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1 Percentages EDUCATIONAL PREPARATION OF NURSES IN LEADERSHIP POSITIONS Chief NursingOfficer (Place an "" The certification pertains to nursing subspecialty (e.g. critical care, orthopaedics, medical-surgical, administration, informatics) but not to a technique (e.g. (one) after the highest degree and ACLS, PALS, NRP). certification): Master/Graduate degree, non nursing Bachelor degree, nursing Master/Graduate degree, nursing Doctorate degree (earned) Certified by a nationally recognized certifying/credentialing organization, if applicable Certified for advanced practice by a nationally recognized certifying organization, if applicable Specify type of certification: Nurse Executives/Supervisors Specify type of degree: Specify type of degree: Specify type of certification: For each position category, please enter the number of FTEs/WTEs of nurses for each level of educational preparation (use the highest level of educational preparation of each nurse Nurse Manager/Ward Manager/ Team Leader MHA MSN CNOR Diploma (3 year post-secondary):.% Associate degree ( year postsecondary):.% Bachelor/university degree, nonnursing:.% Bachelor/university degree, nursing: 3 3.3% Master/Graduate degree, non-nursing: 6.9% MS (Human Resource) 3.4% MS (Health Administration) 3.4% Master/Graduate degree, nursing: % Doctorate degree (earned):.% Certified by nationally recognized certifying body, if applicable: Certified for advanced practice, if applicable: 7.4 Case Management Certitied Prof Healthcare Quality Certified Certified Nurse Manager Certified Nurse Operating Room RN-BC CNRP - Adult CPAN 6 3 MPM-FRM-4 Rev. 8/3/ Rev. No. 8. Pages of 8 pages

2 CAPA Total # of FTEs: MPM-FRM-4 Rev. 8/3/ Rev. No. 8. Pages of 8 pages

3 Unit Designation Advance Practice RN Nurse Practitioners Specify number of FTEs/WTEs in each specialty: APRN Acute Care APRN Acute Care/ (Adult) APRN Acute Care/ (Neonatal) APRN Acute Care/ (Pediatric) APRN Advanced Diabetic Management APRN Adult APRN Family APRN Gerontology APRN Neonatal APRN Nephrology APRN Occupational Health APRN Pediatric APRN Palliative Care APRN Psychiaritc and Mental Health APRN Psychiaritc and Mental Health (Child/Adolescent) APRN Psychiatric and Mental Health (Family) APRN Public Health APRN School APRN Women's Health Care APRN Other: Master/Graduate degree, nursing: 7 8 Doctorate degree: Certification by nationally recognized certifying body: Total # of FTEs: 7 8 MPM-FRM-4 Rev. 8/3/ Rev. No. 8. Pages 3 of 8 pages

4 Medical Clinical Nurse Specialists CNS Acute Care/ (Adult) CNS Acute Care/ (Neonatal) CNS Acute Care/ (Pediatric) CNS Community Health CNS Gerontology CNS Home Health CNS Medical-/Adult Health CNS Pediatric CNS Palliative Care/Hospice CNS Psychiatric and Mental Health (Adult) CNS Psychiaritc and Mental Health (Child/Adolescent) CNS Other Master/Graduate degree, nursing: Doctorate degree: Certification by nationally recognized certifying body: Nurse Anesthetists Total # of FTEs: Certificate only:.6.6 Master/Graduate degree, nursing: Doctorate degree: Total # of FTEs: MPM-FRM-4 Rev. 8/3/ Rev. No. 8. Pages 4 of 8 pages

5 Medical Medical Nurse Midwives, if applicable Certificate only: Master/Graduate degree, nursing: Doctorate degree: Certification by nationally recognized certifying body: Total # of FTEs: Grand Total Nurse Leaders with Graduate Degrees Total Nurse Leaders with National Certification Others: % Percent of All Nurse Leaders with Graduate Degrees Number of Nurse Leaders Certified as APN % Percent of Nurse Leaders with National Certification Percent of Nurse Leaders Certified as APN 5.3% Clinical Nurse Leaders: Master/Graduate degree, nursing: Doctorate degree: Certification by nationally recognized certifying body: Total # of FTEs: Educators by unit: Direct Care Nurse National Certification: MPM-FRM-4 Rev. 8/3/ Rev. No. 8. Pages 5 of 8 pages

6 Units Indicate by unit the number of RN FTEs/WTEs who provide direct patient care or perform other nonleadership/management rolesand are certified as specialist by a nationally or internationally recognized certifying organization. Place nondirect care, non-leader nurses in "V" "All Other". Indicate by unit the percentage of RN FTEs/WTEs who provide direct patient care or perform other nonleadership/management roles and are certified as specialist by a nationally or internationally recognized certifying organization. Place non-direct care, non-leader nurses in "V" "All Other". Specify below the types of certifications and indicate the number of RNs FTEs/WTEs with each type of certification #DIV/! 7.5% 3.% #DIV/! 3.8% 4.% #DIV/! #DIV/! #DIV/! #DIV/! #DIV/! 63.7% 6.% 33.% #DIV/!.7% 3.%.8% 37.7% #DIV/! 48.6% 8.% ACM - Accredited Case Manager CAPA - Certified Perianesthesia Nurse 3 3 CCM - Certified Case Manager CCRN - Registered Nurse CDE - Certified Diabetes Educator 3 6 CEN - Certified Nurse CGRN - Certified Gastroenterology Registered Nurse 8 CHPN - Certified Hospice and Palliative Nurse 9 CIC - Certified Infection Control CMSRN - Certified Medical- Registered Nurse CNOR - Certified Nurse Operating Room 6 5 MPM-FRM-4 Rev. 8/3/ Rev. No. 8. Pages 6 of 8 pages

7 COCN - Certified Ostomy Care Nurse 3 CPAN - Certified Post Anesthesia Nurse 4 CRN - Certified Radiology Nurse 5 CPN - Certified Pediatric Nurse 6 CRRN - Certified Rehabilitation Registered Nurse 3 7 CWCN - Certified Wound Care Nurse 8 OCN - Certified Nurse 9 ONC - Orthopedic Nurse Certified 6 8 PCCN - Progressive Care Certified Nurse RN-BC - Registered Nurse Board Certified SANE-A - Sexual Assault Nurse Examiner - Adult/Adolescent 3 VA-BC - Vascular Access Board Certified : Please indicate by unit the number of RN FTEs/WTEs providing direct patient care that have this as his or her highest NURSING degree. Place nondirect care, non-leader nurses in "V" "All Other". Associate degree ( year postsecondary): Diploma (3 year post-secondary): Bachelor/University degree, nursing: Master/Graduate degree, nursing: Doctorate degree (earned): Is continuing education mandatory for Yes No 9.% % of Direct Care Nurses who have ADNs re-licensure/registration in your state X 37.8% % of Direct Care Nurses who have diplomas or, for international applicants, your Is your organization an Accredited Provider of continuing education? X 39.3% % of Direct Care Nurses who have BSNs Is your organization an Approved Provider of continuing education? X 3.8% % of Direct Care Nurses who have MSNs MPM-FRM-4 Rev. 8/3/ Rev. No. 8. Pages 7 of 8 pages

8 COLLECTIVE BARGAINING Is the nursing staff organized for collective bargaining by a union? (Place an "X" under Yes or No.) If yes, indicate the name of the collective bargaining unit: X.% X X % of Direct Care Nurses who have doctorates in nursing MPM-FRM-4 Rev. 8/3/ Rev. No. 8. Pages 8 of 8 pages

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