Massachusetts Public Health Nursing Survey 2010

American Public Health Association November 2, 2011Public Health Nursing Workforce: Looking toward and planning for the future

1Presenter DisclosuresThe following personal financial relationships with commercial interests relevant to this presentation existed during the past 12 months:Deborah Chaulk, Glynnis LaRosa, Katherine SchmidtNo relationships to disclose2Survey WorkgroupDebbie Chaulk, MSN, RN, PHCNS-BCDawn Dewkett, DNPc, BSN, RN Andy Ellingson, MPHGlynnis LaRosa, MPH, RN, CPHQKaydee Schmidt, MSN, MPH, RN

3Enumerate the MA PHN workforceAnalyze changes of MA PHN workforce 2006 2010Discuss strategies to assure equal access to PHN servicesObjectives4IntroductionPHNs are essential in improving the health of communitiesPHNs are needed to:Address population health issues Reduce health disparitiesCreate healthy social and physical environmentsManage new and emerging health issues

Survey Methods2006 First Survey Baseline data2010 Second Survey Identify trends Document PHN/Population Ratio6Survey MethodsVoluntary pencil/paper 15-20 minutes to completeDistribution2009 MA PHN annual conferenceMA PHN Regional chapter meetingsAvailable on-line

7Survey Methods174 surveys returned Covering 183 municipalities Representing 80% of the population of the Commonwealth89MA PHN Profile

10MA PHN Average Age

HRSA 2010 The Registered Nurse Population Survey

11Percent of MA PHNs >50 yrs and older

12MA PHNs Educational Level

13MA PHNs with Bachelor Degree or higher

HRSA 2010 The Registered Nurse Population Survey

Prior Experience Long Term CareCardiologyHome HealthEmergencyInternational HealthInfectious DiseaseAcute CareHospiceOncologyHealth EducationFacultyEnvironmental HealthDiabetesAdministrationObstetricsMental HealthHIV/AIDSMens HealthSchool NursingRehabilitationPediatricsParish NursingWomens Health

15MA PHN Language Fluency

22% responded that they speak another language17Employment

18MA PHN Average Hourly Rate 2006 / 2010

Bureau of Labor Statistics19MA PHN Hours Worked Per Week

Extra Hours per Week 79 PHNs worked for additional hours26 PHNs were paid for additional hours53 PHNs were not paid for additional hours (average 5 hours/week)

This represents $313,656 of unpaid service per year BenefitsHealth insurance Travel expenses Paid sick timeLiability insurance Membership dues

Retire Within 2-4 years?7% responded they will retire in 2 years 14% responded they will retire in 4 years

Projection of 21% retiring within 4 years

Practice

24Scope of Practice

25Scope of PHN Practice 2010Increase / DecreaseSurveillance, Disease InvestigationsOutreach, Screening, and Case finding 94%hReferral and Follow up, Case Management and Delegated Function91%hHealth Teaching, Counseling and Consultation89%nCollaboration, Coalition Building andCommunity Organization 81%hAdvocacy, Social Marketing and PolicyDevelopment 72%hScreenings/Clinics/Programs

27

Screenings/Clinics/Programs28

Screenings/Clinics/Programs 29

Screenings/Clinics/Programs30Emergency Preparedness and ResponseTraining20062010Behavioral Health Response16%56%Mass Dispensing Site (EDS)49%69%Personal Protective Equipment34%61%

31Emergency Preparedness and ResponseTraining

2006

2010

Incident Command System(ICS)58%80%

32Emergency Preparedness and ResponseTraining20062010Health and Homeland Alert Network (HHAN)43%55%Risk Communication45%59%

33Emergency Preparedness and ResponseTraining20062010Local Emergency Planning Committee (LEPC)41%64%Drill Participation36%69%

34Populations Served

? 90 towns90

http://www.city-data.com/city/Massachusetts.htmlCities & Towns Population over 6000

http://www.city-data.com/city/Massachusetts.htmlCities & Towns 1000 population or less National Recommendation 1 PHN per 5000

