Report on Demographic Profile of Registered Nurses in Pennsylvania per Regional Action Coalition

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1 Report on Demographic Profile of Registered Nurses in Pennsylvania per Regional Action Coalition Data Supplied by the Bureau of Health Planning, Pennsylvania Department of Health Harrisburg, Pennsylvania And Data Obtained from the U.S. Census Bureau American Fact Finder: 2010 Demographic Profile Data Report Reviewed and Approved by the State Steering Committee of the Pennsylvania Action Coalition on November 12,

2 These data were supplied by the Bureau of Health Planning, Pennsylvania Department of Health, Harrisburg, Pennsylvania. The Pennsylvania Department of Health specifically disclaims responsibility for any analyses, interpretations or conclusions. 2

3 Pennsylvania Action Coalition November, 2013 Report on Demographic Profile of Registered Nurses in Pennsylvania per Regional Action Coalition Introduction In October, 2010, the Institute of Medicine (IoM) released its report on The Future of Nursing with the following recommendation: Build an infrastructure for the collection and analysis of interprofessional health care workforce data (recommendation #8). The Pennsylvania Action Coalition (PA-AC), established in fall, 2011 to implement the IoM s recommendations in Pennsylvania, received a State Implementation Program (SIP) grant from the Robert Wood Johnson Foundation (RWJF) in March, 2013, to provide the following deliverables at 18-months and 24-months, respectively: At 18-Months: The PA-AC, in collaboration with state partners (i.e., the Pennsylvania State Board of Nursing [SBoN], the Pennsylvania Department of Health Bureau of Health Planning [DoH-BHP], and the Pennsylvania Department of Labor and Industry [DoLI]), will identify variables to be included in a Nursing Database for Pennsylvania; variables to include age, gender, and ethnic/racial status. At 24-Months: The PA-AC, in collaboration with state partners (i.e., the SBoN, DoH BHP, and DoLI), will create separate databases of the variables previously identified at 18-months according to the nine Regional Action Coalitions (s) in Pennsylvania as of September, 2013 (see Appendix A for identification of counties included in each of the nine s). In addition, data on Pennsylvania s population including gender, race, and ethnicity obtained from the U. S. Census 2010 will be collected and reported according to s. From this database, a baseline of information regarding the nursing workforce in existence in Pennsylvania in 2010/2011 will be described. 3

4 The process employed to provide these deliverables involved several steps. The SBoN surveys registered nurses at the time of relicensure to collect information on the characteristics and distribution of the registered nurse workforce in the Commonwealth. The Board s voluntary 26-item survey is completed either online or by paper form (Appendix B). Survey data is then forwarded to the DoH BHP for analysis. The DoH published its 2010/2011 PULSE of Pennsylvania s Registered Nurse Workforce (Volume 5) in January, This report was based on 176,399 valid surveys returned in the period 2010/2011 a 90.4% response rate. The DoLI, through the Center for Workforce Information and Analysis, makes projections for the nursing workforce based on the data obtained by the BoN and analyzed and reported by the DoH BHP. The SBoN, DoH BHP, and DoLI met with representatives of the PA-AC in spring, 2013, to review the Coalition s request to collaborate on the generation of the following reports, using the 2010/2011 RN survey data: Gender Race Latino or Hispanic origin Highest nursing degree attained Did you hold a Practical Nurse license prior to obtaining your RN license? Have you completed an advanced nursing practice education program? o Do you hold State Certification as a Certified Nurse Midwife? o Do you hold State Certification as a Certified Clinical Nurse Specialist? o Do you hold State Certification as a Certified Registered Nurse Anesthetist? o Do you hold State Certification as a Certified Registered Nurse Practitioner? Are you currently pursuing your nursing education? o What type of nursing degree are you primarily pursuing? o Indicate if you are pursuing any of the following advanced nursing education program 1 See Pennsylvania s Department of Health website ( click on the Newsroom, Publications, and Reports; then click the link Work Force Reports. 4

