CRE Grant Proposal Application FormNCSBN Center for Regulatory Excellence

Send your completed application to:NCSBN Center for Regulatory Excellence

Attention: H. SnyderSubmit as an attached word document to CRE@ncsbn.org

Subject: CRE Grant Proposal

PLEASE TYPE – USE ONLY THE SPACE PROVIDED BELOW

Principal Investigator: Patricia Moulton, PhD

Co-Investigator(s): Rhoda Owens, PhD, BSRN- Co-Principal Investigator, Thomas Petros, PhD- Co-Investigator

Stephanie Deese, MA- Co-Investigator

Investigator Contact Information:

Name: Patricia Moulton, PhD

Title: Executive Director

Organization: North Dakota Center for Nursing

Street Address: 3523 45th Street SouthCity, State, Zip: Fargo, ND 58104Country: United States

Telephone: 701-639-6548E-mail: patricia.moulton@ndcenterfornursing.org

Date Submitted: October 5, 2018

Official from Investigator’s Organization to notify if awarded:

Name: Stacey Pfenning, DNP, APRN, FNP, FAANP

Title: President, ND Center for Nursing Board of Directors

Organization: Executive Director, North Dakota Board of Nursing

Street Address: 919 S. 7th Street Suite $504City, State, Zip: Bismarck, ND 58504

Telephone: 701-328-9781E-mail: spfenning@ndbon.org

Organization Type: (Check one)

_X_ Non-profit ___ Public/Government ___ Individual ___Other, please describe

Organization Information:

Legal Name according to the IRS (for U.S.) or IRS-equivalent (non-domestic): North Dakota Center for Nursing

Tax ID Number: 45-2605788

Does the organization have 501(c)(3) status? __X_ Yes ___ No

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Organization’s Scope of Work: Organizational mission, focus, audience served, and geographic reach.

The North Dakota Center for Nursing is a non-profit, 501c3 organization that was developed in 2011 to represent over

18,000 nurses and over 40 nursing organizations across North Dakota. The mission of the North Dakota Center for

Nursing is through collaboration to guide ongoing development of a well-prepared and diverse nursing workforce to

meet health care needs in North Dakota through research, education, recruitment and retention, advocacy and public

policy. 

A key focus is the collection of nursing workforce research and the development of new policies and regulations. Prior

to the creation of the Center, the Dr. Moulton has been collecting has been tracking education, supply and demand trends

since 2002. This started with the North Dakota Nursing Needs Study, a legislatively mandated study and has continued

with the support of the North Dakota Board of Nursing and through the North Dakota Center for Nursing. The audience

and geographic reach of the North Dakota Center for Nursing as indicated by our mission is to the meeting the health

care needs of the population of North Dakota.

Most recently the ND Center for Nursing has served a key role as a co-lead for the ND Governors Nursing Shortage

Task Force. This has been a great opportunity to further merge nursing workforce research with state policy and

regulation and the research of the center and of the proposed grant project will both serve a central place in state

workforce policy.

How did you hear about the Center for Regulatory Excellence? website

Is this application a CRE Grant re-submission? ____ Yes_X___ No

If yes, please provide project number, if known.

Previous Center for Regulatory Excellence Support -

Has your organization received previous support from NCSBN? ____ Yes __X__ No

If yes, please provide project number, if known.

All funded research projects require IRB approval or exemption. Please indicate the date of Institutional Review Board

(IRB) approval or if approval is pending, list “pending” with date of IRB submission.

Date of IRB approval: ___Pending- Submitted XXX____________________

If your proposal is recommended for funding, we expect that you will have IRB approval by the grant start date.

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Project Title: Influence of Professional Quality of Life and Work Satisfaction on Intent to Stay: A Mixed Methods Approach to Inform Policy

Project Overview

The proposed project provides the unique opportunity to link policy/regulation with research. North Dakota

established a Governors Nursing Shortage Task Force in 2017 that has been working on developing potential

solutions for the nursing shortage. The task force has identified the need to learn more about what factors

increase the likelihood of nursing students and nurses to stay in North Dakota and at their current employers.

Results from the proposed study would be used to inform policy and regulation changes. In addition, the

Workplace Culture subcommittee of the Governor’s task force is working to establish a North Dakota specific

workplace culture designation system. Results from this study will help inform the final system.

The proposed survey phase will incorporate already established instruments to measure Intent to Stay, Nurse

Satisfaction, Professional Quality of Life, Nursing Student Decision-making, and Minimum Data Set

Demographics. This will provide an innovative examination of predictors using a multi-disciplinary approach.

Graduating nursing students and practicing nurses will each receive surveys and all levels of nurses will be

included. This mixed-methods study will utilize focus group data in the second phase to further explore policy

and regulation options in response to survey findings. The assembled multi-disciplinary research team includes

expertise in psychology, public policy, nursing, psychometrics, advanced statistical methods and higher

education. In addition, the Workplace Culture Subcommittee provides vast experience and expertise to advise

the research team at every step of the process and to develop policy and regulation recommendations.

Purpose, Problem Statement or Research Question(s):

The United States is confronting a set of contemporary health and healthcare challenges with numerous

and complex elements. Multilayered health professions education and health care delivery systems face an

array of demands including expectations for responsiveness in meeting current and emerging health care access

and quality needs. For example, demands placed on the nation’s healthcare infrastructure include caring for

culturally diverse populations with different language and health care customs and markedly increased numbers 3

of individuals seeking care for chronic conditions (Greer, 2008; Medicare Payment Advisory Commission,

2008). An aging population also adds expectations for training and deploying the health workforce to deliver

care specific to this population that is accessible, efficient and of high quality. Geographic variation in care

quality also exists. Emerging approaches to solving this set of thorny challenges, including driving performance

improvement through structural changes in payment policy, have major implications for both the delivery of

health care services and the preparation of the workforce providing these services (Wakefield & Moulton,

2008). Health personnel shortages can negatively impact health care quality, through reduced health care

access, increased stress on providers, and the use of under-qualified personnel. Also, shortages can contribute

to higher costs by raising compensation levels to attract and retain personnel and by increasing the use of

overtime pay and expensive temporary personnel.

North Dakota is experiencing a nursing shortage much like most states. Although, there are marked

differences in ND’s nursing workforce shortage. The state has more than the national average of nurses

available, but they tend to live and work in the eastern portion of the state with some of the biggest cities and

larger health care systems. This leaves the other 2/3 of the state with inadequate nurses. However, even the

large health care systems in the urban areas are experiencing recruitment issues as they continue to expand the

size and breadth of health care coverage and compete with nearby facilities in Minnesota that have a marked

increase in salaries that can be partially attributed to differences in reimbursement.

Examining the last five years, the average of LPN program completers by nursing program that intend to

license in North Dakota was over 90% for all programs that have not closed. Over the last five years, the

average of RN program completers by nursing program that intend to license in North Dakota was 84% or

higher for all programs that have not closed.

Further, data shows that ND-educated nurses tend to stay in North Dakota post-graduation for a time,

but data also indicates an increase in the likelihood for a nurse to leave the state 2+ years after graduation, and

that at 5-7 years post-graduation, the average retention rate is 48.68%. (Less than half of RN graduates that

graduated in 2010-2012 are still employed in ND.)

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Table 1: North Dakota employment rates by years after degree completion by cohort year

CohortYear

Coho Size

1 Year 2 Years 3 Years 4 Years 5 Years 6 Years 7 Years

2010 309 73.8% 67.3% 57.6% 55.7% 53.7% 53.1% 49.8%2011 378 68.0% 62.7% 56.1% 52.6% 47.9% 44.2% 2012 415 59.0% 53.0% 48.7% 46.7% 43.4% 2013 456 61.8% 56.8% 51.1% 45.2% 2014 500 58.2% 50.8% 43.2% 2015 520 61.0% 55.6% 2016 562 59.3%

Source: Statewide Longitudinal Data System 2018.

Upon graduation some NPs choose to practice in North Dakota. Overall, 40% of the 2015 and 2016

North Dakota’s NP program graduates began their practice in North Dakota health care facilities (Zwilling &

Owens, 2017).

North Dakota also has higher than average number of nurses that are unemployed. For ND licensed LPNs

that live in North Dakota, 14% are unemployed which is higher than the national average of 10.3% (Budden,

Moulton, Harper, Brunell & Smiley, 2016). For those ND Licensed RNs that live in North Dakota, 8% are

unemployed which is higher than the national average of 5.8% (Budden et al., 2016). For ND nurses, reasons

for unemployment included caring for home and family, going to school and other reasons

In recognition of a shortage of nurses in North Dakota, shortly after being sworn into office, Governor Doug

Burgum convened a taskforce comprised of a diverse group of stakeholders to examine the issue, identify

causes, possible solutions, and to make policy recommendations to address this critical shortage. After

extensive collection and analysis of education, supply and demand and workforce projections, the group

developed draft drivers and strategies that were also vetted with multiple groups in the fall of 2017. This

resulted in a set of 15 strategies that are in the process of being incorporated into the Governor’s Policy agenda

for the 2019 legislative session. The first driver is examining barriers to entry into nursing programs and ways

to maximize current program capacity and filling all available seats across programs. The second driver is to

examine ways to expand program capacity including ensuring there are adequate faculty, clinical sites and

placement of new program sites in rural areas.

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The third driver is to develop policy and strategies to retain graduates from ND nursing programs and

practicing nurses in order to meet demand. Policy changes already drafted and in-process to examine Medicaid

reimbursement to allow for increased salaries, examining nurse licensure and renewal requirements and

processing by the ND Board of Nursing, root cause analysis at individual facilities regarding the utilization of

travel nurses, statewide nurse loan repayment program and increasing diversity. One strategy that will be a mix

of policy and research is to examine barriers to retention of graduating nursing students and nurses within health

care settings and within North Dakota. The purpose of this grant is to implement this study on a statewide basis

utilizing validated instruments to examine the intent to stay within the context of demographic factors,

professional quality of life, and overall work satisfaction. The results from this study will not only inform

future policy and regulation strategies for the 2021 legislative session; but will also be utilized to develop a

North Dakota based health care facility designation system. This would be similar to the concept of Magnet

designation but would be applicable to ND’s rural setting and overall workplace climate. A small grant has been

received from Blue Cross Blue Shield Caring Foundation to support a retreat to start to develop draft criteria for

this designation system and the results from the study will be utilized to finalize the criteria near the end of

2019.

The purpose of this proposed study is to explore and identify factors that influence graduating nursing

students and practicing nurses’ intent to stay in North Dakota and their workplaces and to develop policies that

encourage nurses to stay in the state and workplaces. The central problem in North Dakota is a current and

projected widening gap between the number of nurses licensed in ND compared to the state-wide need for

highly skilled nurses. Vacancy rates range from 4.97% to 13.44% depending on the type of nurse (ND

Governor’s Nursing Shortage Task Force, 2018). With projected increases in population throughout the state of

ND, nursing jobs are expected to continue to grow through 2026 resulting in a need to increase licensed nursing

staff of over 1,200 per year (Moulton, 2018). To address this problem, the proposed project is uniquely

designed to address several key research questions for graduating nurses, LPNs, RNs and APRNS:

1. What factors influence graduating nurse’s post-graduation intent to stay in North Dakota?

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2. What factors influence practicing nurse’s intent to stay in their workplace and in North Dakota?

3. What policies and best practices influence nursing student’s intent to stay in their workplace and in

North Dakota?

4. What policies and best practices influence nurse’s intent to stay in their workplace and in North Dakota?

Contribution to Nursing Regulation:

The proposed project will answer critical questions related to the recruitment and retention of nurses.

