iowa advanced practice nurse tracking system

IOWA ADVANCED PRACTICE NURSE TRACKING SYSTEM

ADVISORY COMMITTEE MEETINGMarch 4, 2019

Meeting Agenda & Participant List

Iowa Advanced Practice Nurse Tracking SystemAdvisory Committee Meeting

Monday March 4, 201910:00 A.M. – 12:00 P.M.

Carver College of Medicine 100 CMAB

Agenda

Welcome and Introductions

Meeting Agenda and Participant List 2017 Annual Report Geographic Distribution Access Summary Trends Workforce Summary

Open Discussion Items


Monday, March 1, 201910:00 A.M. – 12:00 P.M.

Advisory Committee

Lorinda Inman, MSN, RNChair, Iowa Nurses FoundationIowa Nurses Association

Diana L. Huber, PHD, RN, FAAN, NEA-BCAssociate ProfessorUniversity of Iowa College of Nursing

Kathy Weinberg, MSN, RNExecutive DirectorIowa Board of Nursing

Jimmy Reyes, DNP, AGNP, RNAssociate Director of Practice and EducationIowa Board of Nursing

Laura Hudson, MSN, RNAssociate Director, CE/WorkforceIowa Board of Nursing

Kendra Williams-Perez, EdD, RN, CNEProfessor and DeanAllen College of Nursing


Monday, March 4, 201910:00 A.M. – 12:00 P.M.

Iowa Health Professions Tracking Center

Greg NelsonAssistant Dean for Clinical Education Programs

Theresa DunkinProgram Manager/Assistant Director

Nibras ElnourData Analyst/Assistant Manager

Linda ThiesenData Analyst/Assistant Manager

Francisco OlaldeData Analyst/Assistant Manager

Annual Benchmarks

IOWA APNs Annual Workforce Report*

K:\DOCUMENT\NP\YearEnd\2017Yearend\Graphics\np100.ppt

Date APNs• December 2017 2326• January 2017 2180

Gain + 146

Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education ProgramsUI Carver College of Medicine, April 2018

* For year ending 12-31-2017

1

IOWA APNs Entering vs. Terminating Practice

PriorPrior Ten-Year

2017 Year AverageAPNs Entering 281 308 208APNs Terminating -135 -147 - 94

Net Gain/Loss +146 +161 +114

K:Document\NP\YE2017\Graphics\124.PPT


2

IOWA APNs Gender Distribution

2017

Male12%

Female88%

Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education ProgramsUI Carver College of Medicine, April 2018 K:\DOC\NP\YE\2017\Graphics\NP104.PPT

• Female 2049• Male 277

Total 2326

3

IOWA APNsAge Distribution

2017

<4040.3%

40-4927.2%

50-5919.2%

>6013.3%

Age Category No. % Cumulative %< 40 938 40.3% 40.3%40-49 633 27.2% 67.5%50-59 447 19.2% 86.7%> 60 308 13.3% 99.9%

2326 100% 100.0%

K:\DOC\NP\YE\2017\Graphics\np128pie.PPT

Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs UI Carver College of Medicine, April 2018

4

IOWA APNsFull Time vs. Part Time*

2017

APNs Percent

Full Time 2189 94%

Part Time 137 6%Total 2326 100%


K:/DOC/NP/YE/2017/Graphics/FTE-164.PPT

*PT = < 32 hours/week

5

IOWA APNsAge Distribution

Full Time vs. Part Time2017

Age FT % PT % Cumulative %

< 40 904 38.9 34 1.5 40.4

40-49 597 25.7 36 1.5 67.6

50-59 416 17.9 31 1.3 86.8

> 60 272 11.7 36 1.5 100%

2189 94.2 137 5.8

FT = > 32

PT = < 32

Source: University of Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs,UI Carver College of Medicine, April 2018

NP\YE2017\Graphics\FTvPTage.PPT

6

IOWA APNs Detail of Age > 50

2017

0102030405060708090

100

50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78# in Iowa 39 32 46 38 58 55 40 60 43 36 40 49 40 37 36 25 21 15 14 10 8 5 2 1 1 0 3 0 1

Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs UI Carver College of Medicine, April 2018

K:NP\2YE2017\Graphics\Over50-Bar-163.PPT

Age

AP

Ns

Total number of APNs age 50 and over = 755 (32%)

7

IOWA APNsPrincipal Professional Activity

2017

Number Percent

Private Practice 1677 72.1% State Facility 273 11.7% Public/Community Health 120 5.2% Federal 74 3.2% Hospital Medicine 73 3.1% Urgent Care 55 2.4% Teaching/Research 34 1.5% Student Health 14 0.6% Administration 6 0.2%

