Nursing Professional Development Organizational Value Mary G. Harper, PhD, RN-BC Director of Nursing Professional Development, ANPD Joan I. Warren, PhD, RN-BC, NEA-BC, FAAN President, ANPD Julie Aucoin, DNS, RN-BC, CNE
Acknowledgement Funding provided by ANPD
Most Frequent Question How many NPD specialists should my organization have? No prior evidence found
Design Descriptive survey approach 70 data points Distributed to individual hospitals and systems Electronic consent and survey
5000 hospitals 250 submissions Sampling > 14 incomplete/unidentifiable records > 15 duplicates > 16 children s hospitals > 3 long term care facilities 202 acute care hospitals
Hospital Characteristics 6.5 Non-profit For profit 93.5
Hospital Characteristics Urban 22.60% 40.70% Suburban Rural 36.70%
Hospital Characteristics 18% 17% 2% Community Teaching Academic med ctr Govt. 63%
Hospital Characteristics Region # West 12 Central 16 East 15 No answer 7
Hospital Characteristics Mean Range Licensed beds 460 18-2144 # employees 3790 68-29,000 # RNs 1120 26-5421 Budget hrs ed/rn 20 0-182 Hires: # NLNs 64 0-422 Hires: # Experienced RNs 112 0-614
Hospital Characteristics Measures of Excellence Magnet or journey 53% CNE Provider (State/National) 86% CE other disciplines 68% Baldridge 9% US News 41% Leapfrog 22% Top 100 13%
Findings
NPD: Operational Definitions > NPD specialist; nurse assigned primary educator responsibility > Measured as FTE RNs > Measured as unique individuals
Bed Size Analysis Descriptors Bed Size n X Beds X Emp X RNs X NPD (FTE) 0-200 (small) 56 112 1029 279 2.7 201-400 (med) 401-1000 (lg) 1001-2144 (mega) 61 298 2361 687 7.8 63 638 5500 1707 12.7 20 1373 10,384 2864 28
Individual NPD Characteristics (n~2000) NPD 16% Clinical 50% CNE 2% None 32% ASN 4% BSN 34% Masters 59% Doctorate 3% < 1 yr 14% 1-5 yr 34% 6-10 yr 24% 11-15 yr 14% 16-20 yr 7% 20+ yr 7%
Distribution of Resources Activity Mean % Orientation 33% Clinical education 25% Mandatories 25% Life Support 22% Residency 22% Externships 20% Preceptor development 18% Equipment 18% Documentation 15%
Outcomes Measured All certified nurses Newly licensed nurse retention Four HCAHPS measures: communication, pain control, discharge information, medication explanation Influenza vaccine CLABSI rate CAUTI rate
Created rates Analysis Method > NPD RN rate = NPD FTEs / number RNs > NPD Bed rate = NPD FTEs / licensed beds Determined median for outcome measures Compared rates to above and below median Determined significance
Nurse Outcome Results No statistical significance > # certified nurses > Newly licensed nurse (NLN) retention
Patient Satisfaction Results No statistical significance > Pain control > Medication teaching Statistical significance (p<0.05) > Communication: Higher scores with higher rate of NPD/bed > Discharge information: Higher scores with higher rate of NPD/bed
Patient Care Results No statistical significance > Influenza immunization > CLABSI > CAUTI
Limitations Outcomes influenced by variety of factors NPD rates vary by hospital size and # RNs Variation in measurement among organizations (e.g. retention rates)
Implications Data are descriptive, not prescriptive > NPDs vary greatly by facility size > Further analysis by bed size, facility type to create a profile Analysis of workload and work focus Certification in NPD is needed
Future Directions Secondary analysis of data Clarity of definitions Repeat data collection Focus on underrepresented settings Develop NPD staffing models Promote NPD certification
Thank you! Study & session participants Dr. Aucoin: jaucoin@nc.rr.com Dr. Warren: joan.warren@medstar.net Dr. Harper: mharper@anp.org