To this point, most research in North Dakota on the nursing workforce related to policy and regulation has

focused on determining the number and distribution of nurses. While this is important, ongoing issues exist with

regards to the workplace environment. Ensuring a safe, diverse, accessible and effective health care system is a

central role of nursing regulation. The first goal of the North Dakota Board of Nursing’s Strategic is Public

Protection through Evidence-Based Regulation (ND Board of Nursing, 2017). The importance of

understanding the workforce is also reflected by the National Council of State Boards of Nursing (NCSBN)

multiple year National Nursing Workforce Survey which is a joint effort between NCSBN and the National

Forum of State Nursing Workforce Centers (Budden et al., 2016). A better understanding of the decision-

making process and movement of nurses between states will also be useful to other state boards and centers for

nursing as they work to ensure an adequate nursing workforce in their state. The proposed project is also

innovative in its direct connection with state policy making through the Governor’s task force and the utilization

of results to develop a statewide designation system.

Literature Review

The proposed project is designed to examine multiple factors related to the intent of nurses to stay in

their current workplace and in North Dakota. Intent to stay can be defined as the “degree of positive affect that

an individual has toward the idea of voluntarily leaving the employer or an organization” or “the individual’s

attitude toward staying with their current employer” (Kovner, Brewer, Greene, & Fairchild, 2009, p. 84). Both

intent to stay and intent to leave are terms used in the literature to describe factors causing an individual to stay

or leave a job position at an organization. Research has discovered numerous factors impacting newly-licensed

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registered nurses’ decision to stay or leave their job positions. Kovner et al. (2009) concluded that newly

licensed registered nurses’ work behavior is a complex process, influenced by their personal characteristics,

attitudes toward their work, job opportunities, and workplace attributes.

Very few studies have been completed with experienced nurses including advance practice nurses and

their intent to stay. Van Osch, et al. (2018) discovered that for experienced and specialty nurses, a few positive

factors such as effective leadership, interprofessional teamwork, and mentorship may offset the negative aspects

of a practice environment and support nurses’ intent to stay. Feeling valued, respected, and acknowledged by

their colleagues, leaders, physicians, and other interprofessional team members promoted the nurses’ intent to

stay. In addition, clinical leaders who communicate clearly, build teams and engage and empower their

experienced nurses through shared decision-making influence nurses’ intent to stay. Overall, researchers have

found a positive relationship between nurses’ intent to stay and job satisfaction (Kovner et al., 2009; Brewer, et

al., 2015; Jones, 2017; Ross, 2016; Yarbrough, et al., 2017). Research has also discovered a strong relationship

between intent to stay in an organization and actual turnover (Brewer et al., 2012; Hayes et al., 2012). Brewer et

al. (2012) found that work attributes (voluntary overtime, more than one job for pay), work attitudes (intent to

stay, job satisfaction, organizational commitment) were negatively related to turnover while shocks (work

related injuries such as strains and sprains) and working full-time promoted nurse turnover.

Job satisfaction is a particularly interesting factor in the proposed study as it relates to intent to stay.

Many of the same factors that influence job satisfaction also influence intent to stay. Nurse job satisfaction has

been extensively researched and many factors have been found to promote satisfaction. Yarbrough et al. (2017)

concluded that nurses who were not their sole financial provider and had assistance with their financial support

scored higher on job satisfaction. Other factors that promote work satisfaction include optimal orientation,

support for continuing education, perceptions of fair workload, supportive nursing administrators, professional

values, flexible scheduling, variety, and work group cohesion and teamwork (Athey et al., 2016; Ross, 2016;

Yarbrough et al., 2017). In addition, nurses who have an assigned mentor or preceptor are more satisfied (Ross,

2016; Jones, 2017). Lastly, nurses who experience positive work attitudes (job involvement, autonomy,

distributive justice, less job stress, positive provider-nurse relationships, chances for promotion, and social 8

support from peers and supervisors), organizational commitment, voluntary overtime (Athey et al. 2016;

Brewer, Kovner, Greene, Tukov-Shuser, & Djukie, 2012) a lack of family-work conflict, and competitive pay

(benefits and compensation) have greater job satisfaction (Kovner et al., 2009; Hayes et al., 2015).

Further adding to the research on nurses’ work satisfaction, Athey et al. (2016) found that nurse

practitioners who experienced independent billing practices, collaborative relationships with physicians, and

were able to practice in their full scope of practice experienced greater work satisfaction. Owens (2018)

discovered that nurse practitioners perceive job satisfaction when they experience successful role transitions

from their registered nurse to nurse practitioner identities. This process was facilitated by experiential learning,

their incentive to learn, and positive interactions with patients and other interprofessional team members

(Owens, 2018). Finally, Brom, et al. (2016) concluded that there is a positive relationship between nurse

practitioners’ work satisfaction and their intent to stay.

In addition to job satisfaction, the proposed study will also examine the impact of professional quality of

life on intent to stay. This includes compassion satisfaction, burnout and secondary traumatic stress.

Compassion satisfaction (CS), which is boosted through positive emotional valence and an ability to reframe

negative emotions, has been shown to have protective effects on professionals’ wellbeing and job satisfaction

(Li, Early, Mahrer, Klaristenfeld, & Gold, 2014; Samios, Abel, & Rodzik, 2013).

Burnout, as it pertains to work performance, has been defined as a state of exhaustion,

depersonalization, and lowered sense of accomplishment that can occur due to a mix of heightened work

demands, personal disposition, and accumulation of stress. (Freudenberger, 1974; Maslach & Jackson, 1986;

Schaufeli & Buunk, 1996). This phenomenon has been widely researched and well-documented for over 40

years and been applied to a variety of work environments, particularly health professions. As expected, burnout

can negatively affect nurses’ overall wellbeing. Subjective workload, individual attitudes toward work (highly

committed nurses are more sensitive to stressors than others), job satisfaction, level of autonomy, role conflict

and ambiguity, lack of social support, hostile work environment, and low resilience have all shown strong

relationships to burnout development in professionals (Schaufeli & Buunk, 1996).

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Secondary traumatic stress (STS) has likewise been shown to impact healthcare professionals’ work

performance. Secondary traumatic stress is a vicarious form of acute stress and post-traumatic stress which

affects people who work closely with trauma sufferers, or people who are required to learn extensively –

through research or readings – about trauma (Ludick & Figley, 2017). The current wealth of research on STS,

spearheaded by Charles Figley in 1982 (he then termed it “secondary victimization”), has focused mainly on

professionals involved in direct work with traumatized or institutionalized persons – in hospitals, nursing or

rehabilitation facilities, or mental health facilities – and for good reason; STS is associated not only with worker

dissatisfaction, stress, and mental health deterioration, but also with self-reported decreases in quality of care

delivery (Luther et al., 2017), which may impact patients’ overall recovery, satisfaction, and wellbeing, though

this sort of transference has not yet been thoroughly examined.

Methodology

An explanatory sequential mixed-methods design will be used for this proposed study (Creswell &

Plano Clark, 2018). Phase One involves collections of quantitative data followed by Phase Two collecting

qualitative data for the purpose of explaining initial findings in greater depth and implementation into state

policy (Creswell & Plano Clark, 2018). Multiple methods of data collection will be utilized for the proposed

study including two surveys (phase 1) followed by a series of focus groups (phase 2) to further explain survey

results and explore policy solutions. For this particular study, it is proposed that the quantitative data results will

provide a general picture of the problem, while the qualitative data and its analysis will refine and explain those

statistical results by exploring the participants’ perceptions and views in greater depth. The qualitative

component will also provide an opportunity to explore potential policy and regulatory changes.

The initial concepts that informed the research questions and this study was developed by the ND

Governors Nursing Shortage Task Force Workplace Culture committee. This committee is comprised of 19

stakeholders with diverse backgrounds including hospital administration, state government, private health

foundations, non-profit board leadership, professional associations, university researchers and health insurance

(see Table 1). This committee is in the process of developing draft ND-specific designation criteria for healthy

nursing workplace cultures. The results from this study will be utilized to modify criteria and to inform 10

additional policy and regulation changes. The study was developed to provide a comprehensive examination of

the factors that influence students graduating from nursing program and nurses to stay in North Dakota and to

also stay at their current employers. This study is also unique in that all nursing levels will be included in all

phases of the study; LPN, RN and APRN This will be accomplished through a unique model utilizing the

impact of primary factors through the utilization of well-established and validated data collection instruments.

These have been combined to form a graduating nurse survey and a practicing nurse survey.

Table 1: ND Governor’s Nursing Shortage Task Force Workplace Culture Subcommittee

Committee Member Organization City/StatePatricia Moulton- Committee Leader

North Dakota Center for Nursing Fargo, ND

Andrew Scott Dakota Medical Foundation Fargo, NDBrittany Montecuollo Sanford Health System Fargo, NDCarla Hansen North Dakota Center for Nursing

BoardDetroit Lakes, MN

Darleen Bartz North Dakota Health Department Bismarck, NDEvelyn Quigley Nurse Consultant Fargo, NDJan Kamphuis Sanford Health System Bismarck, NDJeanna Kujava North Dakota Public Health

Association, Nursing Section Pembina, ND

Marcie Schulz North Dakota Critical Access Hospital Quality Network

Nicole Christiansen Essentia Health System, North Dakota Organization of Nurse Executives

Fargo, ND

Rhoda Owens University of North Dakota Grand Forks, NDRicki Ramlo Jamestown Regional Medical

Center Jamestown, ND

Shelly Peterson North Dakota Long Term Care Association

Bismarck, ND

Stephanie Deese University of North Dakota Grand Forks, NDSue Heitkamp CHI Home Health and Hospice Fargo, NDSherri Miller North Dakota Nurses Association Bismarck, NDAleana Goergen North Dakota Chapter of Nursing

Association of Directors of Nursing- Long Term Care

Susan Elder Former NursePete Seljevold Blue Cross/Blue Shield of North

Dakota Fargo, ND

Intent to Stay Instruments

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Intent to stay for graduating nurses is defined as the extent to which graduates from North Dakota and

border programs intent to stay and work or continue their nursing education in North Dakota. This will be

measured using components of the North Dakota Nursing Needs Student Survey (NDNNSS) that was

developed over the last 16 years through several studies including focus groups and survey data collection with

nursing students (Moulton, Lacey, Flynn, Kovner & Brewer, 2009). The NDNNSS survey will help determine

intent to stay and decision-making of new nurses in finding employment after graduation and what policies

would assist in encouraging them to stay in North Dakota. This instrument has been reliably utilized multiple

times and results from the study have been used to inform policy and regulation. Specific questions from the

NDNNS survey that will be utilized in this study to measure intent to stay include post-graduation plans,

reasons for choices and factors that influenced their choice of program and future. Students will also be asked if

they are already working as nurse since this is a multiple-nurse level study.

Intent to Stay is defined as the extent to which employees plan to continue membership with their

employers (Price, 2001). The Intent to Stay instrument will be utilized with practicing nurses and comprises a

unifactorial scale of 4 items measured using a 5-point Likert scale ranging from strongly disagree (1) to strongly

agree (5). The scoring involves computing an overall average for the response to all four questions. Frequency

distributions for each of the 4 items can also be determined (Price, 2001). Measuring Intent to Stay using this

tool has been well established with good reliability and validity within other work force studies, which

determined employee’s Intent to Stay (Price, 2001; Kovner et al., 2009).

