1. 2013 & 2014 NSP I Data Joan Warren, PhD, RN-BC, NEA-BC, FAAN
HSCRC Contractor
Associate Professor, University of Maryland School of Nursing

2. 2001 to NSP I $80,600,000 .
2006 – 2015
NSP II $63, 374,650
Between 2001 and 2013 $80.6 million have been funded in rates to support NSP I programs for hospitals

3. NSP I Program
In 2012, NSP I program aims aligned with IOM Future of Nursing recommendations:
“Education and career advancement
Nurse Residency Program
Orientation Critical Need
Transitional (nurse refresher) program
RN Tuition Assistance
RN Tuition Assistance NURSING STUDENTS

4. NSP I Program Patient quality and satisfaction
RN Professional certification
RN Technical certification
RN continuing education
Advancing the practice of nursing
Nursing Excellence (ANCC Magnet or Pathway to Excellence Designation)
Shared Governance Model
Evidence-based Practice, Quality Improvement, and/or Research projects

5. NSP I Data Hospital Completion Rate
Response Rate
% (45/50)
% (44/50)

6. Stress Not number of hospitals-rather funds

8. Budget Distribution 2014 2013 5 M Nurse Residency Programs
1.4 M Tuition Assistance RNs
1.4 M RN Continuing Education
1.1M RN Nursing Excellence
1M Orientation Critical Need Areas
441K Research
3.3 M Nurse Residency Programs
2 M Orientation Critical Need Areas
2 M Tuition Assistance RNs
1.2 M RN Nursing Excellence
1 M RN Continuing Education
773 K Shared Governance

9. Budget Distribution
2014
2013
405 K Tuition Assistance Nursing Students
312 K Shared Governance
276 K Transitional RN Programs
229 K Initial RN Certification
143 K RN Recertification
617 K Research
220 K Tuition Assistance Nursing Students
220 K Initial RN Certification
73 K RN Recertification
53 K Transitional RN Programs

10. NSP I Budget Variance 4,852,006 6,299,636 39% Variance 30% Variance
2013
30% Variance
2014
39% Variance
Reported Total Budget M
Budget Distribution 11.8 M
Variance
4,852,006
Reported Total Budget 16.1
Budget Distribution 11.5 M
Variance
6,299,636
Increased variance may account for changes in amounts reported for each category

11. Education & Career Advancement
Nurse residency programs, Orientation for critical need, Transitional (refresher) RN programs, Tuition assistance programs

12. Nurse Residency Programs
ADN 33% (319)
BSN 61% (581)
MS/MSN 3% (30)
Reported Total 960
N=22
ADN 37% (387)
BSN 60% (628)
MS/MSN 2% (23)
Reported Total 1045
N=22
Hospitals funding residency programs for new RN graduates were asked to report recruitment and retention outcome metrics. Table 3 compares the year-to-year differences. Comparing hospital hiring practices for baccalaureate-prepared RN (BSN) and RN prepared at the associate degree level, it appears hospitals are more likely to hire BSN RN. BSN RN were practically twice as likely to be hired in 2013 (BSN RN=581, 61%; AND RN = 319; 33%) and 2014 (BSN=628, 60%; ADN=387; 37%). Of note, between 2013 and 2014 the turnover rate for newly licensed RN enrolled in a residency program was reduced by 6%.

13. Nurse Residency Programs
2013
2014
Voluntary Turnover 9% (83)
Involuntary Turnover 3% (24)
Total Turnover 12% (107)
Voluntary Turnover 4% (40)
Involuntary Turnover 3% (30)
Total Turnover 7% (70)

14. Orientation Programs: Critical Need
Total RN 264
Voluntary Turnover 34% (89)
Involuntary Turnover 7% (18)
Total Turnover 41% (107)
N=15
Total RN 248
Voluntary Turnover 59% (146)
Involuntary Turnover 7% (17)
Total Turnover 66% (163)
N=16
Hospitals with orientation programs for transitioning RN into hard-to-fill critical need positions were asked to report turnover data (Table 4). Although fewer hospitals (2103 N= 23; 2014 N= 18) funded these programs in 2014, the amount of funding doubled in However even after this large infusion of money, the turnover rate substantially increased from an already high 41% in 2013 to 66% in 2014.

