RN4CAST: Human Resources Forecasting in Europe

Luk Bruyneel

RN4CAST.EU | CONTENTS

1. INTERNATIONAL CONTEXT OF THE

NURSING WORKFORCE

2. RN4CAST: FP7-FUNDED RESEARCH ON THE

NURSING WORKFORCE

3. PRELIMINARY RESULTS

4. FURTHER PROGRESS

RN4CAST.EU | INTERNATIONAL CONTEXT | RATIO NURSES/PHYSICIANS

Source: OESO 2005 – for Belgium

(exact): J.Pacolet, 2006

Ratio nurses/physicians

RN4CAST.EU | INTERNATIONAL CONTEXT | NURSING LITERATURE

� Worldwide numeric, skill and geographic imbalances in

the nursing workforce

� Joint effects of staffing and various practice environment

elements on patient outcomes (Aiken et al., 2002)

� Poor nursing workforce planning and associated

shortages in any country threaten the stability of the

nurse workforce in neighbouring countries and beyond

through distortions in patterns of international nurse

migration

RN4CAST.EU | INTERNATIONAL CONTEXT | NURSING LITERATURE

� Surgical patients in hospital with better nurse work

environments have 13% lower odds on dying

� Patients in hospitals with better staffing (two fewer

patients per nurse) have 11% lower odds on dying

� Patients in hospitals with better educated nurses (20%

more BSNs) have 8% lower odds on dying

� Surgical patients in hospitals that are better on all three

have roughly 30% lower odds on dying

RN4CAST.EU | FP-7 FUNDED RESEARCH | CO-ORDINATION

� RN4CAST: nurse forecasting in Europe

� Timeframe: 2009-2011

� Budget: 3 mio Euros

� Co-ordination:

� Co-ordinator: Walter Sermeus (K.U.Leuven, Belgium)

Vice-coordination: Linda Aiken (Upenn, USA)

� Partners: 15 (+1): 11(+1) in Europe, USA, 3 ICPC

RN4CAST.EU | FP-7 FUNDED RESEARCH | EUROPEAN PARTNERS

BelgiumKatholieke Universiteit Leuven

FinlandKuopio University

GermanyTechnische Universität Berlin

GreeceUniversity of Athens

IrelandDublin City University

The NetherlandsUMC St Radboud

PolandJagiellonian University Krakow

SpainInstitute of Health Carlos III

SwedenKarolinska Institutet

SwitzerlandBasel University

United KingdomKing’s College London

Norway is an official reference partner

University of Pennsylvania, USA: previousexpertiseInternational Cooperating Partner Countriesof the European Union:

ChinaBotswanaSouth-Africa

RN4CAST.EU | FP-7 FUNDED RESEARCH | PARTNERS WORLDWIDE

To refine current forecasting models for manpowerplanning of thenursing workforce with new elements:

1.Various aspects of the nursing work environment2.Impact of nurse deployment on recruitment, retention and productivity of nurses and on patient outcomes

And to present mid-term and long-term projections on a European and national level

RN4CAST.EU | FP-7 FUNDED RESEARCH | OBJECTIVE

Hospitals: acute hospitals (at least 30 per country)

Nursing units: general medicine and surgery (cf. Kane et al., 2007)

Patient questionnaire

Nurse questionnaire

Hospital characteristics

Hospital discharge data

RN4CAST.EU | FP-7 FUNDED RESEARCH | METHODS

Country Nurse survey Patient survey

Hospitals Nurses RR Nurses Hospitals Patients RR Patients

Belgium 56 3186 72.07% 51 2323 68.00%

China 181 9774 97.50% 179 6540 92.50%

Finland 32 1130 45.39% 32 1952 52.03%

Germany * 49 3628 40.19% 12 390 64.87%

Greece * 26 500 38%-81% 26 800 55%-60%

Ireland * 31 2495 56.00% 10 300

Netherlands * 23 3163 69.00% No No No

Norway 35 6600 56.85% No No No

* In progress

RN4CAST.EU | PRELIMINARY RESULTS | DATA COLLECTION

* In progress § Estimated

RN4CAST.EU | PRELIMINARY RESULTS | DATA COLLECTION

Country Nurse survey Patient survey

Hospitals Nurses RR Nurses Hospitals Patients RR Patients

Poland 30 2605 97.31% 30 4136 93.66%

South-Africa * 54 2063 43.80% No No No

Sweden * 60-70 10000 69.00% No No No

Switzerland * 35 2222 71.20% 35 1458 66.05%

UK * 32 6169 32.00% No No No

Spain 61 6560 84.00% 29 960 94.00%

TOTAL EU§

470 48000 225 12000

TOTAL NON EU§

235 11800 179 6540

How satisfied are you with your current job in this hospital?

