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Webinar 4: Development of a New Graduate Nurse Employment Database

Leveraging Data to Make Better Decisions - An Overview of Databases Webinar Series . Webinar 4: Development of a New Graduate Nurse Employment Database. Andrea Baumann RN, PhD Mary Crea- Arsenio MSc. Nursing Health Services Research Unit (NHSRU) McMaster University .

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Webinar 4: Development of a New Graduate Nurse Employment Database

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  1. Leveraging Data to Make Better Decisions - An Overview of Databases • Webinar Series Webinar 4:Development of a New Graduate Nurse Employment Database Andrea Baumann RN, PhD Mary Crea-Arsenio MSc. Nursing Health Services Research Unit (NHSRU) McMaster University Date: Monday January 21, 2013 Time: Noon- 1:00PM (EST)

  2. Big Picture Thinking... • Potential for long-term context • Think carefully about the development of survey even if it is for one study (e.g. Master’s thesis) • If possible, collect data over time

  3. Benefits of Longitudinal Research One-time versus annual survey • Cross-sectional study provides snapshot at one point in time • Longitudinal surveying allows for tracking individuals over time; change, context and trends

  4. Issues of Longitudinal Surveys Survey development • establish reliability and validity • issues of comparability over time • responding to changing context • how much to change survey and re-testing

  5. Sources of Data for HHR* Planning Workforce trends • historical and current employment, sector and practice Workforce profile • demographic, education Transition into the workforce • orientation/mentorship Workforce stability • retention/turnover * Health Human Resources (HHR)

  6. Databases for Decisions SECONDARY PRIMARY Canadian Institute for Health Information (CIHI) New Graduate Nurse Employment College of Nurses Of Ontario (CNO) Healthcare Employers • Ministry of Health and • Long-Term Care • (i)Health Data Branch • (ii) Health Professions Database

  7. Why study nurse employment?

  8. A Focus for Policy • Largest health care workforce • There were 150,149* nurses in 2011 • Changing population needs (e.g. aging population) • Global nursing shortages • Technological changes *Source: College of Nurses of Ontario (CNO) 2011

  9. Historical Context • Fiscal constraints: Ontario health-care restructuring in the 1990s • Organizations reduced full-time nursing positions; hired part-time and casual positions • Result: • Loss of nurses from the workforce • Casualization nursing workforce Source: Alameddine et al., (2006)

  10. A Call for Change: Policy-setting • Required to collect statistics to provide information to government • Ontario Nursing Task Force (1998) • Impact of SARs (2003): Walker report • Variety of government committees and presentations Source: MOHLTC, 1999.

  11. Impact of Casualization College of Nurses of Ontario: Renewal Counts for Registered Nurses, 1995-2012 Source: CNO, 2010.

  12. Impact of Casualization on New Graduate Nurse Employment • Early indication that new graduates were least likely to obtain full-time work • There was a need to study new graduates Source: Baumann et al. (2006). Educated and Underemployed

  13. Generating the Evidence • Survey developed in 2004 • at graduation and six months post-graduation • First wave of data collection (2004) included new graduate RNs • Wave 2 (2005): new graduate RPNs included Source: Baumann et al. (2006). Educated and Underemployed

  14. Evidence for Policy • Data collected presented to the Ministry of Health and Long-Term Care (MOHLTC) • One-third (35%) of 2005 new graduates employed full-time • Policy Recommendation: • Target investment toward increasing full-time opportunities for new graduates Source: Baumann et al. (2006). Educated and Underemployed

  15. Evidence Informed Decision-Making 2007-2012 2004-2006 2005 1999 Source: MOHLTC 1999, 2004, 2006, 2007. Source for photo: http://www.votethomson.ca/Document/168

  16. Nursing Graduate Guarantee 2007-2012 • Policy initiative launched in 2007 • Incentive funding for employers • hire new graduate nurses • temporary full-time supernumerary positions • six months • Evaluated annually Source: Ministry of Health and Long-Term Care (2011). Guidelines for participation in the Nursing Graduate Guarantee.