Index of Work Satisfaction

The Index of Work Satisfaction (IWS) (Stamps, 1997) survey will be given to all practicing nurses and

will measure the participant’s work satisfaction with his or her present nursing job. The survey has been used

successfully in previous nursing workforce satisfaction studies (Stamps, 1997). The IWS survey contains two

parts. Part A (Paired Comparisons) consists of 15 sets of paired comparisons of the six work components, this

measures the relative importance of each of the six components to the respondent, and describes the

respondent’s expectations. Part B (Attitude Questionnaire) of the survey will be used and measures satisfaction

for each of the six components (pay, autonomy, task requirements, organization policies, interaction, and 12

professional status) with 44 items using a 7- point Likert scale ranging from strongly agree (1) to strongly

disagree (7). Each component includes a separate mean component score. Frequency distributions for each of

the 44 items can also be determined. Pay includes the dollar renumeration and fringe benefits received for work

done. Autonomy comprises the amount of job-related independence, initiative, and freedom, either permitted or

required in daily work activities. Task requirements involve tasks or activities that must be done as a regular

part of the job. Organization policies include management policies and procedures put forward by

administration. Interaction comprises opportunities presented for both formal and informal social and

professional contact during working hours. Lastly, professional status includes the overall importance or

significance felt by the participant about his or her job, both in his or her view and in the view of others

(Stamps, 1997). A total weighted score – called the Index of Work Satisfaction – is derived from the

combination of the component weighting coefficient (Part A) and the mean component score (Part B), and then

scaled to represent one summary score. The Index of Work Satisfaction instrument’s reliability and validity has

been found to be adequate in previous studies. The most current version of the IWS has generally good

reliability for each component (alpha = .83 to .89, autonomy and interaction alphas = .70 to .80; task

requirements and organizational policies alphas = .67 to .83; and professional status alpha = .63 to .76 (Stamps,

1997).

Professional Quality of Life

The Stamm’s Professional Quality of Life (ProQOL-5) instrument is an open-sources assessment tool

that has been in use since 1995 and is the most commonly used measure of the negative and positive effects of

being a caregiver (Stamm, 2005). The ProQOL-5 is the most current version and will be used to measure overall

compassion satisfaction (CS), burnout (BO), and secondary traumatic stress/compassion fatigue (STS/CF)

experienced by nurses (Stamm, 2005). The most current edition of the ProQOL-5 has generally good reliability

for each scale (Compassion Satisfaction alpha = .87, Burnout alpha = .72 and Compassion Fatigue, alpha = .80)

and validity is similarly good with shared variance between CF and STS at 2%, CS and BO at 5%, and STS/CF

and BO at 23% (Stamm, 2005). Its usefulness in measuring professional rates of turnover intent and intent to

stay is emerging and the proposed study will help contribute to this. In recent years, researchers have used the 13

ProQOL-5 in conjuncture with other measure to examine nurses’ wellbeing and attitudes toward their work and

found that overall ProQOL was impacted by levels of professionalism in nurses (Jang, Kim, & Kim, 2016),

organizational culture, emotional intelligence (Keesler, 2017), excessive workload, and a sense that the care

provided was ineffective (Austin, Saylor, & Finley, 2017). Nurses who reported higher CF, STS, and BO more

frequently expressed their intent to leave, and higher CS was associated with less turnover intent (Wells-

English, 2018; Yang & Kim, 2016).

National Forum of State Nursing Workforce Centers’ Minimum Dataset

Demographic data will be collected utilizing the National Forum of State Nursing Workforce Centers’

Minimum Dataset (National Forum of State Nursing Workforce Centers Supply MDS, 2016). In 2008, the

National Forum developed a long-term goal of establishing a national repository of nurse workforce data based

on state-level contributions of data collected from nurses, employers, and nursing education programs. A

national repository of state nurse workforce data would be advantageous for state and national nurse workforce

analysts and planners. Consistently collected state-level data would permit state-to-state and state-to-region

comparisons. When aggregated to the national level, such a repository would be the most exhaustive and

accurate source of information ever assembled on the U.S. nursing workforce and would be useful for policy

and regulation. With initial funding from the Center to Champion Nursing in America and in-kind contributions

from members, the National Forum embarked on a year-long process to develop National Nursing Workforce

Datasets for supply, demand and education. This process which is described in detail in two publications

(Moulton et al., 2012; Nooney et al., 2010) included collecting surveys, codebooks and reports from each state

and other national surveys, compiling a list of all of the variables from all states, determining the perceived

important of each variables for forecasting and policy, drafting the initial Minimum Data Set, discussion of draft

sets in a day-long summit, gathering public comment by national entities and workforce data experts, final

dataset drafting and then ratification by the Forum in 2009.

The Forum recently updated the Supply MDS and annually collects information on implementation by state-

based centers for nursing. NDCSBN has also implemented the Supply MDS in the development of its national

supply repository and as the basis for the National Nursing Workforce Study. Dr. Moulton, the Principal 14

Investigator on the proposed study was on the original drafting team for the MDS and was a co-lead of the

NCSBN National Nursing Workforce Study. As President of the Forum of State Nursing Workforce Centers

she also testified to the Institute of Medicine Committee regarding the utilization of the MDS and the current

status of implementation across states (Moulton, 2015). She also served as the lead of a group following the

Assessing Progress on the Institute of Medicine Report: The Future of Nursing (Institute of Medicine, 2015) to

work to create a national nursing repository of nursing workforce data with the Supply MDS as a base.

The proposed study will utilize variables from the Supply MDS which includes 20 variables including

demographics, employment characteristics, educational background, and licensure. These MDS variables will

be utilized to test relationships between Job Satisfaction and Professional Quality of Life scores and how they

serve as moderators to help predict future intent to stay and develop future policy and regulation (see Figure 1

and Table 2).

Figure 1: Statistical Analysis Model

Table 2: Variables/Subscales in Proposed Study

Instrument/Variables STU

NUR

Instrument/Variable STU

NUR

Intent to Stay

PROQOL

Compassion Satisfaction

Burnout

Secondary Traumatic Stress

MDS Demographic Factors

IWS

Autonomy

Interaction

Organizational Policies

Pay

Professional Status

Task Requirments

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DENTS

SES

DENTS

SES

Forum Supply MDS Price Intent to StayGender X X Leave Employer/ND XEthnicity X X Leave Employer/ND ASAP XRace X X Stay with Employer/ND XYear of Birth X X Will not leave Employer/ND XEntry Level Education X X NDNNS Student Intent to Stay Highest Level of Education X X Post-Graduation Plans XHighest Level in another field X X Post-Graduation Further Education Plans XLicense Type X X Intended work location XYear of Initial Licensure X X Factors in choosing where to work XCountry of Initial RN/LPN License X X Factors in choosing to work in ND XLicense Status X X Factors in choosing to work outside ND XAPRN License/Certification X X Plan to work part or full time XEmployment Status X X Reasons plan to work part time XReason for being unemployed X XNumber of positions employed in X X ProQol-5 Factors Hours worked per week X X Compassion Satisfaction Subscale X XEmployers State and Zip Code X X Burnout Subscale X XEmployment Setting X X Secondary Traumatic Stress Subscale X XEmployment Position X XEmployment Specialty X X

Stamp Nurse Satisfaction Index Autonomy Subscale X

Additional Demographic Questions Interaction Subscale XType of shift worked X X Organizational Policies Subscale XAnnual Salary X X Pay Subscale XMarital Status X X Professional Status Subscale XChildren and children under 6 X X Task Requirements Subscale XOverall Health Status X XEnglish as First Language X XNursing Program enrolled in X NDNNS Factors

Factors in Choosing Career XFactors in Choosing Nursing Program XFactors in choosing ND nursing program XLocation of Clinical Practice in ND X

Policy Related Factors Policy related incentives to work in ND X XPolicy related incentives to attend school in ND X X

Participants

16

The first set of participants will include nursing students (PN, RN and Graduate) nearing graduation in

all ND nursing programs along with border programs in East Grand Forks and Moorhead, Minnesota (See Table

3).

Table 3: ND and Bordering Nursing Education Programs

Nursing Program Campus Location Nursing Programs Offered Bismarck State College Bismarck, ND Certificate PN, ADRNDakota College at Bottineau Bottineau, ND Certificate PN, ADRNLake Region State College Devil’s Lake, ND Certificate PN, ADRNWilliston State College Williston, ND Certificate PN, ADRNDickinson State University Dickinson, ND AASPN, BSRNND State College of Science Wahpeton., ND AASPN, ADRN Sitting Bull College Fort Yates, ND AASPNUnited Tribes Technical College Bismarck, ND AASPNConcordia College Moorhead, MN BAN, Accelerated 2nd DegreeMinot State University Minot, ND BSRN, RN to BSRNNorth Dakota State University Fargo, ND BSRN, DNP, FNP, LPN to

BSRN, RN to BSRNNorth Dakota State University at Sanford Health

Bismarck, ND BSRN

University of Jamestown Jamestown, ND BSRNUniversity of Mary Bismarck, ND BAN, BSRN, DNP, MSNUniversity of North Dakota Bismarck, ND BSRN, AGPCNP, DNP, FNP,

MSN, PhD, RN to BSN Rasmussen College Fargo, ND and Moorhead,

MNBSRN

Mayville State University Mayville, ND RN to BSRNMinnesota State University at Moorhead Moorhead, MN RN to BSRN, MSN, DSN/DNPMinnesota State Technical and Community College at Moorhead

Moorhead, MND Certificate PN, ASRN

Northland Community and Technical College

East Grand Forks, MN Certificate PN, ASRN

Graduates will be within a couple of months of receiving one of several degrees specific to the education

program (Practical Nursing Certificate, Associate Degree, Bachelor of Science Degree, Master’s Degree,

Doctor of Nursing Practice Degree, and Doctor of Philosophy). In Phase 1, nursing programs will be asked to

pass out the surveys to students during their classes near the end of their program. In Phase 2, a second set of

students will be invited to focus groups early in the second year of the study.

The second set of participants will include all ND nurses practicing at all licensure levels (LPNs, RNs,

and Advanced Practice Nurses) and nurses licensed in Minnesota, South Dakota and Montana that live in border 17

counties and/or graduated from a North Dakota nursing education program. The goal will be to include

participants practicing at most of the state’s different practice areas such as hospitals, clinics, out-patient

settings, long-term care, education, public health, etc. During Phase 1, these participants will receive their

survey in the mail utilizing addresses from the North Dakota Board of Nursing and neighboring boards of

nursing. During Phase 2, these participants will be invited to focus groups early in the second year of the study.

These focus groups will also be based out of the 8 larger cities and will include invitations to all nurses living in

the area.

Data Collection

Phase 1

Research Question 1: What factors influence graduating nurse’s post-graduation intent to stay in ND?

Graduating nursing students nearing the end of their program will receive their survey between April

and May 2019 during class time. A written explanation of the purpose of the study (and other implied informed

consent information) will be attached to each survey which will be on a scannable survey form that will be

printed by Scantron and mailed to the ND Center for Nursing for distribution to each of the nursing programs.

Instructors will be asked to read the consent information to the class and then distribute the surveys. The

surveys will then be returned to a postage-paid envelope and then sealed and mailed back to the ND Center for

Nursing. The ND Center for Nursing will track and accumulate all envelopes and mail them together to

Scantron for scanning and addition to the database. Scantron will also develop the online link to the survey and

instructors will be asked to email the link with consent information to all distance students and those not able to

attend. Scantron will incorporate all online responses with the scanned in-person surveys into one database for

analysis. It is estimated that the survey will be provided to approximately 1,800 students with an estimated

return rate of 80% (potential sample size=1,440) which is determined by estimating the number of students that

may be absent on the day of class or that don’t fill out the online link.

Research Question 2: What factors influence practicing nurse’s intent to stay in their workplace and in ND?

