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RN4CAST: Human Resources Forecasting in Europe
Luk Bruyneel
RN4CAST.EU | CONTENTS
1. INTERNATIONAL CONTEXT OF THE
NURSING WORKFORCE
2. RN4CAST: FP7-FUNDED RESEARCH ON THE
NURSING WORKFORCE
3. PRELIMINARY RESULTS
4. FURTHER PROGRESS
RN4CAST.EU | INTERNATIONAL CONTEXT | RATIO NURSES/PHYSICIANS
Source: OESO 2005 – for Belgium
(exact): J.Pacolet, 2006
Ratio nurses/physicians
RN4CAST.EU | INTERNATIONAL CONTEXT | NURSING LITERATURE
� Worldwide numeric, skill and geographic imbalances in
the nursing workforce
� Joint effects of staffing and various practice environment
elements on patient outcomes (Aiken et al., 2002)
� Poor nursing workforce planning and associated
shortages in any country threaten the stability of the
nurse workforce in neighbouring countries and beyond
through distortions in patterns of international nurse
migration
RN4CAST.EU | INTERNATIONAL CONTEXT | NURSING LITERATURE
� Surgical patients in hospital with better nurse work
environments have 13% lower odds on dying
� Patients in hospitals with better staffing (two fewer
patients per nurse) have 11% lower odds on dying
� Patients in hospitals with better educated nurses (20%
more BSNs) have 8% lower odds on dying
� Surgical patients in hospitals that are better on all three
have roughly 30% lower odds on dying
RN4CAST.EU | FP-7 FUNDED RESEARCH | CO-ORDINATION
� RN4CAST: nurse forecasting in Europe
� Timeframe: 2009-2011
� Budget: 3 mio Euros
� Co-ordination:
� Co-ordinator: Walter Sermeus (K.U.Leuven, Belgium)
Vice-coordination: Linda Aiken (Upenn, USA)
� Partners: 15 (+1): 11(+1) in Europe, USA, 3 ICPC
RN4CAST.EU | FP-7 FUNDED RESEARCH | EUROPEAN PARTNERS
BelgiumKatholieke Universiteit Leuven
FinlandKuopio University
GermanyTechnische Universität Berlin
GreeceUniversity of Athens
IrelandDublin City University
The NetherlandsUMC St Radboud
PolandJagiellonian University Krakow
SpainInstitute of Health Carlos III
SwedenKarolinska Institutet
SwitzerlandBasel University
United KingdomKing’s College London
Norway is an official reference partner
University of Pennsylvania, USA: previousexpertiseInternational Cooperating Partner Countriesof the European Union:
ChinaBotswanaSouth-Africa
RN4CAST.EU | FP-7 FUNDED RESEARCH | PARTNERS WORLDWIDE
To refine current forecasting models for manpowerplanning of thenursing workforce with new elements:
1.Various aspects of the nursing work environment2.Impact of nurse deployment on recruitment, retention and productivity of nurses and on patient outcomes
And to present mid-term and long-term projections on a European and national level
RN4CAST.EU | FP-7 FUNDED RESEARCH | OBJECTIVE
Hospitals: acute hospitals (at least 30 per country)
Nursing units: general medicine and surgery (cf. Kane et al., 2007)
Patient questionnaire
Nurse questionnaire
Hospital characteristics
Hospital discharge data
RN4CAST.EU | FP-7 FUNDED RESEARCH | METHODS
Country Nurse survey Patient survey
Hospitals Nurses RR Nurses Hospitals Patients RR Patients
Belgium 56 3186 72.07% 51 2323 68.00%
China 181 9774 97.50% 179 6540 92.50%
Finland 32 1130 45.39% 32 1952 52.03%
Germany * 49 3628 40.19% 12 390 64.87%
Greece * 26 500 38%-81% 26 800 55%-60%
Ireland * 31 2495 56.00% 10 300
Netherlands * 23 3163 69.00% No No No
Norway 35 6600 56.85% No No No
* In progress
RN4CAST.EU | PRELIMINARY RESULTS | DATA COLLECTION
* In progress § Estimated
RN4CAST.EU | PRELIMINARY RESULTS | DATA COLLECTION
Country Nurse survey Patient survey
Hospitals Nurses RR Nurses Hospitals Patients RR Patients
Poland 30 2605 97.31% 30 4136 93.66%
South-Africa * 54 2063 43.80% No No No
Sweden * 60-70 10000 69.00% No No No
Switzerland * 35 2222 71.20% 35 1458 66.05%
UK * 32 6169 32.00% No No No
Spain 61 6560 84.00% 29 960 94.00%
TOTAL EU§
470 48000 225 12000
TOTAL NON EU§
235 11800 179 6540
How satisfied are you with your current job in this hospital?