5 Do you provide medical interpretation? o In which language(s) do you feel you can provide medical interpretation? These items were considered relevant to the PA-AC s mission and purpose statements, as approved by the Coalition s State Steering Committee in April 25, 2013 that is, to improve the health of Pennsylvanians by increasing access to, value, affordability, and quality of care; and to expand access to high quality care by ensuring nursing can provide that care when and where Pennsylvanians need it. Representatives from the DoH BHP and the DoLI agreed to provide the analyses requested in nine separate files corresponding to the nine s. In September, 2013, the PA- AC received these data files. The data received was from the 2010/2011 Registered Nurse dataset, which had a total of 176,399 valid survey responses. From this dataset, the DoH BHP filtered surveys to include those registered nurses who resided in counties in Pennsylvania and who (1) worked in health care, (2) worked in direct patient care, and (3) were employed in Pennsylvania. The final datasets included 85, 333 registered nurses. In addition, the PA-AC requested that the SBoN consider adding the following two items to the RN Survey: (1) if you are State Certified as an advanced practice nurse, do you have a DEA number and (2) if you are State Certified as an advanced practice nurse, do you have prescriptive authority. Representatives of the SBoN indicated that they would introduce these two items for consideration by their advisory board in fall, Once received, the data obtained will be used by the PA-AC through the nine s to address the deliverables identified in the SIP grant at the 18-month point (i.e., June, 2014) and the 24-month point (24-months). Findings Using the data obtained from the DoH BHP 2010/2011 and the U.S. Census 2010, the following descriptive statistics were identified per : Total population and total registered nurse population 5

6 Total female population and total female registered nurse population Total male population and total male registered nurse population Total White population and total White registered nurse population Total Black population and total Black registered nurse population Total American Indian/Alaska Native population and total American Indian/Alaska Native registered nurse population Total Asian population and total Asian registered nurse population Total Native Hawaiian/Other Pacific Islander population and total Native Hawaiian/Other Pacific Islander registered nurse population Total Other population and total Other registered nurse population Total Hispanic/Latino population and total Hispanic/Latino registered nurse Total Non-Hispanic/Latino population and total Non-Hispanic/Latino registered nurse population in Table 1 provides the descriptive findings regarding gender, race, and ethnicity for the total population per and for the registered nurse population per. 6

7 Table 1. Demographic Profile of Registered Nurses in Pennsylvania and Demographic Profile of Residents per Regional Action Coalition: 2010 Data 2 Item NW1- NW2 SW- NC- SC- NE1- NE2- SE1- SE2- Total 462,312 (100%) 466,591 (100%) 2,711,262 (100%) 702,566 (100%) 1,677,967 (100%) 717,178 (100%) 882,323 (100%) 3,103,316 (100%) 1,984,854 (100%) Total RN Total Female Total Female RN Total Male Total Male RN Total White Total White RN Total Black Total Black RN Total American Indian/Alas ka Native Total American Indian/Alask a Native RN 2,992 (0.65%) 232,872 (50.4%) 2,712 (90.6%) 227,440 (49.2%) 278 (9.3%) 421,646 (91.2%) 2,903 (97.0%) 24,286 (5.3%) 29 (0.97%) 921 (0.20%) 29 (0.97%) 3,041 (0.65%) 236,501 (50.7%) 2,783 (91.5%) 230,090 (49.3%) 257 (8.5%) 443,464 (95.0%) 2,984 (98.1%) 13,402 (2.9%) 16 (0.53%) 592 (0.13%) 25 (0.82%) 22,060 (0.81%) 1,393,368 (51.4%) 19,827 (89.9%) 1,317,894 (48.6%) 2,227 (10.1%) 2,400,354 (88.5%) 21,005 (95.2%) 205,531 (7.6%) 541 (2.5%) 3,324 (0.12%) 126 (0.57%) 3,961 (0.56%) 350,738 (50.0%) 3,637 (91.8%) 351,828 (50.0%) 324 (8.2%) 657,917 (93.6%) 3,864 (97.6%) 18,520 (2.6%) 19 (0.48%) 1,219 (0.17%) 29 (0.73%) 8,643 (0.52%) 853,639 (51.0%) 7,980 (92.3%) 824,328 (49%) 611 (7.1%) 1,490,293 (88.8%) 8,199 (95.0%) 95,060 (5.7%) 165 (2.0%) 3,090 (0.18%) 56 (0.65%) 4,501 (0.63%) 365,911 (51.0%) 4,070 (90.4%) 352,267 (49.0%) 431 (9.6%) 658,909 (92.0%) 4,369 (97.0%) 21,520 (3.0%) 33 (0.7%) 1,276 (0.18%) 35 (0.78%) 5,603 (0.64%) 451,596 (51.2%) 5,177 (92.4%) 430,727 (48.8%) 425 (7.6%) 726,862 (82.4%) 5,059 (90.3%) 59,750 (6.8%) 206 (3.7%) 2, (0.6%) 18,739 (0.60%) 1,616,657 (52.1%) 17,128 (91.4%) 1,486,659 (47.9%) 1,608 (8.6%) 1,918,332 (62.0%) 14,568 (78.0%) 821,757 (26.5%) 2,377 (12.7%) 9, (0.4%) 15,793 (0.80%) 1,013,188 (51.0%) 14,521 (92.0%) 971,666 (49.0%) 1,266 (8.0%) 1,688,829 (85.0%) 14,152 (90.0%) 115,837 (6.0%) 638 (4.0%) 3, (0.4%) 2 PA data from US Census 2010; RN data 2010/2011from Pennsylvania Department of Health, Bureau of Health Planning 7