18

Phase One will also involve mailing a survey to all currently practicing nurses utilizing the ND Board of

Nursing Licensure Database. The Licensure database will also be obtained/purchased from the Minnesota State

Board of Nursing, the South Dakota State Board of Nursing and the Montana State Board of Nursing. These

licensure lists will be sorted to include all practicing nurses working in the counties that border North Dakota

and nurses that have graduated from a North Dakota nursing program in the last 10 years. It is estimated that a

total of 20,000 nurses will receive the survey. Due to the policy-related nature of the study, the research team

plans to collect information from as many practicing nurses as possible. The survey will be collected in both

paper and online formats utilizing Scantron services. Written consent information on the purpose of the study

will be included with both the online and mailed surveys with completion of the survey confirming participants’

informed consent to participate in the study. In order to maximize our response rate to the anticipated 40%

(potential sample size= 8,000), surveys will be distributed using a modified Dillman approach (Dillman, Smyth,

& Christian, 2009). This was also successfully utilized on two national studies by the PI and other researchers

(Budden et al., 2016; Budden, Zhong, Moulton, & Cimiotti, 2013) This method includes the following steps:

1. Week 1: An announcement postcard will be sent to all nurses selected to participate which will include

the online survey link.

2. Week 2: A letter inviting nurses to complete the survey will be mailed. The hardcopy survey will be

included, along with an online link. Instructions will be to return the survey within 2 weeks of receipt.

3. Week 8: After a 6-week delay, a letter inviting nurses to complete the survey will be mailed to those that

have not responded to the first mailing. The hardcopy survey will be included, along with the online

link. Instructions will be to return the survey within 2 weeks of receipt.

4. Week 14: Deadline for receipt surveys for data analysis and closure of the online option.

In addition to the mailings, nurses will be encouraged to complete the survey through the ND Center for

Nursing enewsletter that is distributed monthly to all ND nurses, an ad placed in the North Dakota Nurses

Association quarterly mailed publication and an ad placed in the ND Board of Nursing/SD Board of Nursing

quarterly mailed publication. Information about the survey will also be sent to all ND nursing organizations as

19

members of the ND Center for Nursing Board of Directors and Leadership team to disseminate to their

members along with the North Dakota Hospital Association and the North Dakota Long Term Care Association.

Phase II

Research Question 3: What policies and best practices influence nursing student’s intent to stay in their

workplace and in ND?

Research Question 4: What policies and best practices influence nurse’s intent to stay in their workplace

and in ND?

Phase Two will involve qualitative data collection with focus groups to follow-up on initial

quantitative findings and to further explore policy options. Standard discussion guides will be developed for

graduating nurse focus groups and nurse focus groups based on their findings from Phase 1. Questions will

clarify quantitative findings and will also focus on emerging policies and best practices that influence

nursing student’s and practicing nurse’s intent to stay at their workplace and in North Dakota. Informed

consent will be obtained from participants prior to beginning each focus group. Focus group meetings will

be audiotaped and transcribed verbatim. Focus groups will be held in conjunction with state wide meetings

as this will present the greatest opportunity to collect information from the greatest number of nursing

students and nurses (see table 3). Invitations to these focus groups will be distributed by association

leadership prior to the event and paper reminders will be distributed to participants at the start of each event.

Focus groups will also be held in the 8 largest cities (see Table 4). An invitation will be placed in the North

Dakota Center for Nursing enewsletter that is distributed to all nurses and through an invitation distributed

to all nursing organizations that are represented through the ND Center for Nursing Board of Directors and

the Leadership Team. Organizations will be asked to electronically send the invitation to all of their

members. Focus group participants will also have the opportunity to provide written feedback along with

demographic questions to enable cartelization of focus group participation. Food will be provided at all

focus groups.

Table 4: List of Meetings/Locations for Focus Groups

20

Gradating Nurses Focus Group Locations Practice Nurses Focus Group Locations

Regional Nursing Student Focus Groups (potential N= 1600)Grand Forks/East Grand Forks, Devil’s Lake, Minot, Williston, Dickinson, Bismarck, Jamestown, Fargo/Moorhead

Regional Nursing Student Focus Groups (potential N= 1600)Grand Forks/East Grand Forks, Devil’s Lake, Minot, Williston, Dickinson, Bismarck, Jamestown, Fargo/Moorhead

ND Nurse Anesthetists Association Annual Fall or Spring Conference- evening session for students (potential N=10)

ND Nurse Anesthetists Association Annual Fall or Spring Conference- evening session for students (potential N=25)

ND Nurse Practitioner Association Annual Conference- evening session for students (potential N= 25)

ND Nurse Practitioner Association Annual Conference- evening session for practicing NPs (potential N= 50)

Nursing Student’s Association of North Dakota breakout session at annual conference (potential N= 100)

North Nurses Association Annual Confernece- evening session for practicing nurses (N=25)

Data Analysis

Phase 1

Research Question 1: What factors influence graduating nurse’s post-graduation intent to stay in ND?

Once the research team has received the graduating nursing student data from Scantron, the data will be

cleaned. This will include running frequency analyses on all variables to determine whether there is missing or

inaccurately coded data. The research team will work with Scantron to resolve any coding issues in the data set.

The research team will also dummy code data as needed to provide for data analysis.

Research Question 2: What factors influence practicing nurse’s intent to stay in their workplace and in ND?

Once the research team has received the practicing nurses data from Scantron, the data will be cleaned. This

will include running frequency analyses on all variables to determine whether there is missing or inaccurately

coded data. The research team will work with Scantron to resolve any coding issues in the data set. The

research team will also dummy code data as needed to provide for data analysis. When the data set is finalized,

a nonresponse bias will be conducted to check for the need to weight the data to best reflect the population.

Although, response rates are a valuable indicator of survey quality, they may not be a good measure of response

21

bias. An analysis of basic demographic data (i.e. gender, age, race/ethnicity, number of years since graduation,

number of years since first licensed) for all LPN, RN and APRN licensees that completed the survey will be

compared with available data from Board of Nursing licensure databases (ND, MN, SD, MT) to determine the

representativeness of the survey participants.

If a nonresponse bias is found, the data will be weighted. For example if a nonresponse bias is found for Age

and Gender as was found on the national survey, the survey response rates for the age variables will be

compared using 5-year group intervals and combined with gender variable response categories to produce

AgeGender categories. The weight would then be calculated using the response rate for each new AgeGender

category. The resulting weights in the proposed study will simply adjust the distribution across those

demographic variables with a nonresponse bias. They will be applied when analyzing relationships between

variables without the effect of artificially increasing the degrees of freedom and thereby affecting significance

tests.

Path analysis will be utilized to determine which demographic factors, nurse satisfaction and professional

quality of life predict intent to stay in North Dakota and at their current employer.

Phase 2

Focus group data from both the student groups and the nurse groups will be transcribed and

transcriptions checking for missing words and completed using contextual references. After focus group tapes

are transcribed, thematic analysis of focus group verbatim transcripts will use the approach by Braun and Clarke

(2006). This process involves: (1) familiarization with the data; (2) generating initial codes: (3) searching for

themes; (4) reviewing themes: (5) defining and naming themes; and (6) producing the report (Braun & Clark,

2006). The focus group data will be independently read and re-read by three researchers separately to become

familiar with the data, make initial notes, and find patterns of meaning. Initial codes will be developed and

categorized into themes as they emerge. The researchers will first complete data analysis separately followed by

coming together to complete further discussions. Themes will be reviewed again by checking with the coding

extracts and across the entire data set until there is consensus amongst the three researchers. Focus groups

transcripts from the graduating nursing students and practicing nurses will be analyzed separately. Potential 22

regulatory and policy changes will be compiled and weighted according to frequency and strength of support of

participants. Finally, the quantitative and qualitative results will together be interpreted and summarized.

Analysis will determine to what extent and in what ways the qualitative results help to explain the quantitative

results (Creswell & Plano Clark, 2018). Focus group results will also be presented to the Governor’s Nursing

Shortage Task Force Workplace Culture group in order to prioritize and implement policy and regulation

recommendations arising from the findings.

Limitations

One potential limitation of the proposed study includes self-response error on the graduating nursing student

and practicing nurse surveys. Information on the surveys will not be validated by a secondary source. This can

be especially problematic for demographic, education background and employment setting data. We will work

to minimize this limitation by ensuring the questions and intended answer categories are as clear as possible

utilizing the most current Supply MDS.

A second potential limitation of the proposed study is a nonresponse bias for the practicing nurse survey as it

will be mailed to all nurses in North Dakota and a sample of Minnesota, South Dakota and Montana nurses

which will result in an anticipated 40% response rate. The 2015 National Nursing Workforce Survey (Budden et

al., 2016) found a nonresponse bias indicating certain groups of nurses may have been slightly overrepresented.

These included White/Caucasian, female, and age 60 or older. For the proposed study, a formal nonresponse

bias will be conducted as described in the Data Analysis section and data will be weighted if a bias is found.

The third potential limitation of the proposed study is the utilization of purposive sampling of participants

instead of random sampling. In order to, maximize the amount of potential input for our focus group questions

we will be hosting focus groups at conferences and meetings and having regionally based groups. As this is the

qualitative phase of the proposed study it in important to ensure that utilize “information-rich” cases are

included in order to ensure the best qualitative data possible (Patton, 1990). The proposed study will minimize

potential differences between focus groups by utilizing a standard focus group discussion guide with prompts

and encouraging participants to provide additional feedback in written form to the same set of questions.

23

Project Timetable:

Start Date: January 1, 2019End Date: December 31, 2020

Project Timeline

Phase 1

Research Question 1: What factors influence graduating nurse’s post-graduation intent to stay in ND?

Major Steps Activities/Key Tasks Responsible Entities Year One Quarter

Year Two Quarter

1 2 3 4 1 2 3 4Finalize survey logistics, arrangements with nursing programs and contract with Scantron .

Finalize contract with Scantron for survey services.

Moulton

Finalize policy/regulation related survey questions with Workplace Culture Committee.

Research Team/Workplace Culture Committee

Finalize survey instrument, online survey and printing with Scantron.

Research Team

Hold confernece call with nursing program contacts to explain research project and finalize distribution dates.

Research Team

Print surveys and launch online survey.

Scantron

Receive printed surveys and print consent letters and other paperwork to distribute to each program.

Moulton

Collect survey data from graduating nursing students.

Distribute survey packets and online links to nursing programs

Moulton

Send a reminder half-way through collection period.

Moulton

Track survey completion and call schools who have not submitted their completed survey packets.

Moulton

Finalize returned survey packet and send to Scantron.

Moulton

Scan surveys and merge with online survey results. Send database back to research team.

Scantron

Data is cleaned and dummy coded as needed for analysis.

Petros, GRA,

Data cleaning and analysis.

Data analysis is conducted. Petros, Deese and GRA

Supporting tables and graphs are developed.

Petros, GRA

Results are incorporated into a presentation for the Governors Workplace Culture group including recommendations for policy and regulation changes related to workplace culture.

Research Team

Publication of results. Results are incorporated into a journal article and submitted to a peer-review journal for publication. Results are also presented at a state or regional conference.

Research Team

Research Question 2: What factors influence practicing nurse’s intent to stay in their workplace and in ND?

Major Steps Activities/Key Tasks Responsible Entities Year One Quarter

Year Two Quarter

1 2 3 4 1 2 3 4Finalize survey logistics, sample and contract with Scantron .

Finalize contract with Scantron for survey services.

Moulton

Finalize policy/regulation related survey questions with Workplace Culture Committee.

Research Team/Workplace Culture Committee

Obtain mailing list from Boards of Nursing, develop cleaned mailing lists and send to Scantron for data collection.