Total 2326 100%


K:\DOC\NP\YE\2017\Graphics\NP126.PPT8

IOWA APNsCertifications

2017

Number Percent Family NP (FNP) 1201 51.6% RN Anesthetist (CRNA) 347 14.9% Pediatric NP (PNP) 162 7.0% Adult NP (ANP) 145 6.2% Psychiatric NP (PSNP) 120 5.2% Ob/Gyn (ONP)/Women’s Health (WHNP) 106 4.6% Nurse Midwife (NMW) 67 2.9% Acute Care NP (ACNP) 60 2.6% Neonatal NP (NNP) 40 1.7% Gerontological NP (GNP)/CGE 37 1.6% CNS Adult Psych (CAP) 16 0.7% Other* 25

1.0%

Total 2326 100%

Source: Office of Statewide Clinical Education Programs, UI Carver College of MedicineIowa Health Professions Tracking Center, April 2018

K:\DOC\NP\YE\2017\Graphiics\NP-CertPPT

*CNS, CNS Med Surg, School NP, CNS Oncology, CNS Adult Health CNS Child/Adolescent Psych, Perinatal NP

9

DISTRIBUTION OF APNsBy City Population Ranges*

2017

K:Doc\NP\YE2017\Grahics\CityPopRanges-Comp.ppt

Population

Cities in Iowa

% of population*

# of Cities with APNs

# of APNs

Percent

Cumulative Percent

< 5,000 867 (62CDP)** 27% 158 334 14.4% 14.4%

5,000-9,999 42 12% 39 264 11.3% 25.7%

10,000-24,999 17 10% 17 192 8.3% 34.0%

25,000-49,999 11 14% 11 238 10.2% 44.2%

50,000-99,999 8 23% 8 891 38.3% 82.5%

100,000 > 2 14% 2 407 17.5% 100.0%

Totals 947 100% 235 2326 100.0%


66% of Iowa’s APNs are in the 21 cities with > 25,000 residents

*Population Source: US Census City Population Estimates 2010**CDP: Census Designated Place

10

IOWA APNsCommunities Gaining/Losing APNs

2017

Community Size #Entering #Leaving Net

<5,000 36 21 +15

5,000 - 9,999 29 12 +17

10,000 - 24,999 19 11 + 8

25,000 - 49,999 29 26 + 3

50,000 - 99,999 118 39 +79

>100,000 50 26 +24Total 281 135 +146

K:Doc/NP/YE/2017Y/Graphics/101-chart.PPTSource: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education ProgramsUI Carver College of Medicine, April 2018 11

Geographic Distributions

Trends

ACTIVE IOWA APNs1999 - 2017

633

707804

872

907

930

997

1044

1087

1176

1260

13531503

16201747

19022019

2180

2326

0

200

400

600

800

1000

1200

1400

1600

1800

2000

2200

2400

'99 '00 '01 '02 '03 '04 '05 '06 '07 '08 '09 '10 '11 '12 '13 '14 '15 '16 '17

K:/Doc/NP/YE/2017/Graphics/NP102.PPT

Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs, UI Carver College of Medicine, April 2018

267% Increase

21

IOWA APNs Net Gain/Loss 1999 - 2017

0

50

100

150

200

250

300

Entering 130 96 121 88 72 96 124 92 104 144 132 149 231 224 247 272 268 308 281

Leaving 11 22 24 20 37 73 57 45 61 55 48 56 81 107 120 117 151 147 135

Net Gain/Loss 119 74 97 68 35 23 67 47 43 89 84 93 150 117 127 155 117 161 146

'99 '00 '01 '02 '03 '04 '05 '06 '07 '08 '09 '10 '11 '12 '13 '14 '15 '16 '17

AP

Ns

K:\DOCUMENT\NP\YearEnd\2017\Graphics\NP168.pptm


22

IOWA APNsAge Distribution Comparison

1999 vs. 2017938

633

447

307

159

280

152

210

100

200

300

400

500

600

700

800

900

1000

Under 40 40-49 50-59 60 and OverYear Total APNs Average Age Median Age

2017 2325** 45 43

K:Doc\NP\YE\2017\Graphics\170.PPT

Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs, UI Carver College of Medicine, April 2018

*Includes 21 unknown

1999 633* 45 45

23

IOWA APNs Working in Communities of <15,000

1999 – 2017

633

10871260

1503

1747

2019

2326

198 219382 405

481 500574 590 629 686 715

2180

1902

1620

1353

872707

907804

11761044

930 997

248 271 274 289258 318 323 357

100300500700900

11001300150017001900210023002500

'99 '00 '01 '02 '03 '04 '05 '06 '07 '08 '09 '10 '11 '12 '13 '14 '15 '16 '17

All APNs <15,000 Comm

Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education ProgramsUI Carver College of Medicine, April 2018 K:/DOC/NP/YE//2017\Graphics\Comm15KNP102.ppt

