Predictive Model to Determine Need for Nursing Workforce

Abstract

This article describes a statistical modeling study designed to improve targets of need for registered nurse (RN) workforce. The model is place-based and incorporates the concepts of clinical need and regional service utilization. A cross-sectional study was conducted in Nebraska (1993-1999), and the unit of study was the county (N = 66). A mixed-model approach was used, and five predictor variables (% age 20-44,% age 45-64,% age 65+,% White non-Hispanic, and area) were significantly (p < .001) associated with service demand. Coefficient estimates were applied to various population projection scenarios, and the model’s algorithm converted service demand into number of RNs needed to compare numbers of RNs employed with projected need. The implications for RN workforce policy and funding decisions—at both federal and state levels—are significant. Further research with a larger, multistate database will be conducted to refine the model and demonstrate generalizability.

Comparative Analysis of Urban and Rural Nursing Workforce Shortages in Nebraska Hospitals

“…For states that are largely rural like Nebraska, where 27 of 93 counties do not have a hospital, underestimating the rural RN shortage is problematic. (It should be noted that this study also examined only those counties with hospitals; however, this was because the intent of this study was to focus only on application of Phase 2 of the "Predictive Model to Determine Need for Nursing Workforce" by Cramer et al, 2004, to determine differences between need for RN workforce and the actual numbers of RNs employed and by geographic setting. )…”

“…Without adequate RN workforce targets that are based on the concept of need, it will be difficult to obtain appropriate funding for important initiatives like nursing education loans, scholarships, or graduate student stipends (Courtney, 2005;Cramer et al, 2004). Moreover, the targets of need must be geographically specific so as to provide necessary additional assistance for schools in rural areas or for students who agree to work in rural areas.…”

“…For more than 30 years, Congress has authorized funding through such programs as Title VII of the Public Health Service Act to increase medical schools and graduating classes and to redirect physician resources to underserved areas when needed through such programs as the National Health Service Corp Scholarship and Loan Repayment Programs, and Rural Health Clinics. (Cramer et al, 2004;Politzer, Hardwick, Cultice, & Bazell, 1999). Unfortunately, there is no such federal designation for RNs because there has been no agreement on what constitutes a shortage (Grumbach et al, 2001), much less what would constitute an adequate supply, or need, for RN workforce in a geographic area.…”

“…This study focused on Phase 2 of the conceptual model, "Predictive Model to Determine Need for Nursing Workforce" (Cramer, Chen, Mueller, Shambaugh-Miller, & Agrawal, 2004; see Figure 1). Overall, the conceptual model was developed to frame the concept of need for RN workforce.…”

In Search of a Croatian Model of Nursing Education

“…As a prerequisite for design of a high-quality curriculum, an assessment must be made of the knowledge, skills, and attributes that the country needs from health professionals (36). In addition, the capability and readiness of the country to change must be assessed carefully.…”