8 Table 1. Demographic Profile of Registered Nurses in Pennsylvania and Demographic Profile of Residents per Regional Action Coalition: 2010 Data. (Continued) Item NW1- NW2 SW- NC- SC- NE1- NE2- SE1- SE2- Total Asian 3,842 (0.83%) Total Asian 15 RN (0.50%) Total Native 125 Hawaiian/ (0.03%) Other Pacific Islander Total Native Hawaiian/ Other Pacific Islander RN Total Other 11,492 3 (2.5%) Total Other 14 RN (0.47%) Total Hispanic/Latino Total Hispanic/Latino RN Total NON- Hispanic/Latino Total NON- Hispanic/Latino RN 11,821 (2.6%) 60 (2.0%) 450,491 (97.4%) 2,917 (97.5%) 2,077 (0.45%) 11 (0.36%) 70 (0.02%) 6,985 (1.5%) 5,286 (1.1%) 61 (2.0%) 461,305 (98.9%) 2,969 (98.0%) 45,580 (1.7%) 219 (1.0%) 517 (0.02%) 24 (0.11%) 55,956 (2.1%) 133 (0.60%) 36,890 (1.4%) 543 (2.5%) 2,674,372 (98.6%) 21,415 (97.1%) 11,401 (1.6%) 28 (0.71%) 160 (0.02%) 13,349 (1.9%) 18 (0.45%) 14,027 (2.0%) 90 (2.3%) 688,539 (98.0%) 3,857 (97.4%) 26,075 (1.6%) 146 (1.7%) 426 (0.03%) 10 (0.12%) 63,023 (3.8%) 65 (0.75%) 78,878 (4.7%) 220 (2.5%) 1,599,089 (95.3%) 8,389 (97.1%) 7,849 (1.1%) 37 (0.8%) 147 (0.02%) 27,477 (3.8%) 22 (0.5%) 40,163 (5.6%) 110 (2.4%) 677,015 (94.4%) 4,360 (97.0%) 21,245 (2.4%) 148 (2.6%) 330 (0.04%) 11 71,553 (8.1%) 138 (2.5%) 121,227 (13.7%) 286 (5.1%) 761,096 (86.3%) 5,288 (94.4%) 151,838 (4.9%) 1,286 (6.9%) 1,214 (0.04%) ,248 (6.5%) 372 (2.0%) 281,581 (9.0%) 705 (4.0%) 2,821,735 (91.0%) 17,931 (96.0%) 81,668 (4.0%) 686 (4.0%) 624 (0.03%) 28 93,993 (5.0%) 214 (1.4%) 132,450 (6.7%) 475 (3.0%) 1,852,404 (93.3%) 15,249 (97.0%) Table 2 provides specific data on registered nurses within each, including information on education, certification, and medical interpretation. 3 Other = Category based on U.S. Census 2010 including those who indicate Some other race and those who indicate Two or more races. 8

