A research team at the University of Nebraska Medical Center is developing
a tool to help Nebraska communities predict and plan for nursing shortages.
Mary Cramer, Ph.D., assistant professor, UNMC College of Nursing, received
a $5,000, 12-month grant from the national Anne Zimmerman, RN American
Nurses Foundation Scholar grant to conduct the research.
The grant recognizes the contributions to nursing science of Anne Zimmerman,
RN. Dr. Cramer said the model she and colleagues are working on is unique.
The model has generated a lot of interest because people just havent
stopped to consider that we havent defined what a shortage is and we havent
developed any targets at all for looking at nursing workforce needs, Dr.
Cramer said. I think everybody is focusing on the nursing shortage and
rightly so theyre looking at what can we do to deal with the problem.
Since nursing is such an important component in health care, this model
would provide a more grounded and predictable approach for communities
who need to know how many nurses they will need, versus the current method
which only looks at economic factors like vacancy rates, turnover rates,
Dr. Cramer said.
She said the current definition of nursing shortage also has been based
on current staffing patterns, which can vary considerably between hospitals
and communities.
We start hearing employers say they cant hire registered nurses,
said Dr. Cramer who specializes in community health nursing. So programs
gear up, colleges gear up and federal money gets assigned for educational
programs. Nobody knows how many nurses are needed for sure.
Most efforts to alleviate the nursing shortage have been aimed at ill-defined
targets, or targets that have been arbitrarily set by current levels of
employers staffing needs. We need a more precise, predictive model that
combines the demand for health services with what we know should be recommended
ratios based on settings and demand for care.
The studys objective is to construct a scientific model to determine
nursing workforce demand in Nebraska. The premise of the model is the need
for registered nurses can be predicted from demands for health services
within a population. The model should provide a look at geographic areas
and population demographics and learn what the demand for services is and
come up with some target number to predict the number of nurses needed,
Dr. Cramer said.
The model could be a resource for health departments and policy makers,
she said.
Researchers will collect a variety of data and create a data base of
age, race, gender and health demand ratios in Nebraska counties to create
a mathematical model. The final product will be a mathematical model to
determine demand and identify nursing workforce targets in Nebraska.
If we know certain characteristics of a population like the age, distribution,
race, gender, we know from the literature and also studies that age is
linked to certain conditions in society. For example, we know a certain
number of people over age 65 will get Alzheimers disease or dementia.
Race also is linked to health care conditions, including diabetes in the
Hispanic population and hypertension and cardiovascular disease is linked
to African-Americans.
From this, we also know there are certain standards that tell us how
many staff are required to be in that type of facility that links registered
nurse staff to patient outcomes.
Dr. Cramer said during past nursing shortages, the market forces geared
up and could handle the shortage. Shortages in the 1980s and 1990s were
fairly rapidly corrected through the market economy of supply and demand.
The shortage is more serious now because there are other factors. Nurses
are getting older, there are retention problems and young people arent
going into nursing quite like they were. So its less likely we can immediately
correct the problem, Dr. Cramer said.
Another factor in the shortage is a greater demand for nursing faculty.
Nursing schools are having trouble attracting nurses to nursing education.
We can only admit as many students as we have faculty. If we cant hire
nursing faculty, we cant let as many students in, she said.
The model also could help nursing schools better plan in communities
on a long-range basis. It will help nursing schools better predict how
many registered nurses they need to educate and what kind of specialties
areas, like geriatrics, they need to be educating. We think this model
also has implications for other health professions, such as dentistry,
pharmacy and the allied health fields.
The grant is a very competitive and prestigious grant to obtain within
nursing circles, said Bernice Yates, Ph.D., associate dean of research,
UNMC College of Nursing.
Once the model is developed, Dr. Cramer said it will provide the framework
for larger studies, which could provide funding from the National Institutes
of Health and other sources. Dr. Cramers research team includes co-investigators,
Li-Wu Chen, Ph.D., and Mike Shambaugh-Miller, Ab.D., Donadea Rasmussen,
research analyst, Keith Mueller, Ph.D., consultant, and Sangeeta Agrawaal,
data analyst.