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2005 Report Building Education/Service Partnerships: The Service Perspective. California Institute for Nursing & Health Care Optimizing the Health of Californians through Nursing Excellence. c i n h c. 2005 Chief Nursing Officer (CNO) Survey Background 2005.
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2005 Report Building Education/Service Partnerships: The Service Perspective California Institute for Nursing & Health Care Optimizing the Health of Californians through Nursing Excellence c i n h c
2005 Chief Nursing Officer (CNO) Survey Background 2005 Sample size: 156 data submissions received • Data represents 172 acute care facilities • 375 surveys sent; 46% response rate • Data represents the period of January 1, 2005 through September 30, 2005 • Reporting period was December 2005
Background Information California’s Nursing Shortage • In 2004, California ranked 50th in supply of nurses per capita • Nearly 45% of the current California RN workforce was educated outside the state or country • Over 70% of current graduates are educated in associate degree programs • California faces a shortfall of up to 116,000 RNs by 2020 Careforce Consulting Group 2003
CINHC & HASCHistory of Initiatives • Initiated in 2001 by the Hospital Association of Southern California, a regional healthcare association • Primary Objective: Increasing local nursing school enrollments by 400 in 2 years • HASC outcomes have resulted in an increase of over 1400 slots over a 5 year period • Bay Area Survey conducted in 2003
Survey Sample by California Region (10) (70) (76)
Survey Sample - Northern CA(HCNCC Areas) (9) (10) (6) (16) (14) (11) (4)
Survey Sample - Southern CA (HASC Areas – including San Diego) (10) (12) (11) (7) (5) (8) (13) (9) (11)
Foreign Nurse Recruitment (Statewide) • 43% of hospitals have engaged in foreign nurse recruitment in last 2 years (68 respondents) • 30% are actively recruiting (47 respondents) • 35% of hospitals are considering in the future (54 respondents) • 25% are considering and have rejected (39 respondents) • Recruitment cost per foreign nurse averages $19,914 ($2,500 – $80,000)
RN Vacancy Trends(Statewide) • Most report a decline in vacancy rate over the last year • The average vacancy rate is 12% (Range: 2% - 10% - 46%) • 76% define vacancy as unfilled budgeted positions that are currently being recruited for even if filled by traveler staff or other temporary staff • 105 facilities reported 9,304 vacancy positions
Improving New Graduate Retention (Statewide) • 94% of respondents monitor turnover/retention of nursing staff and 86% monitors why nurses leave • 133 respondents reported an average RN turnover rate of 9.4% New Graduate Retention Rates
New Graduate Recruitment • 94% of respondents hire new graduate RNs • Number of new graduates hired/plan to hire:
New Graduate RN Orientation • Average number of days of usual orientation: - 41 days for new graduate hires (131 respondents) • Average cost of usual orientation per nurse: - $15,600 for new graduate hires and range from $1,726 - $50,000 (65 respondents)
Experienced RN Orientation • Average number of days for orientation is 13 days (136 respondents) • Average cost per orientation per experienced nurse is $5,600 and range from $400 - $40,000 (60 respondents)
New Graduate Clinical Internship • 74% (116 respondents) provide a new graduate clinical internship program that extends beyond regular nursing orientation • These programs extend beyond the regular nursing orientation an average of 41 days (103 respondents)
Hiring New Graduates into Specialties • 76% hire new graduates into specialty areas and require a specialty training program (119 respondents) • Program lengths vary widely depending on area
Specialty Training Programs • Top reported specialty areas hospitals require a specialty training program: - Intensive Care - 66% (103) - Emergency Room - 56% (87) - Labor and Delivery - 53% (83) - Step Down/Telemetry - 51% (80) - Operating Room - 47% (74)
Faculty/Resource Commitment to Education • 58% of hospitals have internal resources assigned to assist or facilitate student rotations (91 respondents) • 42% of hospitals have staff functioning in a joint appointment (faculty/practice) (66 respondents) - A total of 386 staff serving in this role • 36% of hospitals have additional masters prepared staff who are interested and willing to serve as clinical faculty (56 respondents) • 70% reported that schools pay for the staff time for adjunct faculty (45 respondents)
Hospitals Capacity for Students (Statewide) • 58% of reported hospitals feel they can absorb more students for clinical rotation (90 respondents) • 55% of respondents contribute additional support to schools. (86 respondents) • No significant difference in preference for Bachelor’s or AD students • 39% of hospitals will take LVN students
Clinical Capacity for Student Rotations % of Hospitals with Space Available by Specialty & Time
What Kind of Students Can Hospitals Take? (Economic Regions)
Hospitals Financial Support to Schools • 55% of respondents provide financial subsidies or support local nursing educational programs. • Financial support range between $500 - $2.1 million.