24

IOWA APNsTowns With at Least One APN

1999 - 2017

213

185

164158

151

238

225

219212

209206

179

178

174

172

155155

143

135120130140150160170180190200210220230240250

'99 '00 '01 '02 '03 '04 '05 '06 '07 '08 '09 '10 '11 '12 '13 '14 '15 '16 '17

Tow

ns

wit

h A

PN

s

YearK:/DOC/NP/YE/2017/Graphics/NPS106.ppt

Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs,UI Carver College of Medicine, April 2018

76% Increase

25

135

143

151155

158155

164

172 174178 179

185

206

213209

212

219225

238

239233 232 231 230 230 229

232229

225221 219 217

214 212 213

214

120

130

140

150

160

170

180

190

200

210

220

230

240

250

'99 '00 '01 '02 '03 '04 '05 '06 '07 '08 '09 '10 '11 '12 '13 '14 15 16 17

Com

mun

itie

s

Year

IOWA APNsCommunities with APN or Physician

1999-2017

Towns With At Least One APN

Towns With At Least One PHY

Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs,UI Carver College of Medicine, April 2018 K:Doc/NP/YE2017/NPs106w PHY

76% Increase

12% Decrease

26

IOWA ADVANCED PRACTICE NURSING SUPPLYAll APNs – Primary Care APNs*

2006 - 2017

10441176

1353

1620

1902

2180

566649

749

9401087

1260

1503

1747

2019

2326

1019

854

688606

15081279

12051125

0200400600800

10001200140016001800200022002400

'06 '07 '08 '09 '10 '11 '12 '13 '14 '15 '16 '17

Nur

ses

APNs Primary Care APNs

K:Doc/NP/YE/2017E/Graphics/PrimaryCareTrend 16.ppt

*Primary Care: ANP, FNP, & PNP

Source: Office of Statewide Clinical Education Programs, UI Carver College of Medicine Iowa Health Professions Tracking Center, April 2018

Primary Care APNs*126% Increase (13% per year)

APN Supply 96% Increase (10% per year)

27

IOWA APNsCRNA - Gender

1999 - 2017

136

246

286 287324 330

347340

302286

178161

189167

266

214207 209

166

170164154

101

146

116 122133 133

119135

114

149 162 163 149164

180

170160148

35 47 51 59 67 74 76 7997 104123 137 141

183

050

100150200250300350400

'99 '01 '02 '03 '04 '05 '06 '07 '08 '09 '10 '11 '12 '13 '14 '15 '16 '17

All CRNAs Male Female

Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education ProgramsUI Carver College of Medicine, April 2018 K:Doc\NP\YE\2017YE\Graphics\CRNA-Gender.PPT28

Iowa APNsAttrition Analysis

2010-2017


K:Document\NP\YE2017\Workforce142

Year Retirement Relocation Death Health Training InactiveLocum Tenens Military Misc/UNK Total

2010 9 13 - 1 - 6 - - 27 56

2011 21 18 - - - 3 - - 39 81

2012 19 21 2 1 - 9 1 - 54 107

2013 20 29 - 2 1 8 1 - 58 119

2014 21 36 1 2 1 3 5 - 48 117

2015 30 39 3 - 1 9 2 - 67 151

2016 28 28 - 1 1 4 4 - 78 144

2017 24 16 1 - 5 1 2 - 86 135

Total 172 200 7 7 9 43 15 0 457 910

Annual Average 21.5 25.0 0.9 0.9 1.1 5.4 1.9 0.0 57.1 113.8

29

RELOCATION OF IOWA APNs IN US (16)*

2017

Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education ProgramsUI College of Medicine, April 2018

K:\Document\NP\YE2017\USMap171.ppt

1

1

1 1

2

1

43

*4 unknown

1

30

Workforce Comparisons

IOWA HEALTH PROFESSIONS INVENTORYComposition of Workforce - 2017

K:Graphics/Powerpoint/IA Workforce/ALL-HP-2017/SummarySource: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs, UI Carver College of Medicine, July 2018

Physicians 5926

Pharmacists 2991

Dentists 1523

Nurse Practitioners

Physician Assistants

2326

922

31

IOWA HEALTH PROFESSIONS INVENTORY 2001-2017

4830 4974 5003 51975417 5599 5785 5876 5926

2473 2538 2590 2691 2814 2864 2923 2962 2991

1422 1448 1469 1476 1498 1524

1574 1564

1523

804 907 9971087 1260 1503

17472019

2326

480 538 583 630 681 736 812 893 922

0

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

5500

6000

6500

'01 '03 '05 '07 '09 '11 '13 '15 '17

Physicians 23% Increase

Dentists7% Increase

PAs92% Increase

Pharmacists 21% Increase

APNs 189% Increase

Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education ProgramsUI Carver College of Medicine, June 2018