9 Table 2. Education and State Certification Profile of Registered Nurses in Pennsylvania, 2010/2011 BoN Data per Regional Action Coalition. Item NW1- N=2,992 NW2 N=3,041 SW- N=22,060 NC- N=3,961 SC- N=8,643 NE1- N=4,501 NE2- N=5,603 SE1- N=18,739 SE2- N=15,793 Held PN license prior to RN license Highest Education: ASN or ADN Highest Education: BSN Highest Education: Diploma Highest Education: Doctorate Highest Education: MSN or MN Highest Degree: Other Highest Education: Post- Master s Highest Education: N/A Completed Advanced Practice Nursing Program RNs with CNM State Certification RNs with CNS State Certification RNs with CRNA State Certification RNs with CRNP State Certification 288 (9.60%) 1,156 (38.60%) 1,019 (34.10%) 642 (21.50%) 144 (4.8%) 19 (0.60%) 340 (11.4%) 8 (0.27%) 36 (1.2%) 48 (1.6%) 373 (12.3%) 1,058 (34.8%) 721 (23.7%) 1,114 (36.6%) 124 (4.1%) (11.1%) 7 (0.23%) 37 (1.2%) 50 (1.64%) 2,133 (9.7%) 6,650 (30.1%) 7,001 (31.7%) 6,895 (31.3%) 32 (0.1%) 1,298 (5.9%) ,616 (11.9%) (0.23%) 438 (2.0%) 413 (1.9%) 649 (16.4%) 1,293 (32.6%) 1,181 (29.8%) 1,236 (31.2%) (4.8%) 19 (0.5%) 23 (0.6%) (11.0%) (1.5%) 74 (1.9%) 1,084 (12.5%) 3,170 (36.7%) 3,132 (36.2%) 1,848 (21.4%) 8 (0.1%) 387 (4.5%) 42 (0.5%) 46 (0.5%) 10 (0.1%) 881 (10.2%) 38 (0.4%) (1.0%) 159 (1.8%) 517 (11.5%) 1,571 (34.9%) 1,487 (33.0%) 1,106 (24.6%) 276 (6.1%) 16 (0.4%) 32 (0.7%) (12.8%) (0.4%) 87 (2.0%) 86 (2.0%) 570 (10.2%) 1,663 (29.7%) 2,024 (36.1%) 1,565 (27.9%) 7 (0.1%) 273 (4.9%) 22 (0.4%) 37 (0.7%) (10.9%) (1.1%) 120 (2.1%) 1,272 (6.8%) 4,297 (22.9%) 8,541 (45.6%) 4,389 (23.4%) 22 (0.1%) 1,289 (6.9%) (0.7%) 26 (0.1%) 2,307 (12.3%) 98 (0.5%) (1.2%) 484 (2.6%) 1,115 (7.1%) 4,379 (27.7%) 5,728 (36.3%) 4,519 (28.6%) 13 (0.1%) 953 (6.0%) 63 (0.4%) %) 25 1,974 (12.5%) 56 (0.4%) (1.4%) 342 (2.2%) 9

