Advanced Practice Registered Nurse HEALTH RESOURCE SURVEY 2011 Yur respnses are very imprtant! Please cmplete the questinnaire as accurately as pssible using 2011 infrmatin effective at the time yu cmplete the survey. PLEASE NOTE: The Kansas Health Care Wrkfrce Partnership funded by the Health Research Services Administratin (HRSA) and in crdinatin with the Kansas Department f Health and Envirnment (KDHE) Bureau f Epidemilgy and Public Health Infrmatics (BEPHI) and the Bureau f Cmmunity Health Systems (BCHS) is requesting infrmatin t help mnitr health care practitiner supply, distributin and practice characteristics. This infrmatin is needed fr wrkfrce planning and t assist in develping strategies fr increasing the supply f primary health care prviders. Statistics derived frm this infrmatin will be used in cnjunctin with a physician wrkfrce assessment t apply fr federal designatins f Health Prfessinal Shrtage Areas and Medically Underserved Areas and public health reprting. The infrmatin yu prvide will nt be disclsed except as prvided by KSA 85-6804. I. General 1. Please enter yur Prfessinal License Numbers(s) as assigned by the Kansas State Bard f Nursing: APRN Number RN Number 2. Please list yur first, middle initial and last name: First Middle Initial Last Name 3. In which area d yu practice as an Advanced Practice Nurse? (check all that apply) Nurse Anesthetist Nurse Practitiner Nurse Midwife Clinical Nurse Specialists II. Demgraphic 4. Gender: Male Female Page 1 f 19
5. What is yur ethnicity? Hispanic/Latin Nn-Hispanic/Latin 6. What is yur racial backgrund? American Indian r Alaska Native Asian Black r African American Native Hawaiian r Other Pacific Islander White Multi-Racial Other, please specify 7. Are yu a permanent US resident r a US citizen? yes n 8. What language(s) d yu speak fluently (check all that apply). English Spanish German Russian Arabic Tagalg Chinese Hindi Urdu Pilipin Vietnamese French American Sign Language Other, please specify 9. D yu cmmunicate with sme f yur patients using the language(s) checked abve? yes n 10. Date f birth: Mnth Day Year Page 2 f 19
11. What is the estimated ppulatin f the city/twn where yu spent the majrity f yur upbringing: less than 2,500 2,500-9,999 10,000-14,999 15,000-19.999 20,000-49,999 50,000-149,999 >150,000 12. What is the estimated ppulatin f the city/twn where yu currently wrk? less than 2,500 2,500-9,999 10,000-14,999 15,000-19.999 20,000-49,999 50,000-149,999 >150,000 III. Educatin 13. Path t APRN Credentials: Please prvide all applicable infrmatin in the clumn belw Nursing Educatin Degrees Year Degree Cmpleted Diplma in nursing Assciate degree in nursing Baccalaureate degree in nursing Master's degree in nursing Dctr f Nursing Practice Nursing PhD Other dctral degree 14. The institutin frm which yu received yur Advanced Practice educatin: Name f Institutin City State Cuntry 15. What year did yu cmplete yur APRN educatin? (year) Page 3 f 19
16. If yu were a part-time nursing student, please select the reasn(s) yu chse that ptin (select all that apply): Nt applicable Needed t cntinue wrking full-time didn't want t attend full-time ther, please specify: 17. Hw did yu finance yur Registered Nurse degree? (check all that apply) Wrked (number f hurs) Supprted by family Received grants Tk ut lans, Please list ttal lan debt incurred: Emplyer funded/supprt ( % r years f wrk cmmitment) ther please specify 18. Hw did yu finance yur ADVANCED DEGREE? (check all that apply) Wrked (number f hurs: ) Supprted by family Received grants Tk ut lans, Please list ttal lan debt incurred: Emplyer funded/supprt ( % r years f wrk cmmitment) ther please specify 19. Did the need t pay ff student debt... influence the jb ffer yur accepted? yes n determine the type f specialty yu became certified in? yes Page 4 f 19
