required RNs and LPNs to complete a comprehensive survey every two years when they renew their state licenses. In addition, the legislature raised the licensure fee for RNs and LPNs and dedicated a portion to WCN to assist in the analysis of the newly-collected nursing workforce data and to develop a state-wide plan addressing the future of the Wisconsin nursing workforce. This article will include the history of the WCN and the details of its journey toward sustainability including accomplishments and lessons learned.

International Nurse Migration: Impacts on New Zealand

As a source and destination country, nurse flows in and out of New Zealand (NZ) are examined to determine impacts and regional contexts. A descriptive statistics method was used to analyze secondary data on nurses added to the register, NZ nurse qualifications verified by overseas authorities, nursing workforce data, and census data. It found that international movement of nurses was minimal during the 1990s, but from 2001 a sharp jump in the verification of NZ-registered nurses (RNs) by overseas authorities coincided with an equivalent increase in international RNs (IRNs) added to the NZ nursing register-a pattern that has been sustained to the present. Movement of NZ RNs to Australia is expedited by the Trans-Tasman Agreement, whereas entry of IRNs to NZ is facilitated by nursing being an identified Priority Occupation. Future research needs to consider health system and nurse workforce contexts and take a regional perspective on migration patterns.

Australian nurses volunteering for the Sumatra-Andaman earthquake and tsunami of 2004: A review of experience and analysis of data collected by the Tsunami Volunteer Hotline

Summary This paper provides an outline of the work undertaken by nurses who participated in the relief effort as members of Australian medical teams during the Sumatra-Andaman earthquake and tsunami response. This profile is contrasted with the information provided by nurses who registered their interest in volunteering to help via the Australian Tsunami Hotline. The paper provides an overview of the skills and background of the nurses who provided information to the hotline and describes the range and extent of experience among this cohort of potential volunteers. This data is compared to nursing workforce data and internal rates of volunteering in Australia. The paper concludes that further research is necessary to examine the motivations of and disincentives for nurses to volunteer for overseas (disaster) work and, to develop an improved understanding within the discipline of the skills and experience required of volunteer responders. Further, it is argued that the development of standards for the collection of disaster health volunteer data would assist future responses and provide better tools for developing an improved understanding of disaster volunteering.

The Psychiatric-Mental Health Nursing Workforce: Large Numbers, Little Data

Managing the supply of psychiatric-mental health nursing labor, determining the financial incentives associated with the provision of services by these providers, and ensuring optimal patient and cost outcomes are critical elements of cost control and patient safety in the current health care market. Knowledge of the psychiatric-mental health nursing workforce is needed to plan and evaluate cost-effective programs to accomplish the aforementioned elements. However, the psychiatric-mental health nursing workforce data are woefully inadequate. This paper will review the extent to which national data sources contain workforce information on psychiatric-mental health nurses.