Long Term Care Nursing Pilot Study 2003
Vermont Health Workforce Assessment Survey
PREPARED BY: OFFICE OF NURSING WORKFORCE RESEARCH, PLANNING, AND DEVELOPMENT
University of Vermont, College of Nursing and Health
Sciences
(802) 656-0023 e-mail: marypalumbo@uvm.edu
Notes and References:
1. HWAT members are from the UVM College of Nursing and Health Sciences, School of Business Administration, Community and Economic Development, Bioinformatics, College of Medicine Area Health Education Center and Fletcher Allen Health Care. The project was funded by the VT Department of Health, Office of Rural Health.
2.
American Association of Colleges of Nursing. (2002) Nursing Shortage
Fact Sheet. http://www.aacn.nche.edu/Media/
Backgrounders/shortagefacts.htm (Sept. 30, 2002).
WHY WAS THIS SURVEY DONE?
One factor in assuring access to quality health care for all Vermonters is an ongoing and current knowledge of the state’s health workforce resources. To this end, the Office of Nursing Workforce Research, Planning and Development created the Health Workforce Assessment Team (HWAT)1. This team was charged to develop a new system to assess Vermont’s healthcare workforce, including new ways to measure the state’s need for various healthcare positions. The following is a report of the 2003 pilot survey of long term care facilities. For some positions up to half of the data was missing or invalid.
WHO WAS SURVEYED?
In February 2003, the Vermont Health Workforce Survey was sent to all 44 Vermont long term care facility nursing directors. This contact person was asked to participate in the data collection with assistance from human relations and other department heads. Follow up postcards, letters, telephone calls and replacement surveys were used to assure a high response rate. The response rate was 59% (26 of 44 facilities responded).
WHAT WAS LEARNED?
|
||||||||||||
| Statewide Vacancy Rate | % (Range) |
| RN | 19% (0-100%) |
| Nurse Managers | 11% (0-50%) |
| LPN | 9% (0-60%) |
| LNA | 0% (0-22%) |
| Quality Assurance/Educator | 0% |
| MDS Coordinator | 0% |
| Vacancy rates were calculated as follows: 1 –(Total actual FTEs employed from all responding institutions divided by the total budgeted FTEs from all responding institutions) as of 2/15/03. | |
| Statewide Turnover Rate | % (Range) |
| LNA | 56% (0-128%) |
| Nurse Managers | 46% (0-400%) |
| RN | 35% (0-80%) |
| LPN | 30% (0-115%) |
| Quality Assurance/Educator | 8% |
| MDS Coordinator | 7% |
| Turnover rates were calculated as follows: Total # workers leaving institution between 2/15/02 – 2/15/03 divided by total # part-time + full-time workers employed as of 2/15/03. | |
LIMITED USE OF RECRUITMENT INCENTIVES FOUND:
- 11% of responding LTC facilities reported a positive impact of starting salaries on recruitment.
- 12% of responding LTC facilities reported a pay differential for RN educational preparation.
- 4% of responding LTC facilities reported a pay differential for credentialed RNs.
| IMPACT OF SHORTAGES | Never |
Several times a year |
Monthly |
Weekly |
Daily |
Missing or n/a |
| Reduced number of staffed beds |
62% |
19% |
8% |
12% |
||
| Delayed or diverted admissions |
54% |
27% |
8% |
8% |
4% |
|
| Mandatory staff overtime |
65% |
12% |
4% |
8% |
4% |
8% |
| Decreased patient satisfaction |
54% |
38% |
4% |
|
4% |
|
| Increased patient complaints |
46% |
42% |
8% |
4% |
|
|
| Decreased staff satisfaction |
23% |
42% |
15% |
|
15% |
4% |
| Curtailed plans for facility expansion |
Yes 15% |
No 77% |
8% |
|||
| Discontinued clinical programs |
Yes 12% |
No 81% |
8% |
More of the LTC nursing staff work fulltime compared to other settings.
|
||||
CONCLUSIONS:
Vermont is experiencing a nursing shortage similar to other areas of the country. In September, 2002 the AACN reported that the annual nurse vacancy rate an U.S. hospitals is 13%, and that one in seven hospitals has an RN vacancy rate over 20%2. Vermont’s long term care RN vacancy rates are currently higher than this national average. Fewer RNs are working fulltime, which may decrease agency cost for benefits but may create more underinsured workers. Turnover rates of 30% or more in 4 of 6 nursing positions will mean that valuable health care dollars will be spent on recruitment and orientation. Continuity of care is also at greater risk with increased turnover. At this time, the largest impact of the nursing shortage is in the areas of staff satisfaction and patient complaints.
School of Nursing, University of Vermont
Burlington, VT 05405, phone 802-656-0023