Alaska Nursing

November 18, 2016

Nursing Education

2002 Nursing Education Task Force Recommendations

Double graduates from basic nursing programs

(AAS and BS) – from <100 to >200 – by 2006

Distribute programming across the state from

Anchorage base

Closely articulate levels of nursing education

Accomplishing this would require extensive and intensive

planning and decision-making, and committed stakeholder

engagement. Funding allocations and educational policies and practices had to align.

3

Expansion Timeline

Pre-expansion period

Prior to 2000 through 2002

Growing shortage reported and Task Force convened

Plans made to implement recommendations

Expansion period

2003-2006

Basic nursing programs changed

Graduate numbers doubled

AAS program distributed

Post-expansion period

2007 to present

Maintenance of gains

Additional outreach sites brought on line

Ongoing challenges identified

4

Expansion Details BS program

Trimester schedule; decreased program length to 5 consecutive trimesters

Admission cohort size from 32 to 40

Rolling admission open to all achieving specific GPA

AAS program

Outreach sites established in 13 communities; cohort sized per site capacity

LPN slots added in Anchorage

Admitted to Anchorage site in Fall semester, Outreach sites in Spring semester

Admission process ranked applicants to each site

Program length of 4 semesters with summer breaks

RN-to-BS program

Program improved

Offered via distance delivery methods

5

Basic Nursing Programs (AAS, BS)

0

20

40

60

80

100

120

140

FY

00

FY

01

FY

02

FY

03

FY

04

FY

05

FY

06

FY

07

FY

08

FY

09

FY

10

FY

11

FY

12

FY

13

FY

14

FY

15

FY

16

AAS BS

0

50

100

150

200

250

300

FY

00

FY

01

FY

02

FY

03

FY

04

FY

05

FY

06

FY

07

FY

08

FY

09

FY

10

FY

11

FY

12

FY

13

FY

14

FY

15

FY

16

Total Basic Nursing Graduates

AAS Nursing Program Sites

AnchorageBethelDillinghamFairbanksHomerJuneauKenaiKetchikanKodiakKotzebueMat-SuNomeSitkaValdez Kenai

Homer

Mat-Su

7

NCLEX First Time Pass Rates

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

May

-00

Sep

-00

Jan

-01

May

-01

Sep

-01

Jan

-02

May

-02

Sep

-02

Jan

-03

May

-03

Sep

-03

Jan

-04

May

-04

Sep

-04

Jan

-05

May

-05

Sep

-05

Jan

-06

May

-06

Sep

-06

Jan

-07

May

-07

Sep

-07

Jan

-08

May

-08

Sep

-08

Jan

-09

May

-09

Sep

-09

Jan

-10

May

-10

Sep

-10

Jan

-11

May

-11

Sep

-11

Jan

-12

May

-12

Sep

-12

Jan

-13

May

-13

Sep

-13

Jan

-14

May

-14

Sep

-14

% P

ass

ed N

CL

EX

Fir

st T

ry

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

% P

ass

ed N

CL

EX

Fir

st T

ry

Anchorage Outreach Sites

BS

AAS

Graduation Rates

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%S

u2

00

4

F20

04

Sp2

00

5

Su2

00

5

F20

05

Sp2

00

6

Su2

00

6

F20

06

Sp2

00

7

Su2

00

7

F20

07

Sp2

00

8

Su2

00

8

F20

08

Sp2

00

9

Su2

00

9

F20

09

Sp2

01

0

Su2

01

0

F20

10

Sp2

01

1

Su2

01

1

F20

11

Sp2

01

2

Su2

01

2

F20

12

Sp2

01

3

Su2

01

3

F20

13

Sp2

01

4

Su2

01

4

BS Graduation Rate by Admission Cohort

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

% G

rad

ua

ted

Anchorage Cohorts Outreach Site Cohorts

AAS Graduation Rates Anchorage and Outreach Sites

Graduate Program, Pre-Nursing Majors

0

10

20

30

40

50

60

70

Fall

00

Fall

01

Fall

02

Fall

03

Fall

04

Fall

05

Fall

06

Fall

07

Fall

08

Fall

09

Fall

10

Fall

11

Fall

12

Fall

13

Fall

14

Fall

15

Nursing Science MS and DNP Students

0

200

400

600

800

1,000

1,200

1,400

Fall

00

Fall

01

Fall

02

Fall

03

Fall

04

Fall

05

Fall

06

Fall

07

Fall

08

Fall

09

Fall

10

Fall

11

Fall

12

Fall

13

Fall

14

Fall

15

Pre-Nursing Majors (UAA, UAS)

National Admissions to Basic Nursing Programs 2014

(NLN, national data)

Main Obstacles to Expanding Admissions to

Basic RN Programs, 2014 (NLN, national data)

Nurse Workforce

Workforce Age

1.3%

7.0%

9.7%

9.0%

9.8% 10.3%

13.3%

17.4%

15.3%

7.1%

0.0%

2.0%

4.0%

6.0%

8.0%

10.0%

12.0%

14.0%

16.0%

18.0%

20.0%

<25 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+

Average Age of Alaska RN Survey Respondents

41.0

42.0

43.0

44.0

45.0

46.0

47.0

48.0

49.0

50.0

1996 1998 2000 2002 2004 2006 2008 2010 2012 2014

Alaska Registered Nurse Respondents by Age Group (2014)

30-39

4%

40-49

17%

50-59

49%

60-69

30%

Age SON Faculty 2009

2010 2012 2014

No Plans to Leave 54.0% 50.0% 49.2%

Leave Within 1-5 Years 35.0% 38.0% 38.7%

Leave Within 1 Year 11.0% 12.0% 12.1%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

