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Alice F' Kuehn, Ph'D'

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Title: Alice F' Kuehn, Ph'D'


1
Office of Missouri Nursing Workforce Analysis
O M N W A
  • Alice F. Kuehn, Ph.D.
  • Executive Director/Associate Professor, Emeritus
  • Sinclair School of Nursing
  • University of Missouri Columbia
  • Presented to the Missouri Nursing Coalition
  • March 11, 2003

2
So What Exactly Is the Office of Missouri
Nursing Workforce Analysis (OMNWA)?
OMNWA
DATABASECENTER
PRACTICE/EDUCATION RESEARCH CENTER
MoNF
Vision Create Nursing as Community Create a
community of nurses who appropriately educate and
manage a nursing workforce to serve the health
care needs of Missouris population within an
ever expanding environment . It will emerge as we
transition from a set of multiple isolated roles
into a world community of providers and those we
serve. Initially funded by the RWJF-CIC grant
1996-2002
3
So What Exactly Is the OMNWA Missouri Nursing
Forum (MoNF)?
OMNWA
DATABASECENTER
PRACTICE/EDUCATION RESEARCH CENTER
MoNF
Mission StatementProvides a forum to discuss
education, preparation and management of the
Missouri nursing workforce leading to quality and
cost-effective health care for Missouris
citizens.
4
So What Exactly Does the OMNWA Missouri Nursing
Forum Do?
OMNWA
DATABASECENTER
PRACTICE/EDUCATION RESEARCH CENTER
MoNF
  • The Mission of MoNF is accomplished through
  • VIRTUAL CONSORTIUM using web site-monitored by
    stakeholders in the trenches.
  • PARTNERSHIPS with existing organizations (AHEC,
    MONA) to facilitate meetings and conferences.

5
So What Exactly Does the OMNWA Missouri Nursing
Forum Do?
OMNWA
DATABASECENTER
PRACTICE/EDUCATION RESEARCH CENTER
MoNF
  • The Mission of MoNF is accomplished through
  • LEADERSHIP using existing stakeholders in each
    designated AHEC region.
  • CONTENT DRIVEN BY CURRENT TOPICS affecting
    nurses serving the population
  • MoNF serves as a statewide advisory resource to
    assist OMNWA in database and research missions.

6
So What Exactly Is the OMNWA Database Center?
OMNWA
DATABASECENTER
PRACTICE/EDUCATION RESEARCH CENTER
MoNF
  • Mission of the Database Center
  • Provide Missourians with information on the
    status of the nursing workforce providing health
    care for rural Missouri.

7
So What Exactly Is the OMNWA Database Center?
OMNWA
DATABASECENTER
PRACTICE/EDUCATION RESEARCH CENTER
MoNF
  • The Database Center will provide
  • DATA TABLES created from existing databases and
    OMNWA generated research
  • DATA ANALYSIS provided by expert faculty and
    staff
  • GENERATED REPORTS available on the web site
  • WORKFORCE FORECAST REPORTS available on the web
    site

8
Missouri Database Center Development/Support
Technical Advisory Committee on the Quality of
Patient Care and Nursing Practices
(MoDHSS) Missouri Nursing Coalition Missouri
Rural Nursing Consortium (ruralnursing.org) Rober
t Wood Johnson Colleagues in Caring
9
Examples of Database Sources
  • Providers by setting
  • Hospital (hospital profiles)
  • Nursing home (nursing home profiles)
  • Home health (secondary data Primary surveys)
  • School nurses (primary survey)
  • Public health nurses (primary survey)
  • Enrollment/graduation rates/pass-fail rates
    (state board Primary surveys)
  • Providers by licensure
  • Licensure supply (DHSS)

10
Database Center Activities
  • Collect supply/demand/needs and trend data from
    multiple state and national sources for
    assessment and analysis.
  • Data drawn from both practice and education
    resources.
  • Conduct primary data surveys when no secondary
    database exist.
  • Use data to provide public, professionals, and
    policy makers with strategic planning and/or
    policy decision making.

11
Fast Facts - USA
  • There are 126,000 nursing positions currently
    unfilled in hospitals across America.
  • 56 of hospitals report they are using agency or
    traveling nurses at great expense to fill these
    vacancies.
  • 90 of LTC organizations lack sufficient nurse
    staff to provide even the most basic of care.

12
Fast Facts - USA
  • There are roughly 21,000 fewer nursing students
    today than in 1995.
  • One study found that in 1999, 5 of female
    college freshman and less than .05 of men
    identified nursing as being among their top
    career choice.
  • Nursing schools turned away 5,000 qualified
    baccalaureate program applicants in 2001 because
    of faculty shortages.

13
Fast Facts - Missouri
  • There are currently 57,912 registered nurses
    actively working in MO. This number includes
    1,007 newly licensed nurses. (Database includes
    APNs, RNs, LPNs by county within Missouri).
  • Current graduating LPN students represent 49.11
    of the starting class while RNs across the
    educational venues represent 46.33 of the
    starting numbers.

