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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

Elizabeth H. Zhong, PhD

Kevin Kenward, PhD


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Participating States

Arizona Maryland Massachusetts Minnesota Nebraska North Carolina


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Recidivism

Prior discipline history

1996

2005

Probation Issued during 2001


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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


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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)


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Profile of Disciplined NursesType of License

18.3%

RNs

37.5%

LPNs/VNs

APNs

% Composition

77.6%

59.0%

State License

Statistics

Probation

Statistics







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


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Disciplinary Grounds for 2001 Probation employers during their probation period.


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2001 Probationary Requirements employers during their probation period.

(N=778)


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Remediation Outcomes employers during their probation period.

65% Completed Probation

35% Failed to Complete Probation


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Recidivism Rate for the 2001 Probation employers during their probation period.

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.


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Non-recidivism employers during their probation period.

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


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Non-recidivism employers during their probation period.

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


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Age by Recidivism employers during their probation period.

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


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Logistic Regression Analysis employers during their probation period.

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.


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Non-recidivism employers during their probation period.

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


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Prior Legal History by Recidivism employers during their probation period.

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


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Types of Violations and Recidivism employers during their probation period.

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


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Change of Employers by Recidivism employers during their probation period.

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


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Conclusions employers during their probation period.

  • 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.


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Recommendations employers during their probation period.

  • 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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