Moulton

Finalize survey and online survey with Scantron including postcards and consent letters.

Research Team

Collect survey data from practicing nurses.

Distribute postcards and surveys. Scantron

ND Center for Nursing places reminders to complete surveys online and in newsletter and purchase ads in NDBON and NDNA quarterly publications.

Moulton

Receive and scan mailed surveys and merge with online survey results. Send database to research team.

Scantron

Data cleaning and analysis.

Data is cleaned and dummy coded as needed for analysis.

GRA

Nonresponse bias analysis is completed and weighting as needed.

Petros, Moulton, GRA

Data analysis as detailed in grant is run.

Petros, Owens, Deese and GRA

Supporting tables and graphs are developed.

Petros, Owens, Deese and GRA

Results are incorporated into a presentation for the Governors Workplace Culture group including recommendations for workplace culture designation system.

Research Team

Publication of results. Results are incorporated into a journal article and submitted to a peer-review journal for publication. Results are also presented at a state or regional conference.

Research Team

Phase 2

Research Question 3: What policies and best practices influence nursing student’s intent to stay in their workplace and in ND?

Finalize graduating nurses focus group discussion guide questions based on results from phase 1 and develop consent information.

Develop final focus group questions, discussion guides, and written feedback form

Research Team

Solicit volunteers for focus groups, confirm contact information and date for focus groups. ND Center for Nursing places ad online and in newsletter and purchased ads in

Owen, Moulton

NDBON and NDNA quarterly publication. Hold focus groups, audio tape discussions and distribute written feedback form.

Owen, Moulton

Transcribe focus group tapes and add feedback data to database.

GRA

Analyze qualitative data and feedback data.

Owen, Moulton, Deese

Develop summary information, graphs and tables as needed.

Owen, GRA

Publication of results from focus groups.

Results are incorporated into a presentation for the Governors Workplace Culture group including recommendations for workplace culture designation system. Draft policy/regulation changes are developed.

Research Team

Results are incorporated into a journal article and submitted to a peer-review journal for publication. Results are also presented at a state or regional conference.

Research Team

Research Question 3: What policies and best practices influence nursing student’s intent to stay in their workplace and in ND?Finalize practicing nurse focus group discussion guide questions based on results from phase 1 and develop consent information.

Develop final focus group questions, discussion guides, and written feedback form

Research Team

Solicit volunteers for focus groups, confirm contact information and date for focus groups. ND Center for Nursing places ad online and in newsletter and purchased ads in NDBON and NDNA quarterly publication.

Owen, Moulton

Hold focus groups, audio tape discussions and distribute written feedback form.

Owen, Moulton

Transcribe focus group tapes and add feedback data to database.

GRA

Analyze qualitative data and feedback data.

Owen, Moulton, Deese

Develop summary information, graphs and tables as needed.

Owen, GRA

Publication of results from survey and focus groups.

Results are incorporated into a presentation for the Governors Workplace Culture group including recommendations for workplace culture designation system. Draft policy/regulation changes are developed.

Research Team

Results are incorporated into a journal article and submitted to a peer-review journal for publication. Results are also presented at a state or regional conference.

Research Team

Collaborating Organizations: Other organizations you are working with on the project and the role of each:

Organization Name Role

1. University of North Dakota College of Nursing

and Professional Disciplines and Psychology

Department

Oversee reports to the University of North Dakota Institutional Review Board. Assist with data collection, data analysis and publication development. Oversee Nurse Job Satisfaction and Professional Quality of Life Scoring. Supervise qualitative data transcription and analysis. Supervise overall quantitative data analysis, nonresponse bias analysis and weighting.

2. SCANTRON Development of printed/scannable surveys and online survey tool. Mailing of statewide nurse survey. Compilation of online and scanned survey data into one database.

3.

4.

Amount of Funding Request (USD): $ 300,000

Other Funding Sources: N/A

Organization Name Type of Support Amount

1.

2.

DETAILED BUDGET FOR PROJECT PERIODDIRECT COSTS ONLY

(Budget Justification on next page)

FROM01/01/19

THROUGH12/31/20

PERSONNEL (Applicant organization only) DOLLAR AMOUNT REQUESTED

NAMEROLE ON PROJECT

BASE SALARY

Yr. 1

BASE SALARY

Yr. 2

% effort Year

1

% effort Year

2

SALARY REQUESTE

D

FRINGE BENEFITS TOTAL

Patricia Moulton, PhD Principal Investigator

111,834 116,307 25% 25% 57,036 19,963 76,999

Rhoda Owens, PhD, BSRN Co-Principal Investigator

106,667 110,934 20% 20% 43,520 11,750 55,270

Stephanie Deese, MA Co-Investigator

40,000 41,600 20% 20% 16,320 4,406 20,726

Thomas Petros, PhD CO-Investigator Statistician

123,600 128,544 20% 20% 50,429 13,616 64,045

TBD GRA 5,000 5,000 10,000 N/A 10,000Subtotals 49,735 227,040

CONSULTANT COSTS (Not to exceed $250/day) N/A 0

TRAVEL RELATED TO DISSEMINATION OF RESULTS (Limit $1,500)

Travel to state/regional conferences to present

1,500

DATA COLLECTION, PROCESSING, STATISTICAL ANALYSIS COSTS

Scantron composition of printed and online student and nurse surveys, form scanning, database development and project

management $14,500

Focus group travel to sites, food and materials for participants $3,618

Focus group transcription recorder, microphone and tapes $500

18,618

REPRODUCTION/DISTRIBUTION OF SURVEYS OR OTHER TOOLS COSTS

Scantron Printing and mailing of student and nurse surveys, postcards and reminders. Mailing of student surveys to nursing

programs.

49,000

OTHER EXPENSES DIRECTLY RELATED TO THE RESEARCH PROCESS

Purchase of Minnesota, Montana and South Dakota licensure databases= $642

Purchase of SPSS Statistical Software= $2,200

Marketing costs to place ads in state nursing publications to encourage completion of surveys and focus groups= $1,000

3,842

SUBTOTALS SUBTOTALS $72,960

TOTAL DIRECT COSTS FOR PROJECT PERIOD $300,000

BUDGET JUSTIFICATIONPERSONNEL North Dakota Center for Nursing

Patricia Moulton, PhD, (Effort 25%).  Dr. Moulton will serve as Principal Investigator on the proposed study. Dr. Moulton will serve as a liaison with the National Council of State Boards of Nursing including development of grant reports. Dr. Moulton will administer subcontracts to the University of North Dakota and to Scantron. Dr. Moulton will supervise the overall research team, collection of data, data analysis and publication development. Dr. Moulton will be responsible for connecting with nursing education programs for graduating nursing students and obtaining/cleaning of licensure board data. Dr. Moulton will oversee data collection of the Supply MDS. Dr. Moulton will also serve as a liaison to the ND Governors Nursing Shortage Task Force for which she is the co-chair and to the Workplace Culture Committee for which she is the chair. These committees will be responsible for development and implementation of policy and regulation changes in response to study findings. The remaining .75 FTE of Moulton’s position is allocated to other administrative and research duties at the North Dakota Center for Nursing. 

Fringe Benefits are based on actual and anticipated cost of benefits estimated at 35% of salary. Actual costs will be charged to the grant.  This includes worker’s compensation, retirement, health insurance, dental insurance, social security and federal taxes and unemployment compensation.  

North Dakota Center for Nursing Salary and Fringe Benefits Total = $76,999

University of North Dakota

Rhoda Owens, PhD, BSRN (Effort 20%). Dr. Owens will serve as the Co-Principal Investigator. Dr. Owens will serve as the liaison for the University of North Dakota subcontract. Dr. Owens will oversee reports to the University of North Dakota Institutional Review Board. Dr. Owens will assist with data collection, data analysis and publication development. Dr. Owens will oversee Nurse Job Satisfaction scoring. Dr. Owens will supervise qualitative data transcription and analysis. The remaining .80 FTE of Owens’s position is allocated to other duties at the University of North Dakota College of Nursing and Health Professions. 

Thomas Petros, PhD (Effort 20%) Dr. Petros will serve as a Co-Investigator and Statistician on the proposed study. Dr. Petros will assist with data collection, data analysis and publication development. Dr. Petros will supervise overall quantitative data analysis, nonresponse bias and weighting. The remaining .80 FTE of Petros’s position is allocated to other duties at the University of North Dakota Psychology Department.

Stephanie Deese, MA (Effort 20%). Ms. Deese will serve as Co-Investigator on the proposed study. Ms. Deese will assist with data collection, data analysis and publication development. Ms. Deese will oversee Professional Quality of Life instrument scoring. The remaining .80 FTE of Deese’s position is allocated to other duties and clinical practicum at the University of North Dakota Psychology Department.

TBD, Graduate Research Assistants. Graduate Research Assistants will be paid an hourly wage and will assist with data cleaning, analysis and development of tables for Phase 1 survey data and with focus group transcription for Phase 2.

Fringe Benefits are based on actual and anticipated cost of benefits estimated at 27% of salary. Actual costs will be charged to the grant.  This includes worker’s compensation, retirement, health insurance, dental insurance, social security and federal taxes and unemployment compensation.  

University of North Dakota Salary and Fringe Benefits Total = $150,041  OPERATING EXPENSES 

All operating expenses will be administered by the North Dakota Center for Nursing.

TRAVEL RELATED TO DISSEMINATION OF RESULTS Travel to state/regional conferences to present as funding allows. Travel reimbursement will include

mileage reimbursement using the standard IRS reimbursement rate which for 2018 is 54.5 cents/mile. Hotel reservation costs and per diem reimbursement will also follow IRS guidelines. Conference registration and poster development as applicable will be reimbursed.

Travel Total= $1,500

DATA COLLECTION, PROCESSING, STATISTICAL ANALYSIS COSTS Scantron subcontract composition of printed and online student and nurse surveys, form scanning,

database development and project management = $14,500 Focus group travel to sites (including mileage, per diem, hotel and meeting costs as applicable using the

same standards as dissemination travel), food and materials for participants $3,618 Focus group transcription recorder, microphone and tapes $500

Data Collection Total = $18,618

REPRODUCTION/DISTRIBUTION OF SURVEYS OR OTHER TOOLS COSTS Scantron Printing and mailing of student and nurse surveys, postcards and reminders $48,500 Mailing and return of graduating nursing student surveys from the ND Center for Nursing to nursing

programs $500 Survey Distribution Costs = $49,000

OTHER EXPENSES DIRECTLY RELATED TO THE RESEARCH PROCESS Purchase of Neighboring State Board of Nursing Licensure Data= $642

o Minnesota State Board of Nursing licensure data= $90o South Dakota State Board of Nursing Licensure data= $50o Montana State Board of Nursing Licensure data= $502

Purchase of SPSS Statistical Analysis Software at the ND Center for Nursing= $2,200 Marketing costs to place ads in state nursing publications to encourage completion of surveys and

participation in focus groups = $1,000Other Expenses Total = $3,842

TOTAL OPERATING EXPENSES= $72,960

TOTAL DIRECT COSTS= $300,000

TOTAL INDIRECT COSTS = $0

Due to NCSBN's status as a 501(c)(3) not-for-profit organization, indirect costs cannot be funded by the Center for Regulatory Excellence. See website at https://www.ncsbn.org/691.htm for more information.

BIOGRAPHICAL SKETCH

NAME

Moulton, Patricia L.POSITION TITLE

Executive Director

EDUCATION/TRAINING (Begin with baccalaureate or other initial professional education, such as nursing, and include postdoctoral training.)