20. What is the name f the natinal certifying bdy frm which yu received yur credentials (check all that apply)? American Academy f Nurse Practitiners (AANP) American Assciatin f Nurse Anesthetists (AANA) American Cllege f Nurse-Midwives (ACNM) American Nurse Credentialing Center (ANCC) Natinal Certificatin Bard f Pediatric Nurse Practitiners (NAPNAP) Natinal Certificatin Crpratin fr the Obstetric, Gyneclgist and Nenatal Nursing Specialists Other, please specify 21. D yu intend t pursue further nursing related educatin? yes n 22. If yes, which type: PhD Dctrate NP Pst-masters Certificate Page 5 f 19
IV. Emplyment ****THE TERM "PRIMARY APN POSITION" IN THE FOLLOWING SET OF QUESTIONS REFERS TO THE POSITION AT WHICH YOU WORK MOST HOURS DURING A TYPICAL WORK WEEK. THE TERM "SECONDARY APN POSITION" IS THE POSITION AT WHICH YOU WORK THE SECOND GREATEST NUMBER OF HOURS DURING A REGULAR WORK WEEK.**** 23. In additin t yur principal APN psitin, are yu emplyed in anther psitin that required yur registry as an APN and/r yur RN license? [MARK ONE BOX] Yes, I wrk in tw r mre APN psitins. [GO TO Q24] Yes, I wrk in ne r mre RN psitin(s) in additin t my principal APN psitin. [GO TO Q24] N, I wrk in nly ne APN psitin. [GO TO Q25] 24. IF YES t the last questin, which f the fllwing best describes the reasn yu are emplyed in mre than ne psitin? [MARK ONE BOX] T supplement the earnings frm my principal APN psitin. Wasn't ffered fulltime wrk in my principal APN psitin T gain experience in a different aspect f advanced practice nursing Enjy wrking in varius clinical settings Other (specify) 25. In what ZIP Cde is yur principal APN psitin lcated? List the ZIP Cde f yur secndary APN psitin if applicable. PRINCIPAL APN POSITION SECONDARY APN POSITION ZIP CODE ZIP CODE Page 6 f 19
26. Indicate ne setting that best describes yur Primary and Secndary nursing emplyment setting. (P=Primary, S=Secndary) P S Ambulatry care P S Hme health care P S Hspital If yu marked hspital, what types f patients d yu P S Insurance Cmpany primarily care fr? P S Lng term care P S Acute care/emergency rm P S Nursing educatin prgram P S Newbrn P S Occupatinal health P S Basic medical/surgical P S Public/cmmunity health P S Obstetrics/gyneclgic P S Regulatin P S Chrnic Care P S Schl health P S Operating rm P S Crnary care P S Orthpedic P S Hspice unit P S Outpatient P S Intensive Care P S Pediatric P S Psychiatric P S Rehabilitatin 27. Which f the fllwing best describes yur APRN practice (check ne)? Family Practice Pediatrics Gerntlgy Wmen's Health (OB/GYN) Adult Health Psychiatry Other, please specify 28. Apprximately hw many hurs d yu wrk during a typical w rk week? hurs 29. What are yur plans fr future emplyment as an APRN? MOVE AFTER #34 Remain in current psitin Lking fr new emplyment Plan t retire in the next year Other, please specify Page 7 f 19
30. Which categry mst clsely apprximates yur ttal grss incme (befre APRN taxes) in 2009 frm all f yur APN psitins cmbined? [MARK ONE BOX] $40,000 r less $60,001 t $70,000 $90,001-$100,000 $40,001 t $50,000 $70,001 t $80,000 Mre than $100,000 $50,001 t $60,000 $80,001 t $90,000 Nt Wrking as an APN in 2009 Page 8 f 19
PRACTICE LOCATION #1 (Primary Practice) 31. What is the address f yur primary practice lcatin? a. Organizatin/ffice name: b. Street address: c. Suite#/Bx #/Mailstp/etc.: d. City: e. State (e.g. KS): f. Cunty: g. Zip Cde (5 digits): h. Zip Cde (4 digit extensin) i. Phne Number: j. E-mail address: 32. Please estimate the average number f patients yu see per day. patients/day 33. Please indicate the average number f APRN hurs per week that yu wrk. hurs/week Page 9 f 19