39Examples and Anecdotes ExamplesTown 1 PHN: 6,500 population 1 PHN / 6,500

Town/City 2 PHNs: 65,000 population1 PHN / 32,500

AnecdotesOne larger city had a major reduction (6 PHNs down to 2 PHNs)1 PHN / 30,000 to 1 PHN / 90,000

Another large city has had a reduction 1 PHN / 10,000 to 1 PHN / 12,000 Some towns are without PHN services What Did We Learn!About the PHNs

About the tool and collection process About the PHNsEducation - above national average for BSNsPHNs are aging in placeRetirement % remains consistentSalary increased marginally from 2006 to 2010Growth and DevelopmentScope of PracticeEmergency Preparedness and Response Tool and Survey ProcessData needs to be more timelyReadiness of electronic methods and systemsWebsite advances

Did not capture PHN to population ratio# PHNs with reduced hours# Lost PHN positionsConsolidation of functions or communities Recommendations 2006Lead in Workforce Development

Assure Competency and Preparedness

Recruit and Retain PHNs Recommendations 2010 Maintain local and national alliances

Utilize technologies

Increase attendance at educational, skill building andnetworking sessions Planning for the FutureUtilize Technologies Obtain more timely data survey on-line Develop educational opportunities for building informatics skills and competencies Meet the states mandated electronic reporting Contribute NationallyContinue to document services provided Improve ability to define the denominator 48

Questions or Comments

Massachusetts Association of Public Health Nurses www.maphn.org

THANK YOU 49Chart152.0953.9147

200620102008USRNAverage Age52 years54 years47 years

Sheet1Average AgeSeries 2200652.09201053.91RN National47To resize chart data range, drag lower right corner of range.

Chart16168.57

20062010Percent of PHN over 50 years61%69%

Sheet1Percent of PHN over 50 years200661201068.57To resize chart data range, drag lower right corner of range.

Chart138.9245.515.56

2010Master or higher16%

Sheet1Column12010Series 2Series 3Diploma or associate38.922.42Bachelor45.54.42Master's or higher15.561.83To resize chart data range, drag lower right corner of range.

Chart1516150

20062010RN NationalBachelor or higher51%61%50%

Sheet1Bachelor or higher200651201061RN National50To resize chart data range, drag lower right corner of range.

Chart127.223.693.65.55.55.520

Percent

Sheet1PercentSpanish27.2French23.6Haitian9Creole3.6Chinese5.5Sign Language5.5Italian5.5Other20

Chart1252839.32

20062010MA RN 2009Average Hourly Pay Rate$25.00$28.00$39.32

Sheet120062010MA RN 2009Average Hourly Pay Rate$25.00$28.0039.32To resize chart data range, drag lower right corner of range.

Chart17.069.4115.2912.3555.88

percent

Sheet1percent1-8 hours7.069-16 hours9.4117-24 hours15.2925-32 hours12.3533-40 hours55.88

Chart10.120.230.270.330.230.230.140.120.110.110.320.40.640.69

20062010

Sheet120062010CHNA12%23%Camp insp27%33%Chol screen23%23%HMO senior14%12%Air quality11%11%Biohaz waste32%40%BP Screen64%69%

Chart10.30.290.060.10.150.210.750.790.10.160.380.330.580.45

20062010

Sheet120062010Blood lead30%29%Breast/Cervical6%10%Burial permit15%21%Comm Disease75%79%Dental10%16%Diabetes38%33%Hep A vaccine58%45%

Chart10.750.850.580.790.20.160.140.150.450.510.070.130.20.28

20062010

Sheet120062010Immunization clinic75%85%Influenza planning58%79%Int. travel imm.20%16%Latex allergies14%15%Medicare reimbursement45%51%Rabies animal clinic7%13%Rabies prevention humans20%28%

Chart10.220.150.150.230.630.650.710.730.520.540.660.44

20062010

Sheet120062010School health22%15%Smoking cessation15%23%Tuberculosis nursing63%65%Tuberculosis testing71%73%Universal precautions52%54%Vaccine management BIP66%44%