Very unsatisfied 2.8%

Unsatisfied 18.7%

Satisfied 69.7%

Very satisfied 9.8%

Job dissatisfaction

RN4CAST.EU | PRELIMINARY RESULTS | JOB DISSATISFACTION AND INTENTION TO LEAVE

If possible, would you leave your current hospital within the next year as a result of job dissatisfaction?

Intention to leave

29.5% of the Belgian nurses say they would leave their current hospitawithin the next year as a result of job dissatisfaction

Nursing

�…in another hospital 40%

�…not in a hospital 27.9%

Unclear 2.4%

Non-nursing 29.7%

RN4CAST.EU | PRELIMINARY RESULTS | JOB DISSATISFACTION AND INTENTION TO LEAVE

Min

10th

Pctl

25th

Pctl

50th

Pctl

75th

Pctl

90th

Pctl Max

3.2 7.4 13.3 17.3 30.4 44.1 68.2

Variation between hospitals

Intention to leave

Variation between hospitals

Min

10th

Pctl

25th

Pctl

50th

Pctl

75th

Pctl

90th

Pctl Max

13 16.0 21.2 28.6 37.5 45.7 55.9

Job dissatisfaction

RN4CAST.EU | PRELIMINARY RESULTS | JOB DISSATISFACTION AND INTENTION TO LEAVE

Correlation between job dissatisifaction and

intention to leave at the hospital level

r=0.81

Intention-to-

leave

Job

dissatisfaction

Emotional

Exhaustion

Deperson

alisatoins

Personal

accomplishment

Intention-to-leave the hospital 1

Job dissatisfactie 0.81 1

Emotional exhaustion 0.79 0.84 1

Depersonalisation 0.68 0.77 0.88 1

Personal accomplishment -0.49 -0.65 -0.74 -0.74

RN4CAST.EU | PRELIMINARY RESULTS | JOB DISSATISFACTION AND INTENTION TO LEAVE

Hospital Intention-to-leave

Job dissatisfaction

HOS 2 13.11 % 3.23 %

HOS 7 13.51 % 5.41 %

HOS 11 13.21 % 7.41 %

HOS 18 13.51 % 8.11 %

Hospital Intention-to-leave

Job dissatisfaction

HOS 45 45.57 % 47.50 %

HOS 47 41.18 % 52.94 %

HOS 53 55.88 % 44.12 %

HOS 37 54.55 % 68.18 %

Top 4

Bottom 4

RN4CAST.EU | PRELIMINARY RESULTS | JOB DISSATISFACTION AND INTENTION TO LEAVE

Top 4 Bottom 4

Educational opportunities

Wages

Professional status

Independence at work

Opportunities for advancement

Work schedule flexibility

Educational opportunities

Wages

Professional status

Independence at work

Opportunities for advancement

Work schedule flexibility

RN4CAST.EU | PRELIMINARY RESULTS | JOB DISSATISFACTION AND INTENTION TO LEAVE

A nurse manager who backs up the nursing

staff in decision making, even if the conflict is

with a physician

Praise and recognition for a job well done.

A nurse manager who is a good manager and

leader.

A supervisory staff that is supportive of nurses.

Top 4 Bottom 4

A nurse manager who backs up the nursing

staff in decision making, even if the conflict is

with a physician

Praise and recognition for a job well done.

A nurse manager who is a good manager and

leader.

A supervisory staff that is supportive of nurses.

RN4CAST.EU | PRELIMINARY RESULTS | JOB DISSATISFACTION AND INTENTION TO LEAVE

2009

EU PROPOSAL PROTOCOL FINALISATION DATA COLLECTION DATA ANALYSIS AND POLICY IMPLICATIONS

2007-2008 2010 2011

RN4CAST.EU | FURTHER PROGRESS | 3-YEAR TIMELINE

ERROR: ioerrorOFFENDING COMMAND: image

STACK: