January 2014 (Issue 2)

Volume 11, Issue 2

HEADLINES

THE LATEST FROM THE HILL: SENATOR MURRAY MAY JUMP FROM BUDGET TO HELP COMMITTEE
SUICIDES LEAD HOMICIDES IN VIOLENT DEATHS
ISSUE BRIEFS DISCUSS THE NEED FOR NURSING WORKFORCE DATA

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LINKS

NLN Government Affairs Action Center
NLN Public Policy

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THE LATEST FROM THE HILL: SENATOR MURRAY MAY JUMP FROM BUDGET TO HELP COMMITTEE

Rumors abounded on Friday that Senator Patty Murray (D-WA) may leave her Senate Budget Committee position just as legislators begin work on the fiscal 2016 budget. Fresh off a budget deal triumph, Senator Murray may be tempted to use her seniority to leave the Budget Committee chairmanship next year to succeed retiring Senator Tom Harkin (D-IA) as chairwoman of the Senate Health, Education, Labor and Pensions (HELP) Committee. If Murray decides to do that, she also would likely succeed the Harkin chairwoman of the Appropriations Labor-HHS-Education Subcommittee.

The Title VIII Nursing Workforce Development Programs are under the purview of the HELP Committee.

SUICIDES LEAD HOMICIDES IN VIOLENT DEATHS

The Centers for Disease Control and Prevention (CDC) recently released data collected about violent deaths in 16 states during 2010. The 16 funded states participate in CDC's National Violent Death Reporting System (NVDRS) and provide enhanced understanding of violent deaths to make prevention efforts more effective. The NLN belongs to the coalition that advocates for CDC funding for this program.

Findings show violent deaths from self-inflicted or interpersonal violence disproportionately affected adults younger than 55, males, and certain minority groups. A total of 16,186 deaths from 15,781 fatal incidents were recorded in 2010 in the 16 NVDRS states.

The majority of deaths were suicides (62.8 percent) followed by homicides and deaths caused by law enforcement using deadly force (24.4 percent), deaths of undetermined intent (12.2 percent), and unintentional firearm deaths (0.7 percent). Relationship problems and interpersonal conflicts, mental health problems, and recent crises frequently preceded violent deaths.

An estimated 55,000 people die annually in the United States from violence related-injuries. However, violence is preventable. NVDRS data assist public health authorities in developing, implementing, and evaluating programs that reduce and prevent these deaths at national, state, and local levels. To contact a violence prevention expert, email injurymedia@cdc.gov.

ISSUE BRIEFS DISCUSS THE NEED FOR NURSING WORKFORCE DATA

The foremost data source on the demographics, location, and practice behaviors of US nurses has been discontinued. This situation has put great pressure on states to collect their own nursing workforce data, and to collect common data elements that can be aggregated into a national dataset.

A new set of briefs,developed by a team of researchers funded by the Robert Wood Johnson Foundation's Interdisciplinary Nursing Quality Research Initiative (INQRI), provides information and guidance to assist states in building and maintaining nursing workforce data systems that will help answer questions about the current and future supply, distribution, diversity, and demand for nurses.

The three briefs address the reasons states should build data systems, how to do it, and what kinds of data should be included. To ensure that data are consistent across states and could be part of a national dataset, the research team encourages states to create data systems compatible with the standards of the minimum data sets (MDS) developed by the Health Resources and Services Administration, the National Council of State Boards of Nursing, and the Forum of State Nursing Workforce Centers.

The first brief explains why states need to build better workforce data systems and identifies the types of questions a longitudinal nursing workforce data system can help address:

• How will changing population demographics, economic conditions, and the rapid pace of health systems change affect nursing supply and demand?
• Are the state’s educational programs producing the workforce needed in the future?
• Does the racial/ethnic, geographic, and specialty distribution of the workforce match population health needs?
• What are the basic demographic and practice characteristics of the state’s nursing workforce and how are they likely to change in the future?

The second brief provides recommendations for creating, organizing, and maintaining a state-level data system, including:

• Forming collaborative partnerships early in the process to determine which entities can best collect, analyze, and report the data, and the best ways to fund and maintain the system.
• Housing the data system with a neutral party to ensure objectivity.
• Considering the possible pitfalls of having the state legislate the development of a system, including the reliance on annual appropriations, limited flexibility in determining questions, and the possibility that data collection and analysis may not remain objective.
• Identifying sustainable, long-term funding sources from the outset of the project.

> The third brief examines some of the efforts underway to create state-level nursing workforce data systems and highlights some of the most promising approaches to collecting data, and determining the kinds of data to collect.> The researchers encourage states planning to create nursing workforce data systems to engage in some of these practices, including:

• Using online data collection systems because they lower costs and improve data quality.
• Ensuring that questions and data values are consistent from year to year.
• Avoiding using open-ended or subjective questions in the data collection process.
• Working with the MDS to ensure consistency without compromising a state’s ability to do longitudinal comparisons.

The briefs can be found at http://rwjf.org/en/research-publications/find-rwjf-research/2013/11/meeting-the-need-for-better-data-on-the-nursing-workforce.html.

SHORT . . .

HRSA Releases Report Addressing Workforce Diversity and Health Disparities

The Division of Nursing at the Health Resources and Services Administration (HRSA) has announced the publication of “Nursing in 3D: Workforce Diversity, Health Disparities, and Social Determinants of Health,” a special Public Health Reports supplement. Featured articles advance scholarly inquiry around the intersecting goals of increased workforce diversity, fair and equal access to quality health care and health care resources, elimination of health disparities, and achieving health equity.

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FROM THE STATES . . .

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Access to Care: An Update on APRN Legislation in 2013

In 2013, some states took steps to unleash APRNs from restrictions in recent years.

• Nevada removed a requirement that APRNs work under the supervision of physicians and expanded their prescriptive authority.
• Rhode Island enacted legislation that expands the type of medications APRNs can prescribe.
• In Utah, state Medicaid officials agreed to recognize and reimburse NPs for primary care services for beneficiaries.
• Oregon’s governor signed a law that allows NPs and clinical nurse specialists to dispense prescription drugs.
• In Iowa, the state Supreme Court ruled that NPs can supervise fluoroscopy without physician supervision.

Changes like these suggest that the national movement to empower APRNs and improve patient access to care is picking up steam. However, there is opposition. The American Medical Association has opposed efforts to grant more power to APRNs.> It has stated that, “A physician-led team approach to care, with each member of the team playing the role they are educated and trained to play helps ensure patients get high quality care and value for their health care spending, Increasing the responsibility of nurses is not the answer to the physician shortage.”