10 Table 2. Education and State Certification Profile of Registered Nurses in Pennsylvania, 2010/2011 BoN Data per Regional Action Coalition. (Continued) Item NW1- N=2,992 NW2 N=3,041 SW- N=22,060 NC- N=3,961 SC- N=8,643 NE1- N=4,501 NE2- N=5,603 SE1- N=18,739 SE2- N=15,793 RNs with advanced practice education, not State Certified as an APRN RNs currently in Nursing Education RNs currently in CNM education RNs currently in CNS education RNs currently in CRNA education RNs currently in CRNP education Nursing Program Pursuing: ASN or ADN Nursing Program Pursuing: BSN Nursing Program Pursuing: Doctorate Nursing Program Pursuing: MSN or MN Program Pursuing: Other Nursing Program Pursuing: Post- Master s 248 (73.0%) 330 (11.0%) 9 (2.7%) 17 (5.2%) 51 (15.5%) 11 (3.3%) 182 (55.2%) 7 (2.1%) 104 (31.5%) 22 (6.7%) 243 (72.1%) 333 (11.0%) 11 (3.3%) 13 (3.9%) 60 (18.0%) 192 (57.7%) 9 (2.7%) 99 (29.7%) 25 (7.5%) 1,674 (64.0%) 3,196 (14.5%) 9 64 (2.0%) 166 (5.2%) 644 (20.2%) 27 (0.8%) 1,630 (51.0%) 153 (4.8%) 1,111 (34.8%) 228 (7.1%) 44 (1.4%) 290 (66.0%) 462 (11.7%) 12 (2.6%) 24 (5.2%) 98 (21.2%) 7 (1.5%) 238 (51.5%) 8 (1.7%) 161 (34.8%) 32 (6.9%) 16 (3.5%) 587 (67%) 1,234 (14.3%) 8 (0.6%) 34 (2.8%) 53 (4.3%) 216 (17.5%) 14 (1.1%) 707 (57.3%) 16 (1.3%) 406 (32.9%) 76 (6.2%) 15 (1.2%) 376 (65%) 523 (11.6%) 28 (5.4%) 24 (4.6%) 119 (22.8%) 7 (1.3%) 225 (43.0%) 13 (2.5%) 210 (40.2%) 51 (9.8%) 15 (2.9%) 402 (66%) 858 (15.3%) 23 (2.7%) 47 (5.5%) 173; (20.2%) 14 (1.6%) 405 (47.2%) 18 (2.1%) 331 (38.6%) 77 (9.0%) 10 (1.2%) 867 (62%) 4,023 (21.5%) 35 (0.9%) 96 (2.4%) 159 (4.0%) 803 (20.0%) 41 (1.0%) 2,131 (53.0%) 69 (1.7%) 1,502 (37.3%) 218 (5.4%) 59 (1.5%) 1,319 (67%) 2,991 (18.9%) 8 63 (2.1%) 98 (3.3%) 480 (16.0%) 28 (0.9%) 1,721 (57.5%) 43 (1.4%) 964 (32.2%) 178 (6.0%) 53 (1.8%) Table 3 provides information on the number of registered nurses who provide medical interpretation, including the languages interpreted. 10

11 Table 3. Registered Nurses Providing Medical Interpretation in Pennsylvania, 2010/2011 BoN Data per Regional Action Coalition. Item Provides Medical Interpretation Language: Arabic Language: Chinese Language: Italian Language: PA Dutch Language: Polish Language: Russian Language: Sign NW1- N=2, (1.20%) NW2 N=3, (1.0%) SW- N=22, (1.4%) 16 (0.07%) 24 (0.1%) 8 (0.04%) 12 (0.05%) 12 (0.05%) 47 NC- N=3, (1.2%) SC- N=8, (1.9%) 8 (0.09%) 6 (0.07%) 14 (0.02%) NE1- N=4, (1.9%) 7 (0.16%) NE2- N=5, (3.6%) 6 (0.11%) 9 (0.16%) 8 (0.14%) SE1- N=18, (3.5%) 15 (0.08%) 27 (0.14%) 16 (0.09%) 12 (0.06%) 10 (0.05%) 24 (0.13%) 19 (0.10%) SE2- N=15, (2.8%) 14 (0.09%) 12 (0.08%) 9 (0.06%) 12 (0.08%) 45 2 (0.15%) Language: Spanish 15 (0.50%) 12 (0.4%) 77 (0.35%) 20 (0.5%) 77 (0.9%) 48 (1.1%) 127 (2.3%) 275 (1.5%) 164 (1.0%) Language: Vietnamese 16 (0.09%) 9 (0.06%) Language: Other 10 (0.33%) 133 (0.6%) 16 (0.4%) 56 (0.6%) 23 (0.5%) 46 (0.8%) 289 (1.5%) 193 (1.2%) Conclusions General Characteristics The descriptive data from the nine s reveals that the direct care nursing workforce living and working in Pennsylvania is primarily: female, with a range of female RNs from 89.9% (in the Southwest ) to 92.4% (in the Northeast 2 ); 11