15. RE Transitional (Refresher) ProgramK K
ADN N=17
BSN N= 6
Total 23
N=3
ADN N = 0
BSN N = 2
Total 2
N=3

16. RN Tuition Assistance Number Enrolled
BSN 52% (261)
MS/MSN 30% (150)
DNP/PhD 4% (7)
Reported Total 499
N = 14
BSN 52% (322)
MS/MSN 26% (158)
DNP/PhD 1% (7)
Reported Total 618
N = 15

17. RN Tuition Assistance Academic Progression
2013
2014
Graduates
BSN 66% (78)
MS/MSN 34% (40)
DNP/PhD 0
Reported Total 119
Attrition 2%
Graduates
BSN 83% (92)
MS/MSN 17% (19)
DNP/PhD 0
Reported Total 111
Attrition 3.6%

18. Nursing Student Tuition Assistance Number EnrolledK K
ADN 48% (60)
BSN 43% (53)
MS/MSN 1% (11)
Reported Total 124
N = 13
ADN 37% (47)
BSN 51% (65)
MS/MSN 12% (15)
Reported Total 127
N = 14
Similar to RN tuition assistance hospitals reported on maximum amounts allotted to students for tuition support using NSP I funding. The maximum amount in 2013 was $6,500 with a mean of $2,218. In 2014 the maximum amount increased to $10,000 with a mean of $3,239 Table 8 compares hospital responses regarding tuition assistance support for student nurses. The number of hospitals offering tuition assistance to student nurses declined by more than 25% (2013 N= 23; 2014 N= 17) however the number of students supported by NSP I funds remained essentially unchanged (2013 N= 124; 2014 N=127). With the change in amount of tuition assistance were changes in the type of nursing degree program between these two years. In 2013, a greater number of students were enrolled in AD nursing programs. But in 2014, more students were enrolled in BSN programs. Additionally, student attrition rate declined from 14% (2013 N=9) to 5% (2014 N=9). Of interest, although a greater number of students were enrolled in AD programs in 2013, fewer students graduated from these programs compared to their BSN counterparts (Table 9). It is unclear if this change in program preference for BSN programs is student or hospital preference desiring more BSN prepared RN. Finally, hospitals shared student hiring rates. The number of student hires by the supporting hospitals increased from 85% (Hired N= 61; Total Graduates = 72) in 2013 to 91% in 2014 (Hired N = 84; Total Graduates = 92).

19. Nursing Student Tuition Assistance Academic Progression
2013
2014
ADN 22% (17)
BSN 63 % (49)
MS/MSN 14% (11)
Reported Total 77
Attrition 14%
ADN 16% (10)
BSN 66% (41)
MS/MSN 18% (11)
Reported Total 62
Attrition 5%

20. Patient Quality and Safety
Certification & Continuing Education

21. Certification RN New Cert 115 RN Recert 201 Cert Rate FY Start 23%
Initial 229 K Recert 143 K
Initial 168 K Recert 73 K
RN New Cert 131
RN Recert
Cert Rate
FY Start %
FY End %
N= 11
RN New Cert 115
RN Recert
Cert Rate
FY Start %
FY End %
N= 14
Includes both technical and professional certification; 2-3 % growth over 2 years

22. RN Continuing EducationM M
EBP 39% (507)
Other 24% (306)
Leadership 12% (155)
Patient Safety 9% (122)
Quality 9% (117)
Excellence 3% (47)
Suc Plan 3% (33)
Total 1287
N = 20
Other 34% (306)
EBP 33% (297)
Patient Safety 15% (140)
Quality 7% (60)
Leadership 6% (52)
Excellence 3% (29)
Suc Plan 2% (20)
Total 904
N= 20
Combined Magnet and Pathway

23. External Continuing Education
2013
2015
Total Number 2446
Hospital M= 116
N = 20
Total Number 3494
Hospital M = 159
N = 20

24. Advancing the Practice of Nursing
Nursing excellence programs, Shared governance models, Evidence-based practice and research

25. Nursing Excellence Designation
2013
2014
No plan 25
Magnet designated 7
Magnet Journey 10
Pathway 3
No plan 25
Magnet designated 7
Magnet Journey 11
Pathway 2

26. Shared Governance 2013 312 K 2014 774K 15 Hospitals 2013 & 2014
Qualitative
Funds used to pay staff for education/meeting time
Used to backfill staff during meetings

27. Research 2013 5 Hospitals 2014 8 Hospitals 2013 441 K 2014 618 K
Qualitative
Nurse residency retention
Healthy work environments
Perinatal depression
Used to support nurse residents with EBP project

28. Hospital Metrics RN Vacancy Rate 11% RN Vacancy Rate 9% Turnover
2013
2014
RN Vacancy Rate 11%
Turnover
Voluntary 14%
Involuntary 4%
New Hire Retention 76%
RN Vacancy Rate 9%
Turnover
Voluntary 12%
Involuntary 4%
New Hire Retention 76%

29. Summary Education Steering Committee
Revised data collection tool including definitions
Importance of accurate data
Attestation of data by CFO, CNO, & NSP I Coordinators
Orientation
Steering Committee
Software for reporting and analyzing outcomes data
Program monitoring/audits