INSTITUTION AND LOCATION DEGREE(if applicable) YEAR(s) FIELD OF STUDY

University of North Dakota Grand Forks, ND

B.S. 1997 Psychology

University of North Dakota Grand Forks, ND

M.A. 1999 General Psychology

University of North Dakota Grand Forks, ND

Ph.D. 2002 Experimental Psychology

Positions and EmploymentNorth Dakota Center for Nursing Jul 2011- Present

Executive DirectorJob duties: Overall non-profit corporation management, strategic planning, program planning, development and assessment, marketing including website and social media development, fundraising, grant writing, lobbying and advocating, board support and coordination, volunteer recruitment and management, financial and risk and facilities management, community and public relations and research analysis and dissemination.

University of Jamestown Jul 2017-PresentAdjunct FacultyJob Duties: Instructor for Grant Writing class and Public Policy classes for Master of Arts in Leadership Program.

Impact Foundation Aug 2014-PresentGrant Writing ConsultantJob Duties: Provide grant writing advice and assistance to small and large non-profits developing foundation and federal grant applications. Develop training materials and teach workshops on grant writing.

University of North Dakota, Grand Forks, ND Jul 2011Associate Professor / Center for Rural Health, School of Medicine and Health Sciences

University of North Dakota, Grand Forks, ND Jan 2010- Jun 2011Assistant Professor / Department of Family and Community Medicine, School of Medicine and Health Sciences

Job Duties: Grant writing, data collection, analysis and dissemination, program development and administration, supervise project staff and graduate student assistants, program evaluation, teaching and university and state service.

University of North Dakota, Grand Forks, ND Jun 2002- Jun 2011Assistant Professor / Center for Rural Health, School of Medicine and Health SciencesJob Duties: Grant writing, data collection, analysis and dissemination, program development and administration, staff management, program evaluation, teaching and university and state service.

University of North Dakota, Grand Forks, ND Jan. 2006- Jun 2011Adjunct Assistant Professor / Psychology Department

Job Duties: Provide support to graduate level psychology students. Teach federal grant writing to graduate students.

University of North Dakota, Grand Forks, ND Spring, 2003Lecturer/ Psychology Department

Job Duties: Serve as primarily instructor for large 200 student introduction to psychology class. Supervise graduate teaching assistants.

University of North Dakota, Grand Forks, ND Spring 2000-2002Undergraduate Director’s Assistant/ Psychology Department

Job Duties: Founding Directors Assistant developed job duties, provided undergraduate advising, website development and other services.

University of North Dakota, Grand Forks, ND Fall, 2000Lecturer/ Introduction to Psychology

Job Duties: Serve as primarily instructor for large 200 student introduction to psychology class. Supervise graduate teaching assistants.

University of North Dakota, Grand Forks, ND Summer, 2000Graduate Service Assistant: Registrar's Office/Institutional Research

Job Duties: Analyzed institutional data and created reports. U.S.D.A. Human Nutrition Research Center, Grand Forks, ND Summer, 1999

Psychology Summer Research InternJob Duties: Carried out animal research studies and analyzed data.

University of North Dakota, Grand Forks, ND Spring, 1999Lecturer, Introduction to Psychology

Job Duties: Serve as primarily instructor for large 200 student introduction to psychology class. Supervise graduate teaching assistants.

University of North Dakota, Grand Forks, ND Fall,1997- Spring,2001Graduate Teaching Assistant, Psychology

Job Duties: Assist faculty in multiple classes including statistics, introduction to psychology and research methods.

Research Expertise Dr. Moulton has conducted health workforce research for the past 16 years. This includes a ten-year, statewide longitudinal nursing supply, education and demand study that was mandated by the ND State Legislature. Dr. Moulton has also served on the research team for two national supply surveys with the National Council of State Boards of Nursing and the National Forum of State Nursing Workforce Centers (Forum). These surveys utilized the Forum’s Nursing Supply Minimum Data Set which Dr. Moulton served as a co-lead and was an author on two articles describing the development of the data sets. Dr. Moulton’s research was also used in a national nursing shortage designation study conducted by SUNY New York and funded by HRSA. As the President of the Forum, Dr. Moulton testified before the Institute of Medicine as a part of their evaluation of the status of the Future of Nursing recommendation implementations. Dr. Moulton currently co-leads a Governor’s Nursing Shortage Task Force and has served as the Executive Director of the ND Center for Nursing for the last eight years. Dr. Moulton has served in a leadership role of over $11 million in federal, state and local/foundation grants. Dr. Moulton is also an adjunct faculty at University of Jamestown where she teaches Grant Writing and Public Policy to students in the Master’s in Leadership program.

Peer-reviewed Publications and Manuscripts in Press 1. Budden, J., Moulton, P., Harper, K. & Brunell, M. (2016). 2015 National Nursing Workforce

Study. Journal of Nursing Regulation 7(1). Supplement.2. Budden, J., Zhong, E., Moulton, P. & Cimiotti, J. (2013). The National Council of State Boards of Nursing and The Forum of State Nursing Workforce Centers 2013 National Workforce Survey of RNs. Journal of Nursing Regulation 4(2) 3. Moulton, P., Wiebusch, PL., Cleary, BL., Brunell, ML, Napier, DF, Bienemy, C., LeVasseur, SA., Cimiotti, JP. (2012). Towards Standardization (Part 2): Status of Implementation of National Nursing Workforce Minimum Data Sets. Policy, Politics and Nursing Practice, 13 (3), 162-9.4. Shanta, L.L., Kalanek, C.B., Moulton, P.L., Lang, T. (2011). Evidence for policy and

regulation: A model to address development of under-qualified faculty. Policy, Politics and Nursing Practice, 12 (4) 224-35. 5. Yang, C.C., Su, Y.Y. & Moulton, P. Evidence-based investigation for determining the characteristics of knowledge management on organizational innovation within Taiwanese teaching hospitals. In Press at IBuisness6. Nooney, J., Cleary, B., Moulton, P., Wiebusch, P., Murray, J., Yore, M., Brunell, M. (2010). Towards Standardization (Part 1): Assessment of State and National Nursing Workforce Data Sources. Policy, Politics and Nursing Practice, 11(3) 173-183.7. Rudel, R., Moulton, P. and Arneson, K. (2009) The Shortage Tsunami and High School Guidance Counselors’ Perspectives on Future Nurse Recruitment. MEDSURG Nursing18 (6). 369-384.8. Moulton, P., Lacey, L., Flynn, L., Kovner, C. & Brewer, C. (2009). Addressing the complexities of survey research. In Dickson, G. & Flynn, L eds. The Research-to-Policy Connection: Nurses and their Work. Springer: New York. 9. Rudel, R. & Moulton, P. (2009). Nursing’s long-term pipeline: A study of high school Students using a unique data collection method. In Dickson, G. & Flynn, L eds. The Research-to-Policy Connection: Nurses and their Work. Springer: New York.10. McDonald, LR, Ludtke, RL, Moulton, P, Muus, K, Knudson, AD, Wakefield, M. (2009). Health Policy and Program Implications That Will Enhance the Way Rural Native Americans Will Age in the Twenty-First Century. In Stanford, E. Percil & Nelson, Thomas C. eds. Diversity and Aging in the 21st Century: Let the Dialogue Begin. AARP.11. Amundson, M., Moulton, P., Zimmerman, S. & Johnson, B. (2008) An Innovative Approach to Student Internships on American Indian Reservations. Journal of Interprofessional Care 22, 93-101.12. Muus, K, McDonald, L, Ludtke, R, Allery, A, Knudson, A, & Moulton, P. (2007). Arthritis among American Indian and Alaska Native Elders: Prevalence, Demographic Patterns, and Comorbidities. Journal of Native Aging and Health, 2. 5-13.13. Moulton, P., Miller, M., Offutt, S. & Gibbens, B. (Winter 2006/2007) Identifying Rural Health Care Needs Using Community Dialogues. Journal of Rural Health Vol. 23.14. Moulton, P., Petros, T., Apostal, K., Park, R., Ronning, B., King, B., & Penland J. (2005). Alcohol-Induced Impairment and Enhancement of Memory: A Test of the Interference Theory. Physiology and Behavior, 85. 240-245.15. Moulton, P., McDonald, L., Muus, K., Knudson, A. & Ludtke, R. (2005). Chronic Disease in American Indian/Alaskan Native Elders. IHS Primary Care Provider, 5. 120-123. 16. Petros, T., Bridewell, J., Jensen, W., Ferraro, F.R., Bates, J., Moulton, P., Turnwall, S., Rawley, D. & Howe, T. (2003). Post-Intoxication effects of alcohol on flight performance after moderate and high blood alcohol levels. International Journal of Aviation Psychology, 13. 287-300.17. Weatherly, J. N., Moulton, P. L. & Ritt, J. (2002). Rats’ response rates for 1% sucrose when food- pellet reinforcement is upcoming: Effect of upcoming reinforcement contingency. Psychological Record, 52. 221-240.18. Weatherly, J. N. & Moulton, P. L. (2001). The effect of food-pellet reinforcement on rats’ rates of lever pressing for 1% sucrose reinforcers across procedures. Learning & Motivation, 32 193-218.19. Moulton, P., Boyko, L., Fitzpatrick, J., and Petros, T. (2001). Effect of five-day dosage of ginkgo biloba on memory in healthy male volunteers. Physiology & Behavior, 73. 659-665.20. Weatherly, J.N., Himle, M.B., Plumm, K. M. & Moulton, P. L. (2001). Three tests of ‘anticipatory responding’ as an account for induction produced by upcoming food-pellet reinforcement. Behavioural Processes, 56. 49-66.

Research Support2017-2018 Development of a High School Recruitment Program

Otto Bremer Trust:Role: Principal Investigator $15,000

2012-Present North Dakota Board of Nursing North Dakota Center for NursingRole: Executive Director $1,056,221

2002- 2012 Nursing Needs Study: North Dakota Board of Nursing. Role: Project Director (2002) Principal Investigator (2003-2012) $702,000

2011-2012 North Dakota Center for Nursing Infrastructure GrantOtto Bremer FoundationRole: Executive Director $38,000

2011-2012 A Qualitative Study Examining Care Coordination between Rural and Urban HospitalsUND Faculty Seed Grant Role: Principal Investigator $16,766

2010-2011 North Dakota State Workforce Planning GrantACA State Health Workforce Planning GrantsHRSARole: Co- Principal Investigator $184,937

2010-2011 Mobile Interdisciplinary Simulation Team SkillsARRA Equipment to Enhance Training for Health Professionals Area Health Education Center Infrastructure Development AwardsHRSARole: Principal Investigator $249,835

2008-2011 Health Workforce Assistance CenterDHHS, Health Resources and Services AdministrationRole: Workforce Expert $3,750,000

2008-2011 Area Health Education Center ProgramHealth Resources and Services AdministrationRole: Associate Program Director $1,984,332

2006-2011 Rural Research to Diverse AudiencesU.S. Department of Health and Human Services, HRSA, Office of Rural Health Policy. Role: Deputy PI (2006-2008) Principal Investigator (2009-2013) $774,000

2009-2010 Health Workforce Pipeline ProjectND State AppropriationsRole: Lead Investigator: Health Professions Workforce Assessment $60,000

2009-2010 North Dakota Nursing Education ConsortiumND State LegislatureRole: Program Evaluator $500,000

2008-2009 North Dakota Environmental ScanDakota Medical FoundationRole: Co-Investigator $30,000

2007-2009 Nurse Faculty Intern Pilot StudyNational Council of State Boards of NursingRole: Co-Investigator/Statistician $117,571

2007 Nurse Faculty Recruitment and Retention ProjectDakota Medical FoundationRole: Principal Investigator $35,000

2006- 2009 Building Research Infrastructure and Capacity (BRIC).

