ANALYZING NURSING WORKFORCE DATA TO DESIGN
NURSING EDUCATION STRATEGIES TO MEET THE
EXPANDED HEALTHCARE NEEDS OF THE FUTURE
The National Forum of State Nursing Workforce Centers
June 11, 2015
Virginia D. Ayars, EdD, MS, RN, CNE, Texas Board of Nursing
Pamela Lauer, MPH, Texas Center of Nursing Workforce Studies
Purpose
• Assess how data collection assists in the tracking
and implementation of state-based nursing
education initiatives aimed at expanding and
improving the nursing workforce.
Learner Objectives
• Describe the impact of data in designing
education models to increase the number of
nurses enrolling in advanced degree programs.
• Discuss recommendations for quality
improvement in clinical instruction based upon
data, literature findings, and dialogue among
experts.
Collaboration
• Texas Center for Nursing Workforce Studies (TCNWS)
• Texas Legislature created TCNWS in 2004
• Educational and employment trends
• Supply and demand trends
• Nursing workforce demographics
• Migration of nurses
Collaboration (cont.)
• Texas Board of Nursing (BON)
• Mission
• Licensees in Texas
• 250,000 RNs
• 96,000 LVNs
• Nursing Education Programs
• 117 Professional Nursing Education Programs
• 1 Diploma
• 69 Associate Degree
• 47 Baccalaureate Degree
• 93 Vocational Nursing Education Programs
• 24 Advanced Practice Registered Nurse Programs
Process of Development and Revisions of
Two Data Instruments
• Nursing Education Program Information Survey
or NEPIS
• Compliance Audit for Nursing Education
Programs or CANEP
Samples of Data Reports
• Developed by TCNWS for state legislature
• Provide evidence for funding formula decisions and
faculty loan repayment programs
Accepting the Challenge
• IOM Recommendation to increase BSN-prepared
nurses to 80% by 2020
• RN-to-BSN Programs (32 programs in 2014)
• RN to BSN Fact Sheet
• Academic Progression in Nursing (APIN) Grant
Program
Methods for growth
• Increase the number of ADN graduates enrolling
immediately following graduation in RN-to-BSN
programs
• Encourage those already in practice to return to
school for the BSN
• APIN Grant focus:
• Increasing enrollments
• Monitoring progress through data collection and analysis
Data to Track Academic Progression
• In academic year 2014, 2,902 RNs graduated
from Texas RN-to-BSN programs.
• Nursing workforce data and BON licensing data
can be used to determine:
• Total number of RNs needed by 2020 (demand
projections)
• Current breakdown of nurses by highest degree (licensure
data)
• Number of students enrolling and graduating from RN and
RN-to-BSN programs (education data)
Sub-goals and Tactics
• Develop policy strategies
• Increase diversity in nursing workforce
• Demonstrate alignment and collaboration between
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practice and education
Implement APIN II Grant
Develop a faculty student distance model using
technology
Provide leadership
Create and deploy tool box for faculty
New Curriculum Model
• Consortium for Advancing Baccalaureate Nursing
Education in Texas or CABNET model to promote
mobility into advanced degree programs
CABNET Objectives
• Expand the number of CABNET agreements between community
colleges and universities
• Expand number of programs participating in concept-based
curriculum to 15.
• Develop, implement, and evaluate faculty development programs
CABNET Objectives (cont.)