14
Fast Facts - Missouri
  • MONA salary data for 2000. Average full-time
    salary for RNs was 46,740 with an average of
    14.2 years of experience.
  • The average age of an RN in the state of MO is
    44.7 years of age and the average LPN age is
    46.9.
  • 51 of all RNs and 58 of all LPNs are over the
    age of 45.

15
Missouri Nursing Summit April 2001 Office of
Missouri Nursing Workforce Analysis
16
Missouri Nursing Coalition March 2003 Office of
Missouri Nursing Workforce Analysis
17
Missouri Nursing Coalition March 2003 Office of
Missouri Nursing Workforce Analysis
18
So What Exactly Is the ONMWA Practice /Education
Research Center ?
OMNWA
MoNF
DATABASECENTER
PRACTICE/EDUCATION RESEARCH CENTER
Mission of the Practice/Education Research
Center To create a model of nursing role
clarity for education and practice.
19
So What Exactly Is the ONMWA Practice /Education
Research Center ?
OMNWA
MoNF
DATABASECENTER
PRACTICE/EDUCATION RESEARCH CENTER
  • The mission of the practice/education research
    center is accomplished by
  • Concept analyses of differentiated practice and
    role clarity
  • Support/facilitate implementation of the concept
    of role clarity in hospital, long term care and
    public health settings.
  • Support educational institutions in efforts to
    appropriately prepare nurses at all levels to
    interact with each other and to serve a dynamic
    population

20
Current Model of Nurse Staffing Based on Role
TRENDS
NEEDS
Nurse Role
Nurse Role
APRIL 1999
21
The Role Clarity Model
Role clarity is a conceptual model of nursing
practice and education that delineates scope of
responsibilities and accountability for actions
based on expected competencies of nurses.
22
The Role Clarity Model
The theoretical framework of the model is
trimodalNursing theory, role theory, and the
concept of community Nursing theories offer a
beginning articulation of what nursing is and
what roles nurses play(Afaf Meleis, 1991)
23
The Role Clarity Model
Role-the part one plays. The expected and
actual behaviors associated with a given position
within a given situation or context. The actions
of the individual cannot ever be truly
independent but are interconnected with the
actions of others and framed within the structure
of the organization.
24
The Role Clarity Model
Role Identity-the interpretation of role
expectations by the individual assuming the given
role. Role redefinition and realignment are
ongoing processes related to expanding knowledge
and increasing consumer demands for access to
care.
25
The Role Clarity Model
Community is not only a place but a powerful
social resourceof networks, relationships and
shared sense of purpose and responsibility.
Communities must be created and maintained
through focused human effort. (Hobbs, 1996
Koerner, 1996)
26
A Nursing Forecast Model Pivoted upon Clarity
of Nurse Role using Differentiated Practice
TRENDS
NEEDS
Nurse Role
APRIL 1999
27
Practice/Education Research Center Grant Support
Fund for the Improvement of Post-Secondary
Education (FIPSE) ADN/BSN/MSN students become
acquainted with each others roles in a teamwork
approach to education and practice FIPSE North
American Mobility Students and faculty explore
nurse role clarity and collaboration across the
borders of Canada, Mexico, and USA. HRSA Nursing
Education and Practice Improvement Act of 1998
Supports career mobility and leadership
development for the expanding role of public
health nurses. Studies the impact of education
upon the public health work environment.
28
Practice/Education Research Accomplishments
  • DIFFERENTIATED PRACTICE CONCEPT ANALYSIS
    developed by Dr. Louise Miller/Dr. Alice Kuehn
  • FITZGIBBON HOSPITAL - Best Practices Model for
    DP, initiated development in 1997 currently
    developing model for LTC working on Magnet
    Status.
  • PUBLIC HEALTH/SCHOOL NURSES- Enhancing education
    and resources to prepare them to assume new roles
    in population-based nursing.
  • WEB SITE DEVELOPMENT Nursingfutures.org assisting
    nurses with updates, education, and discussion
    forums.

29
So What Is the Future of OMNWA?
  • Proposals
  • National Library of Medicine (NLM) community
    nursing utilizing information in practice.
    (Submitted January,2003 Notification October,
    2003).
  • CDC letter of intent environmental health
    conference(submitted February, 2003 Notification
    may, 2003)
  • National Science Foundation an innovative
    nursing workforce stability model(to be submitted
    April, 2003 Notification October, 2003)

30
So What Is the Future of OMNWA?
  • Continue MoNF development
  • Continue database center development
  • Continue practice/research center
    development
  • Facilitate development of role clarity/differentia
    ted practice and education.
  • Facilitate hospitals, LTC settings to achieve
    magnet status
  • Evolve to
  • Missouri Center for Nursing Excellence (MoCNE)

31
Office of Missouri Nursing Workforce Analysis
MoNF
DATABASECENTER
PRACTICE/EDUCATION RESEARCH CENTER
Missouri Center for Nursing Excellence
32
The Phenomenon of Nursing Is One of an Ever
Increasing Complexity Within an Ever Expanding
Environment . (Kuehn, 2000 Koerner, Parpiuk,
1994)
Missouri Center for Nursing Excellence
NURSINGS FUTURE IS OURS TO SHAPE
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