Agency for Healthcare Research and QualityGreat Plains Institute for Rural Health Services ResearchRole: Co-Investigator $500,000

2006-2008 Northern Plains Center for Behavioral Research TranslationInstitutional Clinical and Translational Science Award (CTSA) R20 planning grant. National Center for Research Resources, National Institutes of Health. Role: Chair of Community Engagement and Dissemination Core $149,783

2005-2007 Pesticide Impact on Neurological Diseases- Reducing RisksCenters for Disease Control and PreventionRole: Co-Principal Investigator $500,00

2004-2007 Impact of Pesticide Exposure on Cognition in Children Academic Research Enhancement AwardNational Institute of Environmental Health SciencesRole: Co-Principal Investigator. $140,050

2004-2007 National Health Service Corp Student Research Experienceand Rotations in Community Health Program. Department of Health and Human Services. Role: Evaluator $320,611

2005-2006 Utilization of Medication Assistants in North DakotaNorth Dakota Board of Nursing. Role: Principal Investigator $10,000

2005 Quentin N. Burdick Rural Interdisciplinary Training GrantDepartment of Health and Human Services. Role: Evaluator $200,000

2004-2005 Comparison of Health, Nutrition and Cognitive Status in Young and Older Adults

University of North Dakota Seed GrantRole: Principal Investigator $25,000

2004-2005 North Dakota Health Providers' Self-Assessment of Knowledge,Skills and Preparedness for Treating Pesticide-Contaminated Patients University of North Dakota Seed Grant. Role: Co-Investigator. $39,850

2004 Assessment of the North Dakota Department of Health’s Internal Organizational Climate North Dakota Department of Health Role: Principal Investigator $10,129

2003-2004 Prevalence of Chronic Disease and the Degree of Rurality of American Indian Elders Grant Program for Policy-Oriented Rural Health Services Research (R04)Office of Rural Health Policy, HHSRole: Principal Investigator $150,000

BIOGRAPHICAL SKETCHNAMEOwens, Rhoda A.

POSITION TITLE

Assistant Professor

EDUCATION/TRAINING (Begin with baccalaureate or other initial professional education, such as nursing, and include postdoctoral training.)

INSTITUTION AND LOCATIONDEGREE

(if applicable)

YEAR(s) FIELD OF STUDY

Minot State University - Minot, ND B.S. 1985 NursingUniversity of North Dakota - Grand Forks, ND M.S. 2006 NursingUniversity of North Dakota - Grand Forks, ND Ph.D. 2015 Teaching and Learning

Higher Education

Positions and EmploymentUniversity of North Dakota – College of Nursing and Professional Disciplines 2015-PresentGrand Forks, ND

Assistant ProfessorJob Duties: Instructor for undergraduate Medical-Surgical courses, RN-BSN Professional Role Development and Interprofessional Care courses, Nursing Theory and Concepts and Foundations of Nursing Science courses for Master of Science and PhD Nursing Students, teach both face-to-face and online courses; Dissertation Committees for PhD Nursing Students

Williston State College, Minot, ND 2009-2015Assistant Professor/Site ManagerJob Duties: Managed the distant site; Instructor for Medical-Surgical courses at the RN and LPN in both the RN and LPN education programs, clinical instructor for both RN and LPN students, andProfessional Role Development course for the RN students

Trinity Health System, Minot, ND 2010-PresentRegistered NurseJob Duties: Part-time/Casual position in the First Care Clinic

Trinity Health System, Minot, ND 1986-2009Registered NurseJob Duties: Worked as staff nurse and charge nurse in Medical and Pediatric patient care units,hospital evening supervisor, case manager home health/hospice, hospice coordinator, staff development department

Mercy Hospital, Williston, ND 1985-1986Registered NurseJob Duties: Staff and charge nurse on surgical unit

Research Expertise

Rhoda Owens PhD, RN has a PhD in Teaching and Learning/Higher Education and has 8 years of research experience utilizing both qualitative and quantitative data collection and analysis. Dr. Owens’ research interests include nursing workforce issues, nurses’ role transition and professional identity development in rural healthcare settings. She has recently published completed studies on nursing faculty and family nurse practitioners and completed papers on North Dakota’s Nurse Practitioner Workforce. In addition, she is a member on the North Dakota Governor’s Nursing Shortage Task Force, and the University of North Dakota’s College of Nursing and Professional Disciplines Research and Scholarship committee.

Peer-reviewed Publications and Manuscripts in Press1. Owens, R.A. (2018). Transition experiences of new rural nurse practitioners. The Journal for Nurse Practitioners. 14(8), 605 – 612. doi: 10.1016/j.nurpra.2018.05.0092. Owens, R.A. (2018). Nurse practitioner role transition and identity development in rural healthcare settings:

A scoping review. Nursing Education Perspectives. (Accepted for publication 2/21/18) NEP-2018-001R13. Owens, R.A. (2018). Two-year institution part-time nursing faculty experiences during their role transition

and identity development: A phenomenological study. Nursing Education Perspectives. 39(1), 10-15. doi: 10.1097/01.NEP.0000000000000250

4. Owens, R.A. (2017). Part-time nursing faculty perceptions of their learning needs during their role transition experiences. Teaching and Learning in Nursing. 12(1), 12-16. doi: dx.doi.org/10.1016/j.teln.2016.10.002

5. Owens, R.A. (2012). Transcultural nursing course in Tanzania, Africa. Home Healthcare Nurse, 30(6), 347-352. doi: 10.1097/NHH.0b013e318257569a.

6. Owens, R. A. (2012). Chapters 32, 34, 35, 36 and 37 of the Gastrointestinal System Unit. In L. White, G. Duncan, & W. Baumle (Eds.), Medical-Surgical nursing an integrated approach (3rd

ed.). (pp. 651-667; 690-763). New York: Delmar Cengage Learning. 7. Owens, R.A. (2008). Teaming up to improve the quality of surgical care. American Nurse Today, 3(5), 25-

26. 8. Owens, R.A. (2006). The caring behaviors of the home health nurse and influence on

medication adherence. Home Healthcare Nurse, 24(8), 517-526.

Manuscripts Under Review for Peer-reviewed Publications1. Owens, R.A. Accelerated baccalaureate student perceptions of their learning in a hybrid course: A pilot

study. Nursing Education Perspectives. (submitted 9-15-18)

Research Support

2018-Present Exploring Rural Nurse Pracitioners’ First Year Experiences Horter Endowment Award $2000

Role: Principle Investigator

2016-2017 Exploring the Transition Experiences of Registered Nurses to Nurse Practitioners in Rural Healthcare Settings University of North Dakota/College of Nursing and Professional Disciplines Faculty Seed Grant $3000 Role: Principle Investigator

BIOGRAPHICAL SKETCH

NAMEThomas V.Petros, Ph.D.

POSITION TITLE

Professor of PsychologyeRA COMMONS USER NAME (credential, e.g., agency login)EDUCATION/TRAINING (Begin with baccalaureate or other initial professional education, such as nursing, include postdoctoral training and residency training if applicable.)

INSTITUTION AND LOCATIONDEGREE

(if applicable)

MM/YY FIELD OF STUDY

Kent State University, Kent Ohio BA 1975 Secondary Education Kent State University, Kent Ohio MA 1978 Developmental PsychKent State University, Kent Ohio Ph.D. 1981 Cognitive Psychology

Positions and Employment

1977-8/80 Teaching Fellow, Kent State University9/80-8/81 Instructor, University of North Dakota9/81-8/85 Assistant Professor, University of North Dakota9/85-9/91 Associate Professor, University of North Dakota9/91-present Full Professor, University of North Dakota

Research Expertise

Dr. Petros for the last several years has conducted research in psychological assessment, especially with Native Americans. He and his colleagues have examined the validity of common psychological assessment tools (ie., Beck Depression Inventory, Beck Anxiety Inventory, Substance Abuse Subtle Screening Inventory) with Native Americans. In addition, they have examined the role of environmental factors along with cultural factors that influence response of Native Americans on the MMPI-2 and on the WISC-III). In addition, he has conducted work in the area of human factors and cognition, especially in the area of aviation related issues. Most recent work used physiological measures (EEG, EOG, ECG) to measure fatigue and task engagement in air traffic controllers during periods of high and low workload. Other work has examined the impact of nutritional intake, high altitude and alcohol hangover on aviation performance.

Earlier work has examined the impact of various pharmacologic agents on cognition and performance. For example, he and his colleagues have studied the impact of common drugs such as alcohol, caffeine and nicotine on cognition and performance. In addition, they have examined the impact of several factors that moderate the impact of these drugs such as time of day, along with endogenous levels of estrogen and testosterone. Further, they have examined the impact of a dietary supplement (Gingko Biloba), a hormone (cortisol) and a neuropeptide (Vasopressin) on cognition and performance.

Dr. Petros has extensive experience providing statistical consultation for the Department of Psychology and many other departments at the University of North Dakota. Dr. Petros teaches and consults on a variety of statistical topics to graduate students in several disciplines at the University of North Dakota. The topics include analyses of variance of all types, multiple regression analysis of all types, mediational analysis, and modeling techniques.

Selected Peer-reviewed Publications & Presentations

Gray, J.S., Brionez, J., Petros, T., and Gonzaga, K.T. (2018). Psychometric evaluation of depression measures with Northern Plains Indians. Journal of American Indian and Alaska Native Mental Health Research. American Journal of Orthopsychiatry, In Press.

Bernhardt, K., Jorgenson, T., Carson, C., Dreschsel, P., Iseminger, C., Poltavski, D., Ferraro, F.R., & Petros, T. (2017). Tracking Workload and Engagement in Air Traffic Control Students Using Electroencephalography Cognitive State Metrics. Paper presented at the Aviation Psychology Conference, Dayton, April 2017.

Bernhardt, K., Solomon, K.A., Ferraro, F.R., Crockett, R.J., Terrell, H., Petros, T., and Vacek, J. Individual Differences in Dynamic Multitasking Performance. Proceedings of the Human Factors and Ergonomics Society 2016 Annual Meeting

Gray, J.S., McCullagh, J.A, and Petros, T. (2016). Assessment of anxiety among Northern Plains Indians. American Journal of Orthopsychiatry. 86(2), 186-193.

Lindseth,G. and Petros, T. (2016). Neurobehavioral Effects of Consuming Dietary Fatty Acids. Biological Research for Nursing, 18, 573-581

Vandal, R., Kagan, C., Petros, T., and Gray, J.S. Differences Between Native Americans and Caucasians in Responding to Scale 7 of the MMPI-2 Center for Rural Health, Seven Generations Center of Excellence in Native Behavioral Health, School of Medicine and Health Sciences, University of North Dakota. Paper presented at APA, 2016.

Yawakie, B.E., Wheeler, M.J., Gray, J.S. and Petros, T. SASSI-3 Sensitivity to Detect Substance Dependence in Northern Plains American Indians Center for Rural Health, Seven Generations Center of Excellence in Native Behavioral Health, School of Medicine and Health Sciences, University of North Dakota. Paper presented at APA, 2016.

Young, A., Kagan, C., Petros, T., and Gray, J.S. Differences in Responding to the Depression Scale on the MMPI-2: Native Americans and Caucasians Center for Rural Health, Seven Generations Center of Excellence in Native Behavioral Health, School of Medicine and Health Sciences, University of North Dakota. Paper presented at APA, 2016.

