leveraging data to make better decisions - an overview of databases webinar series webinar 4:...
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Leveraging Data to Make Better Decisions - An Overview of Databases
Webinar Series
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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
Leveraging Data to Make Better Decisions - An Overview of Databases
Webinar Series
Date: Monday January 21, 2013Time: Noon- 1:00PM (EST)
Leveraging Data to Make Better Decisions - An Overview of Databases
Webinar Series
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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
Leveraging Data to Make Better Decisions - An Overview of Databases
Webinar Series
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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
Leveraging Data to Make Better Decisions - An Overview of Databases
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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
Leveraging Data to Make Better Decisions - An Overview of Databases
Webinar Series
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
5* Health Human Resources (HHR)
Leveraging Data to Make Better Decisions - An Overview of Databases
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Databases for Decisions
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PRIMARY SECONDARY
New Graduate Nurse Employment
College of Nurses Of Ontario
(CNO)
Ministry of Health and Long-Term Care (i)Health Data Branch
(ii) Health Professions Database
Healthcare Employers
Canadian Institute for Health Information
(CIHI)
Leveraging Data to Make Better Decisions - An Overview of Databases
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Why study nurse employment?
Leveraging Data to Make Better Decisions - An Overview of Databases
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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
Leveraging Data to Make Better Decisions - An Overview of Databases
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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)
Leveraging Data to Make Better Decisions - An Overview of Databases
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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.
Leveraging Data to Make Better Decisions - An Overview of Databases
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Impact of Casualization
Source: CNO, 2010.
College of Nurses of Ontario: Renewal Counts for Registered Nurses, 1995-2012
19941995
19961997
19981999
20002001
20022003
20042005
20062007
20082009
20102011
201275,000
80,000
85,000
90,000
95,000
100,000
105,000
110,000
115,000
Total Workforce Employed in Nursing
Year
Cou
nt
Casualization
Leveraging Data to Make Better Decisions - An Overview of Databases
Webinar Series
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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
Leveraging Data to Make Better Decisions - An Overview of Databases
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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
Leveraging Data to Make Better Decisions - An Overview of Databases
Webinar Series
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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
Leveraging Data to Make Better Decisions - An Overview of Databases
Webinar Series
Evidence Informed Decision-Making
15Source: MOHLTC 1999, 2004, 2006, 2007.Source for photo: http://www.votethomson.ca/Document/168
Nursing Enhancement Fund
70% Full-Time Commitment
New Graduate Initiative
Nursing Graduate Guarantee (NGG)
1999 2005 2007-20122004-2006
Leveraging Data to Make Better Decisions - An Overview of Databases
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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
16Source: Ministry of Health and Long-Term Care (2011). Guidelines for participation in the Nursing Graduate Guarantee.
Leveraging Data to Make Better Decisions - An Overview of Databases
Webinar Series
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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).
Leveraging Data to Make Better Decisions - An Overview of Databases
Webinar Series
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*
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*early survey findings are validated with CNO new member employment data
Leveraging Data to Make Better Decisions - An Overview of Databases
Webinar Series
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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)
Leveraging Data to Make Better Decisions - An Overview of Databases
Webinar Series
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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
Leveraging Data to Make Better Decisions - An Overview of Databases
Webinar Series
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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.
Leveraging Data to Make Better Decisions - An Overview of Databases
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New Graduate Data Just-in-time data Data are leading Used to advise decision-
makers on effectiveness of policy
Sample (30%) representative of population
CNO Data Database composed of
total population of new graduate nurses employed in nursing
Data are lagging Historical data available
for trending
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Leveraging Data to Make Better Decisions - An Overview of Databases
Webinar Series
Sample Data Validation
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Age
NG Survey
N=715CNO New Members
N=2800 Chi-square18-24 361 51% 1495 53%
χ2=4.037 p=0.4010
25-29 180 25% 725 26%30-34 63 9% 232 8%35-39 56 8% 182 7%
>40 51 7% 166 6%
Total 711 100% 2800 100%Gender
Female 653 92% 2565 92%
χ2=0.00600 p=.9383
Male 57 8% 235 8%
Total 710 100% 2800 100%
Source: Baumann et al., 2009; CNO, 2008 *significant at p< .05
Comparison of Demographic Variables of RN New Graduate Survey Respondents and CNO General Class RN New Members, 2008
Leveraging Data to Make Better Decisions - An Overview of Databases
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Sample Data Validation
24Source: Baumann et al., 2008; CNO, 2007 *significant at p<.05
18-24* 25-29 30-34 35-39 >400%
10%
20%
30%
40%
50%
60%
NG SurveyCNO New Members
Age
Per
cen
tage
Comparison of age categories RN New graduate Survey Respondents and CNO New Member RNs, 2007
Leveraging Data to Make Better Decisions - An Overview of Databases
Webinar Series
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
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Leveraging Data to Make Better Decisions - An Overview of Databases
Webinar Series
Full-time Employment of New Member RNs by Location of Nursing Education
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1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 20100%
10%
20%
30%
40%
50%
60%
70%
80%
90%
ONIENOther Cdn
Year of first renewal
Per
cen
tage
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
First cohort of NGGs
Leveraging Data to Make Better Decisions - An Overview of Databases
Webinar Series
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Features of Database Standardized Aligned with secondary databases Annual reports generated (employment and
preferences)
Leveraging Data to Make Better Decisions - An Overview of Databases
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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
Leveraging Data to Make Better Decisions - An Overview of Databases
Webinar Series
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
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Leveraging Data to Make Better Decisions - An Overview of Databases
Webinar Series
ReferencesBaumann, 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.
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Leveraging Data to Make Better Decisions - An Overview of Databases
Webinar Series
Contact Information
Andrea Baumann, PhD
Scientific Director Nursing Health Services Research Unit
McMaster University
Michael DeGroote Centre for LearningMDCL 3500
(905) 525-9140 ext. [email protected]
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