34. Please estimate the current payer mix in the clinical practice f yur principal APN psitin. [PERCENT SHOULD ADD UP TO 100%] % % % % % Private Insurance Medicare Medicaid CHP TriCare/CHAMPUS/VA % Wrker's Cmpensatin % Self-pay and sliding fee schedule % Uncmpensated care % Other (specify) 100% Ttal MOVE #41 HERE? (ld #29) What are yur plans fr future emplyment as an APRN? Remain in current psitin Lking fr new emplyment Plan t retire in the next year Other, please specify 35. Are yu planning t leave yur principal APN psitin in the next 12 mnths? yes n 36. IF YES t Q35, which f the fllwing factrs are influencing yur decisin t leave yur principal APN psitin? [MARK THE RELATIVE IMPORTANCE OF EACH FACTOR] Very Smewhat Nt Imprtant Imprtant Imprtant Desire a primary care psitin that des nt utilize my APN training Desire nn-clinical health-related psitin Want t pursue additinal educatin Want t wrk in nursing educatin Page 10 f 19
37. What type f wrk setting is yur primary practice lcatin? KDHE Lack f respect fr APNs by physicians and emplyers Wrk is nt prfessinally challenging Insufficient wages given the wrklad and respnsibilities invlved Family respnsibilities interfere with my ability t cntinue wrking Health des nt allw me t cntinue wrking as an APN Plan t retire frm the active wrkfrce Other specify Self-Emplyed, Sl Practice Physician Partnership r Grup Practice Cmmunity/General Hspital - Fllw private inpatients; practice primarily ambulatry Hspital Based: Predminantly Inpatient Services, e.g. pathlgy, hspitalist Medical Schl/Teaching Hspital Residency r fellwship Participant Rural health Clinic (federally certified) Federally Qualified Health Center Emergency Department (hspital) Emergency Medical Service/Transprt Military, Federal r VA Hspital Lcum Tenens (if mre than 10 hurs per week) Lng-term nursing r ther facility, hme health care, assisted living, residential treatment Crrectinal Facility (jail, prisn, detentin - yuth/adult) University/Cllege Campus Health Schl System/Schl Clinic K-12 Lcal r State Public Health/Gvernmental/Regulatry Agency HMO/Health Plan/Insurance Cmpany Ambulatry Surgery Center Independent Labratry Psychiatric Hspital (private) Radilgy/Imaging Center Other Specialty Hspital Other Patient Care Emplyment Other Nn-Patient Care Emplyment Page 11 f 19
Other, please specify Page 12 f 19
38. During a typical wrk week, what prprtin f time d yu spend n the fllwing activities at yur principal APRN clinical setting? [PERCENT SHOULD ADD UP TO 100%] KDHE % Direct, face-t-face patient care % Indirect patient care (e.g., phne calls, reviewing labs, charting) % Administratin (e.g., f wn practice, hspital cmmittees) % Teaching % Cntinuing educatin (e.g., curses, jurnal reading, vide and auditapes) % Research % Activities related t quality imprvement r patient safety % Other activities, please 100% Ttal specify 39. At yur primary practice lcatin, hw ften is a physician present n site t discuss patient prblems as they ccur? Never Seldm (25% r less f the time) Smetimes (26% - 50%) Usually (51% - 75%) Nearly always (76% - 100%) 40. Hw wuld yu characterize yur practice? Independent Practice Grup practice, n physician in the grup Grup practice, with physician(s) in the grup Other 41. Hw satisfied are yu with yur Advanced Practice Registered Nursing psitin at yur primary lcatin? s Very Satisfied Smewhat Satisfied Neutral Smewhat Dissatisfied Very Dissatisfied Page 13 f 19
42. D yu have a secnd practice lcatin? Yes (cntinue survey) N (skip t the signature line at the end f the survey) PRACTICE LOCATION #2 (Secndary Practice) 43. What is the address f yur secndary practice lcatin? a. Organizatin/ffice name: b. Street address: c. Suite#/Bx #/Mailstp/etc.: d. City: e. State (e.g. KS): f. Cunty: g. Zip Cde (5 digits): h. Zip Cde (4 digit extensin) i. Phne Number: j. E-mail address: 44. Please estimate the average number f patients yu see per day. hurs/day 45. Please indicate the average number f APRN hurs per week that yu wrk. hurs/week Page 14 f 19