Lindseth, G., Coolahan, S., Petros, T., Lindseth, P.  (2014). “Neurobehavioral Effects of AspartameConsumption, Research in Nursing and Health. 37(3), 185-193.

Lindseth, P.D., Lindseth, G.N., Petros, T.V., Jensen, W.C., & Caspers, J. (2013). Effects of Hydration on Cognitive Functions of Pilots. Military Medicine, 178, 792-798.

Lindseth,G., Lindseth, P., Jensen, W., Petros, T., Helland, B., & Fossum, D. (2011). Dietary Effects on Cognition and Pilots’ Flight Performance. International Journal of Aviation Psychology, 21(3), 269-282.

Robertson, C., Ayers, F., French, J., Connolly, T., Blickensderfer, E., Petros, T., Summers, M., Weber, R. (2005). The Impact of Scenario Based Training, Traditional Training and Familiarization on Transfer from Analog gauge to TAA Aircraft. Paper presented at the 13th Biannual Symposium on Aviation Psychology, Oklahoma City, Oklahoma.

Petros, T., Bridewell, J., Jensen, W., Ferraro, F.R., Bates, J., Moulton, P., Turnwell, S., Rawley, D., Howe, T., & Gorder, D. (2003). Postintoxication Effects of Alcohol on Flight Performance After Moderate and High Blood Alcohol Levels. The International Journal of Aviation Psychology, 13, 287-300.

Jensen, W., Petros, T., Moulton, P., Boehle, J., & O’Keefe, S. The Influence of Circadian Variations and Moderate Levels of Simulated Altitude on Sustained Cognitive Performance. Paper presented at the 12th International Symposium on Aviation Psychology, Dayton, Ohio, 2003.

Bartholomew, C.J., Jensen, W., Petros, T.V., Ferraro, F.R., Fire, K., Biberdorf, D., Fraley, E., Schalk, J., & Blumkin, D. (1999). The effect of moderate levels of simulated altitude on sustained cognitive performance. International Journal of Aviation Psychology, 9, 351-359.

Poltavski, D. V., Petros, T. V & Holm, J. E. (2012). Lower but not higher doses of transdermal nicotinefacilitate cognitive performance in smokers on gender non-preferred tasks. Pharmacology, Biochemistry and Behavior, 102, 423-433.

Poltavski, D. & Petros, T. (2006). Effects of transdermal nicotine on attention in adult non-smokers with and

without attentional deficits. Physiology & Behavior, 87, 614-624Poltavski, D. & Petros, T. (2005). Effects of Transdermal Nicotine on Prose Memory and Attention in Smokers

and Non-Smoker. Physiology & Behavior, 83, 833-843Krebs, S., Petros, T., & Beckwith, B. (1994). The Effects of Smoking on Memory for Prose. Physiology and

Behavior, 56, 723-727.Poltavski, D. V., Marino, J., Guido, J., Kulland, A., & Petros, T. (2011). Effects of Acute Alcohol Intoxication

on Verbal Memory in Young Men as a Function of Time of Day. Physiology and Behavior, 102, 91-95.Moulton, P.L., Petros, T.V., Apostal, K.J., Park, R.V., Ronning, E.E., King, B.M., & Penland, J.G.(2005).

Alcohol-Induced Impairment and Enhancement of Memory: A Test of the Interference Theory. Physiology & Behavior, 85, 240-245.

Haut, J. S., Beckwith, B. E., & Petros, T. V. (1990). Acute ethanol intoxication, gender differences, and prose processing. Pharmacology,Biochemistry, and Behavior, 36, 439-440.

Lamberty, G., Beckwith, B. E., Petros, T. V., & Ross, A. (1990). Post-Trial Treatment with Ethanol Enhances Recall of Prose Narratives. Physiology & Behavior, 48, 653-658.

Haut, J. S., Beckwith, B. E., Petros, T. V., and Russell, S. (1989). Gender differences in retrieval from long-term memory following acute intoxication with ethanol. Physiology and Behavior, 45, 1161-1165.

Petros, T. V., Kerbel, N., Beckwith, B. E., Sacks, G., & Sarafolean, M. (1985). The Effects of Alcohol on Prose Memory. Physiology &Behavior, 35, 43-46.

MacPherson, J., Sternhagen, S., Miller, T., Devitt, M., Petros, T. V., & Beckwith, B. (1996). The Effect of Caffeine, Impulsivity, and Gender on the Components of Text Processing and Recall. Experimental and Clinical Psychopharmacology, 4, 438-446.

Arnold, M. E., Petros, T., Beckwith, B. E., Coons, G., & Gorman, N. (1987). The Effects of Caffeine, Impulsivity, and Sex on Memory for Word Lists. Physiology & Behavior, 41, 25-30.

Erickson, G., Hager, L. B., Houseworth, C., Dungan, J., Petros, T. V., & Beckwith, B. E. (1985). The Effects of Caffeine on Memory for Word Lists. Physiology & Behavior, 35, 47-51.

Beckwith, B. E., Petros, T.V., Bergloff, P. J., & Swenson, R. R. (1995). Failure of Posttrial Administration of Vasopressin Analogue (DDAVP) to Influence Memory in Healthy, Young, Male Volunteers. Peptides, 16, 1327-1328.

Beckwith, B. E., Petros, and Swenson, R. R. (1991). Do vasopressin-like neuropeptides influence human memory? In Biological Psychiatry, Vol 2 edited by G. Racagni, N. Brunello, & T. Fukuda. The Netherlands:Elsevier, pp 531-533.

Beckwith, B. E., Petros, T. V., & Knutson, K. (1990). Effects of DDAVP on Gender Specific Verbal and Visuospatial Tasks in healthy Young Adults. Peptides, 11, 1313-1315.

Beckwith, B. E., Petros, T. V., Couk, D. I., & Tinius, T. P. (1990). The Effects of Vasopressin in Healthy Young Adult Male Volunteers: Theoretical and Methodological Issues. In the Annals of the NewYorkAcademy of Science, 579, 215-226.

Beckwith BE, Petros TV, Bergloff, PJ, Staebler RJ. Vasopressin analogue (DDAVP) facilitates recall of narrative prose. Behav Neurosci. 1987 Jun;101(3):429-32. PubMed PMID: 3606814.

Beckwith, B. E., Petros, T., Beckwith, S. K., Couk, D. I., Haug, R. J., & Ryan, C. (1982). Vasopressin analog (DDAVP) facilitates concept Learning in human males. Peptides, 3, 627-630

Beckwith BE, Petros TV, Scaglione C, Nelson J. Dose-dependent effects of hydrocortisone on memory in human males. Physiol Behav. 1986;36(2):283-6. PubMed PMID: 3961002.

Selected Research Support

The UND Psychological Department Study Management System (co-authored with Mark Grabe and Bruce Sawler). This was a $100,000 grant of computer hardware and software from the Digital Equipment Corporation to develop computer assisted study management programs, 1985.

Carry-over Effect of Ethanol on Pilot Performance. Thomas V. Petros, PI, Warren C. Jensen, Co-PI, John B. Bridewell, Co-PI, F. R. Ferraro, Co-PI (6/97-5/98 extended until 5/99). Alcoholic Beverage Medical Research Foundation. Direct Costs, $33,000.

Impact of Pesticide Exposure on Cognition in Children. (2003-2005). Funded by the National Institute of Environmental and Health Sciences. Academic Research Enhancement Award, $100,000.

Co-PI on a grant entitled Northern Plains Center for Behavioral Research with Dr. Glenda Lindseth of the Nursing College a the PI. The grant was funded for $4,000,000 to construct a new building for reseach.

Northern Plains Center for Research Translation: Bridging Research and Practice1P20 RR 023489-01 Co-Collaborator DHHS 9/06-9/07 Direct Costs: $149,783

Center of Excellence for Unmanned Aerial Vehicle (UAV) and Simulation ApplicationsCo-Investigator ND Dept. Commerce 6/06-6/08 Direct Costs: $1,000,000

Petros, T., Ferraro, R., Lindseth, P., Jensen, W., & Higgins, J. Factors that Moderate Age-Related Changes in Pilot Performance and Decision Making. Grant submitted to the Airline Owner’s and Pilot Association. Funded $368,519.00 Beginning and End Dates: 1/1/08 to 12/31/09

Kenville, K., Higins, J., Jensen, W., Petros, T., McBride, R. Airposrt and Air Carrier Resource Manuel: Employees Coping with Traumatic Events. Grant submitted to the Airport Cooperative Research Program of the Transportation Research Board. Funded $299,416. 9/07 to 10/8.

Automated Terminal Airspace Technologies. Department of Defense Grant to Northrup Gruman who subcontracted with UND. The subcontract to UND was to Petros, T. & Kroeber, S. Petros was the PI for the subcontract to UND. The duration of the grant was 11/16/16 to 11/11/17. The amount for UND was $50,000.

Optomizing Human-Automation Team Workload through a Non-Invasive Detection System. Defense Advanced Research Projects Agency Phase 1 Grant to Sonalysts,Inc and to UND. The contract to UND was to Petros, T. & Poltavski, D. Petros was the PI for the contract to UND. The duration of the grant was 3/1/2017 to 2/28/2018. The amount for UND was $60,000.

 BIOGRAPHICAL SKETCH

NAME Deese, Stephanie L. 

POSITION TITLE  Clinical Psychology Doctoral Student

 EDUCATION/TRAINING  (Begin with baccalaureate or other initial professional education, such as nursing, and include postdoctoral training.) 

INSTITUTION AND LOCATION  DEGREE (if applicable)  YEAR(s)  FIELD OF STUDY 

Richmond Community College – Hamlet, NC  A.A.S.  2012 Applied ScienceWingate University – Wingate, NC  B.S.  2014 PsychologyWestern Carolina University – Cullowhee, NC University of North Dakota – Grand Forks, NC

M.A. Ph.D.

2016 Anticipated

2020

Clinical Psychology Clinical Psychology

Positions and EmploymentPresent Practicum Student, Northwestern Mental Health Center, Crookston, MN2017-Present Psychology Extern, Life Skills & Transition Center, Grafton, ND2016-2017 Graduate Teaching Assistant, Psychology Department, UND 2016 Psychometrist, Blue Ridge Neuropsychological Associates, Asheville NC2015-2016 Practicum Student, Blue Ridge Neuropsychological Associates, Asheville, NC2015-2016 Graduate Teaching Assistant, Advanced Research Methods & Design I & II, WCU2014-2015 Writing Tutor, Writing and Learning Center (WALC), WCU2014 Summer Undergraduate Intern, Monroe Rehabilitation, Monroe, NC

Research Expertise

Stephanie Deese, MA, is a Co-Evaluator for the proposed program. Ms. Deese has a MA in Clinical Psychology and four years of both clinical and research experience utilizing both qualitative and quantitative data collection and psychometric assessment methods. Ms. Deese has extensive knowledge of current psychometric measures used to assess professional quality of life, syndromes related to job stress, personality, and individual motivations.

Selected Presentations and Projects1. Deese, S. L. (2015). The effects of nesting on grandparent investment. Seminar presented at SEPA,

March 20, 2015.2. Deese, S. L. (2015). The effects of nesting on grandparent investment. WCU Graduate Symposium,

March 26, 2015.3. Longamore, E., Deese, S. L., & McCord, D., (2016). Contrast effects of opposite sex attraction. Poster

presented at SEPA, March 30, 2016.4. Deese, S. L., & Ferraro, R. F. (2018). Trait anxiety’s relationship to executive functioning and cell

phone dependency in college-aged adults. Poster presented at APS, May 27, 2018.5. Deese, S. L. Extensions of Mindfulness-Based Stress Reduction: Promoting Increased Wellbeing of

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