12 White, with a range of White RNs from 78.0% (in the Southeast 1 ) to 98.1% (in the Northwest 2 ); non-hispanic/latino Origin, with a range of non-hispanic/latino RNs from 94.4% (in the Northeast 2 ) to 98.0% (in the Northwest 2 ); and a diploma or associate degree prepared workforce, with 48,551 nurses (57% of the 85,182 nurses who provided their highest education in nursing) holding either a hospital diploma (23,314; 27%) or an associate degree (25,237; 30%) as their highest nursing education. Advanced Practice Nurses The nursing workforce includes 10,078 registered nurses who have completed advanced practice nursing education programs. 3,499 (35%) of the registered nurses who have completed advanced practice nursing education programs hold state certification in an advanced practice role, including: o Certified Nurse Midwife (278, 8%), o Certified Clinical Nurse Specialist (203; 6%), o Certified Registered Nurse Anesthetist (1,242, 35%), and o Certified Registered Nurse Practitioner (1,776, 51%). The number of state certified advanced practice nurses residing in each is as follows: 4 o Northwest 1 = 92; ratio of APRNs to total population is 1 : 5,025 5 o Northwest 2 = 94; ratio of APRNs to total population is 1 : 4,964 o Southwest = 942; ratio of APRNs to total population is 1 : 2,878 o North Central = 147; ratio of APRNs to total population is 1 : 4,779 o South Central = 294; ratio of APRNs to total population is 1 : 5,707 o Northeast 1 = 199; ratio of APRNs to total population is 1 : 3,604 o Northeast 2 = 209; ratio of APRNs to total population is 1 : 4,222 4 These figures report the residence of APRNs per ; they do not reflect county of employment of state certified APRNs. 5 This figure is reported to the highest whole number. 12

13 o Southeast 1 = 867; ratio of APRNs to total population is 1 : 3,579 o Southeast 2 = 655; ratio of APRNs to total population is 1 : 3,030 The number of state certified advanced practice nurses residing in each who can serve as primary care providers (PCPs) is as follows: 6, 7 o Northwest 1 = 56; ratio of PCP-APRNs to total population is 1 : 8,256 8 o Northwest 2 = 50; ratio of PCP-APRNs to total population is 1 : 9,332 o Southwest = 454; ratio of PCP-APRNs to total population is 1 : 5,972 o North Central = 86; ratio of PCP-APRNs to total population is 1 : 8,169 o South Central = 197; ratio of PCP-APRNs to total population is 1 : 8,518 o Northeast 1 = 96; ratio of PCP-APRNs to total population is 1 : 7,471 o Northeast 2 = 135; ratio of PCP-APRNs to total population is 1 : 6,536 o Southeast 1 = 582; ratio of PCP-APRNs to total population is 1 : 5,332 o Southeast 2 = 398; ratio of PCP-APRNs to total population is 1 : 4,987 13,950 registered nurses reported enrollment in nursing education programs (16% of the registered nurse population. Of these, 3,645 (26%) were enrolled in advanced practice nursing programs, as follows: o Certified Nurse Midwife (60; 2%), o Certified Clinical Nurse Specialist (340; 9%), o Certified Registered Nurse Anesthetist (601, 16%), and o Certified Registered Nurse Practitioner (2,644, 73%). The Pennsylvania State Board of Nursing updates quarterly the number of active licensees according to type of license. As of June 27, 2013, there were 8, 397 certified registered nurse practitioners (CRNPs), with 5,926 (71%) of this number holding CRNP Prescriptive Authority licenses. Since primary care delivery requires prescriptive authority, as of June 27, 2013, only those holding such prescriptive authority licenses could be considered 6 These figures report the residence of Certified Nurse Midwives and Certified Registered Nurse Practitioners who hold state certification per ; they do not reflect county of employment of APRNs who are state certified. 7 APRNs defined as Primary Care Provides (PCPs) include Certified Nurse Midwives and Certified Registered Nurse Practitioners. 8 This figure is reported to the highest whole number. 13