Respondents’ Plansto Leave Nursing

Diversity

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Fall

2000

Fall

2003

Fall

2004

Fall

2005

Fall

2006

Fall

2007

Fall

2008

Fall

2009

Fall

2010

Fall

2011

AK

2010

AAS BS

% Caucasian Nursing Students

% Caucasian RN Survey Respondents

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

1996 1998 2000 2002 2004 2006 2008 2010 2012 2014 AK

2010

Caucasian Alaska Native/Native American

Asian/Pacific Islander Black/African American

Other/Two or More

Employment

0

1000

2000

3000

4000

5000

6000

7000

8000

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

# R

egis

tere

d N

urs

es i

n W

ork

forc

e

Annualized Quarterly Employment of RNs in Alaska

(government and self-employed not included)

DOLWD

Number of RN License-holders in 2014:

Residents = 8,487; Non-residents = 4,089

16

Labor Market Area Alaska Licensees (%)Alaska Population (%)

2014 est.

Anchorage / Mat-Su 65.4 54.2

Gulf Coast 10.0 11.0

Interior 10.9 15.3

Southeast 9.9 10.1

Southwest 2.2 5.8

Northern 1.7 3.7

Projected Workforce Demand

78

220

167

256

231251 249

201

0

500

1000

1500

2000

2500

3000

1994 1998 2002 2004 2006 2008 2010 2012

5.7%

11.0% 11.5%

8.0%

9.0%

11.0% 11.0%

9.0%

0.0%

2.0%

4.0%

6.0%

8.0%

10.0%

12.0%

2000 2001 2002 2003 2005 2007 2009 2012

Projected Annual Demand for Additional RNs (does not include government/self-employed)

Vacancy Rate – All RN Positions

DOLWD

UAA

DOLWD Projects 10.2% IncreaseFor Registered Nurses 2014-2024

Growth 545 Replacement 1,328 Total 1,873

ASHNHA Employer Survey 2016 (29 Respondents)

Positions Vacancies Vacancy Percent

Hospitals:

Urban 3591 333 9.3%

Rural 392 55 14.0%

Hospital Total: 3983 388 9.7%

LTC:

Urban 206 19 9.2%

LTC Total: 206 19 9.2%

Total: 4189 407 9.7%

ASHNHA MembersTrouble filling generalist

positions?Trouble filling specialist

positions?

Total Respondents 20 Y, 9 N 21 Y, 7 N

Urban Hospitals 4 Y, 6 N 9 Y, 0 N

Rural Hospitals 11 Y, 2 N 10 Y, 3 N

Urban Long Term Care 5 Y, 1 N 2 Y, 4 N

Facility CategoriesUrban Hospitals: 10 Nurse Positions

Peacehealth Ketchikan 200

Mat-Su Regional 296

Central Peninsula 200

Bartlett Memorial 105

Alaska Regional 400

NorthStar 90

Providence AMC 1000

Elmendorf 200

Fairbanks Memorial 300

Alaska Native Medical Center 800

3591

Rural Hospitals: 13 Nurse Positions

Samuel Simmonds 35

Cordova 10

Wrangell Medical Center 9

YKHC 50

South Peninsula 120

Sitka Community 50

Norton Sound 7

Providence Seward 16

Petersburg Medical Center 20

Maniilaq 8

Kanakanak 30

Providence Kodiak 9

Providence Valdez 28

392

Urban LTCs: 6 Nurse Positions

Denali Center 39

Horizon House Assisted Living 2

Prestige 44

Providence Transitional Care 30

Wildflower Court 25

Providence Extended Care 66

206

Education Level Preference

Does your organization require bachelor's preparation for new staff nurse hire?Urban Hospital Rural Hospital Urban LTC Total

Yes, requires bachelor's preparation 1 0 0 1

No, but is considering requiring bachelor's preparation for new hires 1 0 2 3

No, but prefers bachelor's preparation in hiring 4 10 1 15

No, has no stated or understood preference for bachelor's preparation in hiring 4 3 3 10

When you hire a general staff nurse, do you prefer to hire …?Urban Hospital Rural Hospital Urban LTC Total

A nurse with a bachelor's degree 5 6 0 11

A nurse with an associate degree 0 1 0 1

Either - doesn't matter whether bachelor's or associate degree 3 2 5 9

Depends on position 1 4 1 6

Hard to Fill Specialties

0

2

4

6

8

10

12

Urban Hospital Rural Hospital Urban LTC Totals

From ASHNHA Employer Survey

# Occupation % w Difficulty

1 Psychiatric Nurse Practitioners 100%

1 Psychiatrists 100%

1 Rehabilitation Counselors 100%

4 Chief Medical Officers 94%

5 Surgical Technicians/Technologists 93%

6 Psychiatric Nurses 91%

7 Substance Abuse Disorder Counselors 90%

8 Occupational Therapists 90%

9 Mammographers 89%

10 Perioperative Nurses 88%

11 Nurse Managers 87%

12 Pharmacists 86%

12 Obstetric Nurses 86%

12 Diagnostic Medical Sonographers 86%

15 Geriatric Nurses 85%

16 Case Management Nurses 84%

16 Speech-Language Pathologists 84%

18 Critical Care Nurses 83%

18 MRI Technologists 83%

18 Pediatricians 83%

20 Physical Therapists 82%

Hardest to Fill Occupations 2015 (DOLWD)

22