  17. Policy Evaluation • Trend study* design • New graduate nurses grouped into annual cohorts and employment status compared over time • New graduate survey data validated with CNO new member employment data * Trend studies are a type of longitudinal research that focuses on a particular population (e.g., new graduate nurses) sampled repeatedly (Cohen, Manion, and Morrison 2000).

  18. Methodology Real-time data collection • New graduate nurse employment survey was adapted to include questions about the NGG • Revised survey was re-tested in 2007 Secondary database • CNO new members employment data* *early survey findings are validated with CNO new member employment data

  19. New Graduate Nurse Data Elements • Demographic data: • Age, sex, employment status, type of employer, position in nursing, primary area of practice, and practice location (geographic region). • Preferences data: • employment status (FT/PT/casual) • sector of employment (hospital/long-term care/community/other) • geographical location (urban/rural)

  20. CNO Administrative Database • Administrative database is an annual mandatory census (total population of nurses in Ontario). • New graduates included as new members. • New members are nurses who have registered with the CNO in a given year and renew their membership for the first time

  21. CNO Administrative Database: Variables of Interest Nurse category – Category of nursing registration (RN/RPN). Location of initial nursing education – Country or province in which the nurse’s initial nursing education was obtained. Employment status –FT/PT/casual Sector of employment –hospital, long-term care, community and other.

  22. New Graduate Data CNO Data Database composed of total population of new graduate nurses employed in nursing Data are lagging Historical data available for trending • Just-in-time data • Data are leading • Used to advise decision-makers on effectiveness of policy • Sample (30%) representative of population

  23. Sample Data Validation Comparison of Demographic Variables of RN New Graduate Survey Respondents and CNO General Class RN New Members, 2008 Source: Baumann et al., 2009; CNO, 2008 *significant at p< .05

  24. Sample Data Validation Comparison of age categories RN New graduate Survey Respondents and CNO New Member RNs, 2007 Source: Baumann et al., 2008; CNO, 2007 *significant at p<.05

  25. Key Issues in Data Integration • Timing • data collection • length of time to integrate, link and validate • report publication/data access • Lack of standardization • Data quality

  26. Full-time Employment of New Member RNs by Location of Nursing Education First cohort of NGGs Note. Year of first renewal reflects new graduates of previous year (e.g. new graduates in 2009 are included in first renewal for 2010. Source: CNO, unpublished data, 2012

  27. Features of Database • Standardized • Aligned with secondary databases • Annual reports generated (employment and preferences)

  28. Types of Analysis • Develop indicators (e.g. full-time employment rate) • Trend analysis of preferences over 8 cohorts of new graduates • Trend analysis of employment across 8 cohorts of new graduates

  29. Points to consider • View survey in context of the field of study • If there is an opportunity, collect data over time • Establish validity and reliability; re-establish based on changes over time • Linking of databases enhance data quality • Multiple sources of data for decision-makers

  30. References Baumann, A. Hunsberger, M & Crea-Arsenio, M (2012). Impact of Public Policy on Nursing Employment: Providing the Evidence. Canadian Public Policy. Baumann, A., Hunsberger, M., & Crea-Arsenio, M. (2011). Workforce Integration of New Graduate Nurses: Evaluation of a Health Human Resource Employment Policy. Healthcare Policy. Vol 7(2), 47-59. Baumann, A. Hunsberger, M & Crea-Arsenio, M (2012). Full-Time Work for Nurses: Employers' Perspectives Journal of Nursing Management. Baumann, Blythe, J., Cleverley, K., &Grinspun, G. (2006, May). Health Human Resource Series Number 2. Educated and underemployed: The paradox for nursing graduands. Hamilton, Ontario: Nursing Health Services Research Unit, McMaster University.

  31. Contact Information Andrea Baumann, PhD Scientific Director Nursing Health Services Research Unit McMaster University Michael DeGroote Centre for Learning MDCL 3500 (905) 525-9140 ext. 22581 baumanna@mcmaster.ca

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