14 primary care providers. Unknown at this time is the number of CRNPs with prescriptive authority who hold a Drug Enforcement Administration registration number allowing them to write prescriptions for controlled substances (for schedules 2, 2N, 3, 3N, 4, and 5). Additionally, there were 158 Clinical Nurse Specialists licensed as of that same date. The information on CRNP licensees, CRNP Prescriptive Authority licensees, and the Clinical Nurse Specialist licensees as of 2011 were not available at the time this report was written. Registered Nurses Sixteen percent (13,950) of registered nurses reported current enrollment in nursing education programs in 2010/2011. The enrollment patterns of respondents are as follows: enrolled in associate degree nursing programs; 7,431 enrolled in baccalaureate nursing programs; 4,888 enrolled in master s nursing programs; 336 enrolled in nursing doctoral programs; 212 enrolled in post-master s nursing programs; and 907 enrolled in other programs. Of the registered nurses pursuing their nursing education at the time of this survey, the following findings are noted: The majority is engaged in baccalaureate nursing programs (7,431), with the Southeast 1, the Southeast 2, and the Southwest together capturing 5,482 of these nurses (74%); There are 149 nurses pursuing associate degrees, with the Southeast 1, the Southeast 2, and the Southwest together capturing 96 of these nurses (64%); There are 336 nurses in direct care positions enrolled in nursing doctoral programs, with the majority in the Southwest (153, or 46%); and 9 The figures reported include those in advanced practice nursing programs, whether at the master s or clinical doctoral level. 14

15 907 nurses throughout the s are pursuing other, non-nursing degrees. Only 8,001 (9.4%) of registered nurse respondents indicated that they held the Practical Nurse license prior to receiving their Registered Nurse license. Lastly, a total of 1,980 (2.3%) of registered nurse respondents indicated that they provide medical interpretation, including: Eight hundred fifteen nurses (41% of those providing interpretation) throughout all s provide medical interpretation in Spanish; Ninety (4.5% of those providing interpretation) throughout all s provide medical interpretation in sign language; and Additional languages interpreted included Chinese, Italian, PA Dutch, Polish, Russian, and Arabic. Recommendations Based on the findings in this report, the following are proposed as recommendations for consideration: Discuss with SBoN the inclusion of two additional items on the RN relicensure survey: o If you are a state licensed advanced practice registered nurse, do you hold a current DEA registration number? o If you are a state licensed advanced practice registered nurse, do you hold a current Prescriptive Authority license? Discuss with the SBoN, the DoH BHP, and the DoLI the request to analyze the complete RN relicensure survey data annually according to s. Begin a series of conversations within the PA-AC and between the PA-AC and the SBoN, the DoH BHP, and the DoLI regarding expectations for a reflection of gender, race, and ethnicity of populations within the RN populations of s. That is, what is the likelihood that the diversity profile of each population will be reflected in the diversity profile of the RN population within each? 15

16 Begin a series of conversations within the PA-AC regarding the low rate of State Certification of nurses who have completed advanced nursing practice education programs. Continue such conversations within the PSNA, PCANE, and professional nursing education associations. Consider a research program to explore variables related to the gaps between: o Completion of advanced practice nursing education programs versus certification as advanced practice nurses, o Holding CRNP licenses from the SBoN versus holding CRNP Prescriptive Authority licenses from the SBoN, and o Holding CRNP licenses from the SBoN versus holding DEA registration numbers from the U.S. Drug Enforcement Administration. Analyze the number of state certified advanced practice nurses employed in each ; also analyze the number of state certified nurse practitioners and nurse midwives employed as primary care providers (PCPs) in each. This information will enable the distribution pattern of APRN-PCPs employed throughout the s to be outlined; thus, highlighting possible mal-distribution of primary care delivery by APRN-PCPs throughout the state. Consider working with health insurance providers to identify criteria for credentialing as a PCP; also, to identify the numbers of credentialed APRN-PCPs, CNSs, and CRNAs among the state s health insurance payers. 16

17 The PA-AC wishes to thank the Pennsylvania State Board of Nursing, the Pennsylvania State Department of Health Bureau of Health Planning, and the Pennsylvania State Department of Labor and Industry for their collegial assistance in providing the information needed to complete this report. It has been a pleasure working with these state offices. 17

18 Appendix A Regional Action Coalitions of the Pennsylvania Action Coalition 18

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20 Appendix B Pennsylvania State Board of Nursing Survey of Registered Nurses

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