46. Please estimate the current payer mix in the clinical practice f yur principal APN psitin. [PERCENT SHOULD ADD UP TO 100%] % % % % % Private Insurance Medicare Medicaid CHP TriCare/CHAMPUS/VA % Wrker's Cmpensatin % Self-pay and sliding fee schedule % Uncmpensated care % Other (specify) 100% Ttal 47. Are yu planning t leave yur principal APN psitin in the next 12 mnths? yes n 48. IF YES t Q23, which f the fllwing factrs are influencing yur decisin t leave yur principal APN psitin? [MARK THE RELATIVE IMPORTANCE OF EACH FACTOR] Very Smewhat Nt Imprtant Imprtant Imprtant Desire a primary care psitin that des nt utilize my APN training Desire nn-clinical health-related psitin Want t pursue additinal educatin Want t wrk in nursing educatin Lack f respect fr APNs by physicians and emplyers Wrk is nt prfessinally challenging Insufficient wages given the wrklad and respnsibilities invlved Family respnsibilities interfere with my ability t cntinue wrking Health des nt allw me t cntinue wrking as an APN Page 15 f 19
Plan t retire frm the active wrkfrce Other specify 49. What type f wrk setting is yur primary practice lcatin? Self-Emplyed, Sl Practice Physician Partnership r Grup Practice Cmmunity/General Hspital - Fllw private inpatients; practice primarily ambulatry Hspital Based: Predminantly Inpatient Services, e.g. pathlgy, hspitalist Medical Schl/Teaching Hspital Residency r fellwship Participant Rural health Clinic (federally certified) Federally Qualified Health Center Emergency Department (hspital) Emergency Medical Service/Transprt Military, Federal r VA Hspital Lcum Tenens (if mre than 10 hurs per week) Lng-term nursing r ther facility, hme health care, assisted living, residential treatment Crrectinal Facility (jail, prisn, detentin - yuth/adult) University/Cllege Campus Health Schl System/Schl Clinic K-12 Lcal r State Public Health/Gvernmental/Regulatry Agency HMO/Health Plan/Insurance Cmpany Ambulatry Surgery Center Independent Labratry Psychiatric Hspital (private) Radilgy/Imaging Center Other Specialty Hspital Other Patient Care Emplyment Other Nn-Patient Care Emplyment Other, please specify Page 16 f 19
50. During a typical wrk week, what prprtin f time d yu spend n the fllwing activities at yur principal APN clinical setting? [PERCENT SHOULD ADD UP TO 100%] % Direct, face-t-face patient care % Indirect patient care (e.g., phne calls, reviewing labs, charting) % Administratin (e.g., f wn practice, hspital cmmittees) % Teaching % Cntinuing educatin (e.g., curses, jurnal reading, vide and auditapes) % Research % Activities related t quality imprvement r patient safety % Other activities, please 100% Ttal specify 51. At yur primary practice lcatin, hw ften is a physician present n site t discuss patient prblems as they ccur? Never Seldm (25% r less f the time) Smetimes (26% - 50%) Usually (51% - 75%) Nearly always (76% - 100%) 52. Hw wuld yu characterize yur practice? Independent Practice Grup practice, n physician in the grup Grup practice, with physician(s) in the grup Other 53. Hw satisfied are yu with yur Advanced Practice Registered Nursing psitin at yur primary lcatin? Very Satisfied Smewhat Satisfied Neutral Smewhat Dissatisfied Very Dissatisfied Page 17 f 19
54. When are yu eligible t retire? less than 1 year 1-5 years 6-10 years 11-15 years 16-20 years 21-30 years greater than 30 years 55. When d yu plan t retire? less than 1 year 1-5 years 6-10 years 11-15 years 16-20 years 21-30 years greater than 30 years 56. D yu plan t reduce yur hurs prir t retiring? yes n Please sign yur name and date yur respnses belw: Name Date ADD IMMUNIZATION QUESTIONS THANK YOU FOR PROVIDING VALUABLE WORKFORCE INFORMATION BY COMPLETING THIS SURVEY. ALSO, PLEASE SIGN YOUR NAME, DATE AND RETURN THE SURVEY WHETHER OR NOT YOU HAVE COMPLETED IT. THIS IS IMPORTANT IN CALCULATION OF SURVEY RETURN RATES. Page 18 f 19
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