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Remediation Outcome Study

Remediation Outcome Study. Elizabeth H. Zhong, PhD Kevin Kenward, PhD. Participating States Arizona Maryland Massachusetts Minnesota Nebraska North Carolina. Recidivism. Prior discipline history. 1996. 2005. Probation Issued during 2001. Discipline Record and Recidivism Rates.

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Remediation Outcome Study

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  1. Remediation Outcome Study Elizabeth H. Zhong, PhD Kevin Kenward, PhD

  2. Participating States Arizona Maryland Massachusetts Minnesota Nebraska North Carolina

  3. Recidivism Prior discipline history 1996 2005 Probation Issued during 2001

  4. Discipline Record and Recidivism Rates Prior Probationary Action Between 1996-2001(N=60) Probationary Action During 2001 (N=207) Post Probationary Action Between 2001-2005 (N=81) Rate of Recidivism (39.1%) 147 39.5% 58 60 38.3% 23 60

  5. Profile of Disciplined NursesGender About 15% of the disciplined nurses were male, the number of disciplined male nurses was disproportionate in the nursing workforce. RNs LPN/VNs 16.9% % of Male Nurses 10.7% 6.0% 5.3% 2004 National Sample Survey of Registered Nurses 2001 Probation Statistics (Six States)

  6. Profile of Disciplined NursesType of License 18.3% RNs 37.5% LPNs/VNs APNs % Composition 77.6% 59.0% State License Statistics Probation Statistics

  7. Years Licensed in 2001

  8. Profile of Disciplined NursesEducation

  9. Profile of Disciplined NursesType of Facility

  10. Profile of Disciplined Nurses Board Actions

  11. About 35% of the disciplined nurses had a prior legal history (arrest or conviction)

  12. About 33% percent of the disciplined nurses changed employers during their probation period.

  13. Disciplinary Grounds for 2001 Probation

  14. 2001 Probationary Requirements (N=778)

  15. Remediation Outcomes 65% Completed Probation 35% Failed to Complete Probation

  16. Recidivism Rate for the 2001 Probation 39% Non-recidivism 61% Recidivism Non-recidivism:Completed the 2001 probationary term and were not reported to the board of nursing for additional offenses within a four-year period from 2001 to 2005. Recidivism: Failed the 2001 probation by having additional offenses during or after the probation.

  17. Non-recidivism Recidivism Length of Probation Term by Outcome No statistical significance was identified in the actual time spent on probation in regards to the remediation outcome Yrs Yrs

  18. Non-recidivism Recidivism Gender by Recidivism Statistically significant relationship between the gender of disciplined nurses and the recidivism rate 43.3% 63.8% 56.7% 36.2% Male Female

  19. Age by Recidivism Non-recidivism Recidivism Disciplined nurses who recidivated were about three years younger than those who successfully completed the 2001 remediation. Those who were under the age of 40 years old were more likely to recidivate 50.7% 66.4% 49.3% 33.6% ≤ 40 Yrs Old > 40 Yrs Old

  20. Logistic Regression Analysis There is a negative correlation between age and recidivism, every unit increase in age decreases the odds of being a recidivist to 0.95. For a 10 year age increase, 40% decrease in the odds that the older individual recidivated If a disciplined nurse changed employers during their 2001 probation period, she/he will be 2.55 times more likely to recidivate compared to those who remained with the same employers.

  21. Non-recidivism Recidivism License by Recidivism There was a higher percentage of LPN/VNs than RNs that recidivated 49.3% 68.0% 50.7% 32.0% RNs LPNs/VNs

  22. Prior Legal History by Recidivism Non-recidivism Recidivism Significant relationship between the disciplined nurses’ prior legal history (arrest or conviction) and the remediation outcome 43.6% 67.1% 56.4% 32.9% With Legal History Without Legal History

  23. Types of Violations and Recidivism Non-recidivism Recidivism The disciplined nurses who committed different types of violations between 1996 and 2001 were more likely to recidivate again during or after the 2001 probation 21.2% 68.4% 78.8% 31.6% Same Different

  24. Change of Employers by Recidivism Those disciplined nurses who changed employers during probation were more likely to fail the 2001 remediation program 52.8% Non-recidivism 76.6% Recidivism 47.2% 23.4% Change of Employer No Change

  25. Conclusions • Male nurses, LPNs/VNs, and nurses who had prior legal histories were at higher risk for recidivism. • Changing employers during probation, committing different types of violations were positively related with recidivism. • Age of the disciplined nurses was negatively related with recidivism.

  26. Recommendations • Carefully screen the prior legal histories of the disciplined nurses. • Focus on male nurses, LPNs/VNs, as well as those nurses at a younger age (under 40 years old). • Pay more attention to those who commit different types of offenses. • Whenever possible, encourage disciplined nurses to remain working with the same employer.

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