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How responsive are internationally educated nurses to an evolving - - PowerPoint PPT Presentation

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How responsive are internationally educated nurses to an evolving Canadian Health Care System? Presented by: Ryanna Bowling & Xiaoqian (Maureen) Li Canadian Institute for Health Information cihi.ca @cihi_icis April 27, 2018 hhr@

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Canadian Institute for Health Information cihi.ca @cihi_icis

How responsive are internationally educated nurses to an evolving Canadian Health Care System?

April 27, 2018 hhr@

Presented by: Ryanna Bowling & Xiaoqian (Maureen) Li

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Outline

  • About Canadian Institute for Health Information (CIHI)
  • Nursing Workforce data at CIHI
  • Setting the stage for analyzing workforce trends
  • Taking a closer look at responsiveness of internationally educated nurses
  • Trends to watch
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Independent not-for-profit corporation 27 data holdings Expertise in:

  • Data collection

and analysis

  • Information

standards

  • Education and outreach

About CIHI

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Nursing Workforce Data at CIHI

Regulated Nursing Contents Record-level supply and distribution information on RNs (including NPs), LPNs and RPNs Demographic, education, employment and geographic Aggregate data on nursing programs, including seats and graduates Data Source Provincial and territorial nursing regulatory bodies Canadian Association of Schools of Nursing, individual schools, Ministries of Advanced Education Data back to RN data: 1980 (NP data as of 2003 where legislation exists) LPN and RPN data: 2002 Nursing Education data: RN – 1997, NP – 2002 RPN – 1989 LPN – 2007

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Setting the stage

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Canadian health care system

“…it goes without saying that health care in Canada today has evolved into a much more comprehensive and complicated affair. It encompasses a broad range of services across a continuum of every possible age, culture, gender and care need.”

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  • Fundamental paradigm shift for Canadian

health care system

  • Focus on delivering care in community
  • Emerging roles in nursing profession
  • Integration, retention and mobility of health

professionals

Setting the stage

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Nursing in the news…

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IENs in the news…

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Taking a closer look at IENs

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Internationally educated LPNs more than quadrupled in the last decade

  • 50.0%

0.0% 50.0% 100.0% 150.0% 200.0% 250.0% 300.0% 350.0% 400.0% 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 RN LPN RPN

LPNs 6,706 349.5%

IENs

Cumulative Growth 2007-16 CENs LPN 44.9% RN 8.6% RPNs 5.1%

RPNs 373 3.6% RNs 26,710 21.9%

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Proportion of IENs varies by nurse type, 2016

RNs LPNs RPNs

Source: Health Workforce Database, CIHI, 2017

Overall Supply 298,743 116,491 5,859 IEN Supply 26,710 6,706 373 % IEN 8.9% 5.8% 6.4%

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14.8% 11.2% 4.8%

Variability by jurisdictions and nursing profession

9.5% 8.3% 9.5% 1.3% 3.5% IENs – RN Canada = 9.0% IENs – LPN Canada = 5.8% 5.3%

  • <1.0%

10.3% 11.1% 9.4% 6.3% 1.5% <1.0%

1.8%

IENs – RPN Canada = 6.8% 9.7% 9.3% 1.1% 1.0% 2.6% 1.8% † 7.7% 9.9% †

Notes † Digit suppressed in accordance with CIHI’s privacy policy; digit is from 0 to 9. Source

Health Workforce Database, 2017.

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Zoom in on registered nurses

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CENs are more likely than IENs to enter the workforce during their early career

Career

0% 10% 20% 30% 40% 50% 60% 70% Early Career <35 Mid Career 35-54 Late Career 55+ CEN IEN

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Did you know….

IENs are 2x more likely to work in nursing homes/long- term care setting than CENs

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A larger proportion of IENs are employed full-time, regardless of setting

Employment Status

60% 30% 10%

CENs

Full Time Part Time Casual 68% 23% 9%

IENs

Full Time Part Time Casual

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Telehealth Health Informatics Genetics Patient Navigators Care Coordination Coaching Palliative Care

Emerging Roles for RNs

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CENs higher retention in emerging places;

Place of Work

40% 50% 60% 70% 80% 90% 100% 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 Hospital Community Health Nursing Home/LTC Other 40% 50% 60% 70% 80% 90% 100% 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

Examples of emerging workplaces may include:

  • Telehealth
  • Hospice care
  • Blood transfusion centre
  • Cancer centre
  • Children treatment centre
  • Diabetes education centre
  • Correctional facility
  • Mobile nursing station
  • Clinical trials centre
  • Spa
  • Cruise ship

IENs more vulnerable to health care reform

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There is a movement away from institutional care to community-based care and other new delivery models (2016)

Hospital Other Community Health Nursing Home/LTC

21 % (775) 37 % (1,373) 42 % (1,580) 56 % (2,562) 9 % (417) 35 % (1,598) 47 % (836) 22 % (404) 31 % (553) 55 % (2,321) 36 % (1,535) 9 % (361)

CENs IENs

44 % (225) 28 % (145) 28 % (144) 50 % (181) 34 % (123) 16% (56) 60 % (133) 22 % (48) 18 % (40) 11% (34) 54 % (165) 35% (105) (1,793) (221) (4,577) (360) (3,728) (514) (4,217) (304)

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Did you know….

1 in 25 nurse practitioners

are internationally educated

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Area of Responsibility

Decrease for CENs in traditional roles; increase in IENS in traditional roles

60% 65% 70% 75% 80% 85% 90% 95% 100% 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

Traditional Direct Care AoRs

CEN IEN 60% 65% 70% 75% 80% 85% 90% 95% 100% 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

Emerging Direct Care AoRs

CEN IEN Examples of emerging roles may include

  • Telehealth
  • Care coordination
  • Health informatics
  • Genetics and genomics
  • Patient safety
  • Disaster and emergency preparedness
  • Coaching
  • Palliative care
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Parallel stories

Jennifer Neha

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Trends to watch

  • Barriers in entry-to-practice
  • Bridging programs
  • IEN integration and retention
  • Demand and recruitment for emerging roles in nursing
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cihi.ca

@cihi_icis hhr@cihi.ca

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References

  • 1. Emerging Roles in Healthcare 2014: Awareness Exceeds Preparation in Building the New Workforce; AMN Healthcare

Services, Inc. https://www.amnhealthcare.com/uploadedFiles/MainSite/Content/Workforce_Solutions/Survey-Emerging- Roles-in-Healthcare-2014.pdf

  • 2. Exploring New Roles for Advanced Nursing Practice; Canadian Nurses Association, 2005.

https://www.cna-aiic.ca/- /media/cna/page-content/pdf-fr/exploring_new_roles_anp-05_e.pdf

  • 3. Nurses Take on New and Expanded Roles in Health Care, January 20, 2015, Robert Wood Johnson Foundation.

https://www.rwjf.org/en/library/articles-and-news/2015/01/nurses-take-on-new-and-expanded-roles-in-health-care.html

  • 4. New and emerging roles for nurses; February 11

th, 2013, Nurse.com Blog. https://www.nurse.com/blog/2013/02/11/new-

and-emerging-roles-for-nurses-2/