• Use a focus group methodology to assess employer and regional
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leaders’ perceptions of behaviors demonstrating competence of the
“nurse of the future” especially for IOM concepts
Increase the percentage of RNs who are ethnic minorities by 5% of
2014 baseline number
Document the employment policies used by partnering clinical sites
that support academic progress for nurses
Develop a process to document the number of Texas ADN graduates
immediately enrolling in BSN programs
Develop a process to document the number of graduates from out-ofstate RN-to-BSN programs
Concept-based Curriculum
• Concept is an organizing idea, principle or
unifying classification
• Sustainable
• Universal
• Attributes (characteristics)
• Defining attributes are rules or parameters
Conceptual Learning
• Focusing on big ideas – concept
• Linking concepts to exemplars for content knowledge
• Linking to inter-related concepts
• Fostering deep learning, and deep understanding through
connections and reflection (as opposed to surface
learning)
• Using clinical context as a foundation for student-centered
learning with a purpose
Positive Aspects
• Allows for deep learning of concepts
• Content management
• Maximizes efficiency
• Prevents content saturation
• Application to key exemplars
• Variety of clinical settings
Texas CBC
• Professional Nursing Concepts
• Health Care Concepts
• Clinical Judgment
Future Monitoring
• Program Effectiveness can be monitored through:
• Program track data (education data)
• Enrollment, graduation, and admission numbers
(education data)
• Workforce race/ethnicity data (licensure data)
• Student race/ethnicity data (education education)
Using APRN Data
• Provide readiness through data to meet the
needs of the ACA
• Establish an APRN database
• Reflect enrollment and graduation trending
Recommendations for Quality
Improvement
• October 2011 Charge to BON Task Force to
Study Implications of Growth in Nursing
Programs in Texas
• Create a forum for dialogue
• Ensure state will continue to provide quality nursing
education
Products
• Two new Education Guidelines
• Precepted Clinical Learning Experiences
• Utilization of Part-time Clinical Nursing Faculty
• Two new charges issued to Task Force at
October 2013 Board meeting
• Develop guideline re. optimal clinical instruction
• Provide analysis of findings from 2013 NEPIS re. required clinical
hours
Collection of Data
• Online Task Force Survey
• BON Survey
• Texas Team Clinical Placement Survey
• TAVNE Survey
• 2013 NEPIS Reports
Application of Data
• Task Force Monograph
Towards Defining Excellence in Clinical
Instruction in Pre-licensure Nursing
Education Programs
Ten Criteria
1) Patient Safety is fundamental to every student patient
encounter.
2) Sufficient opportunities are provided for students to apply
knowledge and skills.
3) Faculty have the authority to plan, supervise, and evaluate the
clinical experience.
4) Faculty provide coaching and positive feedback to students
consistently.
5) Clinical experiences are provided in a variety of clinical
settings.
Ten Criteria (cont.)
6) Opportunities are provided for faculty to guide clinical
decision-making by students.
7) Evaluation tools are used to document student performance
and promote growth.
8) The program supports opportunities for faculty skill
development.
9) Clinical evaluation tools reflect competencies in the
Differentiated Essential Competencies for Graduates of
Nursing Education Programs in Texas (DECs).
10) Simulation activities are provided that mimic reality of the
clinical setting.
Recommendations
• Programs
• Support faculty development.
• Provide adequate orientation to new faculty.
• Evaluate the use of preceptors, possibly reserving for a capstone
course.
• Emphasize the importance of relationship building among faculty,
students, and clinical partners.
• Evaluate whether faculty-to-student ratios promote patient safety.
Recommendations (cont.)
• Faculty
• Carefully plan time in the clinical setting.
• Consider other venues for pre- and post-conferences.
• Review and revise clinical evaluation tools to provide a formative
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and summative evaluation.
Seek ways to enhance the use of skills and simulation laboratories.
Ensure that clinical experiences are planned to meet clinical
objectives.
Seek supplemental learning activities for medication administration
and documentation.
Model positive characteristics of respect and caring.
Recommendations (cont.)
• Students
• Take advantage of strategies to engage in active learning activities
to fully gain the knowledge, skills, and abilities essential to safe,
competent nursing practice.
• Express positive characteristics of respect and caring to peers,
faculty, and patients.
Recommendations (cont.)
• Clinical Partners
• Patient safety foremost factor in clinical placement of students.
• Consider allowing faculty to participate in opportunities for clinical
skills development.
• Contribute to relationship building among faculty, students, and
clinical partners.
• Engage in dialogue with education programs to clarify joint
expectations for preceptor roles, clinical objectives and clinical
supervision.
• Assist the programs by providing feedback regarding the clinical
learning experiences.
Major Outcomes
• Data instrumental in monitoring progress re:
1) increasing nurses with BSN degrees
2) increasing minorities in nursing
3) a pilot project that implements a Concept-Based Curriculum Model
designed for ease of mobility into a BSN program
4) increasing APRN enrollment
5) using more clinical time in simulation to free space in clinical
settings among pre-licensure nursing programs
Conclusions
• Efforts for growth and quality improvement are based in
part upon workforce data and will rely upon data for
evaluating the effectiveness of new strategies and
planning for the future.
Thank You!
Email
Phone
Website
Virgina.Ayars@bon.texas.gov
512-305-7660
www.bon.texas.gov
Pamela.Lauer@dshs.state.tx.us
512-776-6723
www.dshs.state.tx.us/chs/cnws