Very unsatisfied 2.8%
Unsatisfied 18.7%
Satisfied 69.7%
Very satisfied 9.8%
Job dissatisfaction
RN4CAST.EU | PRELIMINARY RESULTS | JOB DISSATISFACTION AND INTENTION TO LEAVE
If possible, would you leave your current hospital within the next year as a result of job dissatisfaction?
Intention to leave
29.5% of the Belgian nurses say they would leave their current hospitawithin the next year as a result of job dissatisfaction
Nursing
�…in another hospital 40%
�…not in a hospital 27.9%
Unclear 2.4%
Non-nursing 29.7%
RN4CAST.EU | PRELIMINARY RESULTS | JOB DISSATISFACTION AND INTENTION TO LEAVE
Min
10th
Pctl
25th
Pctl
50th
Pctl
75th
Pctl
90th
Pctl Max
3.2 7.4 13.3 17.3 30.4 44.1 68.2
Variation between hospitals
Intention to leave
Variation between hospitals
Min
10th
Pctl
25th
Pctl
50th
Pctl
75th
Pctl
90th
Pctl Max
13 16.0 21.2 28.6 37.5 45.7 55.9
Job dissatisfaction
RN4CAST.EU | PRELIMINARY RESULTS | JOB DISSATISFACTION AND INTENTION TO LEAVE
Correlation between job dissatisifaction and
intention to leave at the hospital level
r=0.81
Intention-to-
leave
Job
dissatisfaction
Emotional
Exhaustion
Deperson
alisatoins
Personal
accomplishment
Intention-to-leave the hospital 1
Job dissatisfactie 0.81 1
Emotional exhaustion 0.79 0.84 1
Depersonalisation 0.68 0.77 0.88 1
Personal accomplishment -0.49 -0.65 -0.74 -0.74
RN4CAST.EU | PRELIMINARY RESULTS | JOB DISSATISFACTION AND INTENTION TO LEAVE
Hospital Intention-to-leave
Job dissatisfaction
HOS 2 13.11 % 3.23 %
HOS 7 13.51 % 5.41 %
HOS 11 13.21 % 7.41 %
HOS 18 13.51 % 8.11 %
Hospital Intention-to-leave
Job dissatisfaction
HOS 45 45.57 % 47.50 %
HOS 47 41.18 % 52.94 %
HOS 53 55.88 % 44.12 %
HOS 37 54.55 % 68.18 %
Top 4
Bottom 4
RN4CAST.EU | PRELIMINARY RESULTS | JOB DISSATISFACTION AND INTENTION TO LEAVE
Top 4 Bottom 4
Educational opportunities
Wages
Professional status
Independence at work
Opportunities for advancement
Work schedule flexibility
Educational opportunities
Wages
Professional status
Independence at work
Opportunities for advancement
Work schedule flexibility
RN4CAST.EU | PRELIMINARY RESULTS | JOB DISSATISFACTION AND INTENTION TO LEAVE
A nurse manager who backs up the nursing
staff in decision making, even if the conflict is
with a physician
Praise and recognition for a job well done.
A nurse manager who is a good manager and
leader.
A supervisory staff that is supportive of nurses.
Top 4 Bottom 4
A nurse manager who backs up the nursing
staff in decision making, even if the conflict is
with a physician
Praise and recognition for a job well done.
A nurse manager who is a good manager and
leader.
A supervisory staff that is supportive of nurses.
RN4CAST.EU | PRELIMINARY RESULTS | JOB DISSATISFACTION AND INTENTION TO LEAVE
2009
EU PROPOSAL PROTOCOL FINALISATION DATA COLLECTION DATA ANALYSIS AND POLICY IMPLICATIONS
2007-2008 2010 2011
RN4CAST.EU | FURTHER PROGRESS | 3-YEAR TIMELINE
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