K:Graphics\Powerpoint\IA Workforce\ALL‐HP‐2017\Trendline32


Net Gain/Loss Summary

K:Graphics/Powerpoint/IA Workforce/ALL-HP-2017/Gain-LossSource: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs

UI Carver College of Medicine, July 2017

Entering % Leaving % Net % Total

Physicians 410 6.9% 409 6.9% 1 0.02% 5926

Pharmacists 150 5.0% 136 4.5% 14 -0.5% 2991

Dentists 48 3.2% 68 4.5% -20 -1.3% 1523

Nurse Practitioners 281 12.1% 135 5.8% 146 6.3% 2326

Physician Assistants 88 9.5% 70 7.6% 18 1.95% 922

33


Gender

Male % Female % Total

Physicians 4071 1855 5926

Physician Assistants 269 653 922

Dentists 1074 449 1523

Pharmacists

APNs

1075

277

1916

2047

2991

2326

Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs, UI Carver College of Medicine, June 2017 K:Graphics/Powerpoint/IA Workforce/All-HP-2016/GENDER.PPT

29%

69%

71%

36%

71%

29%

88%

31%

12%

64%

34

PhysiciansPhysician Assistants Dentists Pharmacists APNs

<40 1410 24%

44148%

49533%

127443%

93840%

40-49 162127%

21523%

31521%

76626%

63327%

50-59 152526%

17319%

29719%

51717%

44719%

> 60 137023%

9310%

41627%

43314%

30713%

Total 5926 922 1523 2991 2326

Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs, UI Carver College of Medicine, July 2018

K:Graphics/Powerpoint/IA Workforce/ALL-HP-2017/AGE

IOWA HEALTH PROFESSIONS INVENTORYComposition of Workforce – 2017

Age

35


Retirement Summary

K:Graphics/Powerpoint/IA Workforce/ALL-HP-2017/RetirementSource: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs

UI Carver College of Medicine, June 2017

Percent of Average Age All Average Age

Retired All Attrition Retirement Attrition All Attrition

Physicians 125 31% 67 410 53

Pharmacists 37 27% 67 136 47

Dentists 35 52% 68 68 57

Nurse Practitioners 24 18% 67 135 49

Physician Assistants 6 8% 62 73 41

36

IOWA HEALTH PROFESSIONS INVENTORYDistribution by Community Size*

2017CommunityPopulation

Number of CommunitiesWith Providers

Number of Providers % of Providers

Pharms APNs Phys PA Pharms APNs Phys PA Pharms APNs Phys PA

< 1,000 14 38 14 22 20 43 19 23 0.7% 1.8% 0.3% 2.5%

1,000-4,999

128 122 112 77 373 259 295 115 12.5 11.1 5.0 12.5

5,000-9,999

40 37 40 35 381 251 436 109 12.7 10.8 7.4 11.8

10,000-49,999 22 22 22 19 491 347 864 118 16.4 14.9 14.6 12.8

50,000-99,999 5 5 5 5 695 608 1864 215 23.2 26.1 31.5 23.3

> 100,000 4 4 4 4 1031 818 2448 342 34.5 35.2 10.3 37.1

Total213 238 197 162 2991 2326 5926 992 100%

*Using 2010 census population figures, combining adjacent communitiesSource: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs,

UI Carver College of Medicine, June 2018 K:Graphics/Powerpoint/IA Workforce/All‐HP‐2017/CommDist‐NP‐Pharm‐PA‐Phys37

IOWA PROFESSIONS OBSTETRICSAge Distribution Comparison

2017

0

6166

79

65

2

59 58

4035

0 3 37

20

10

20

30

40

50

60

70

80

90

Under 30 30-39 40-49 50-59 60 and Over


Source: Iowa Health Professions Tracking Center, Office of Statewide Clinical Education Programs, UI Carver College of Medicine, February 2019

KeyBlack: APNBlue: PHYRed: PA

38

IOWA PROFESSIONS MENTAL HEALTHAge Distribution Comparison

2017

0

36

61 60

75

6

46 4439

44

29

59 9

0

10

20

30

40

50

60

70

80

Under 30 30-39 40-49 50-59 60 and Over




39

IOWA PROFESSIONS ANESTHESIAAge Distribution Comparison

2017

0

49

99

8488

2

126115

48

71

1 2 0 1 00

20

40

60

80

100

120

140

Under 30 30-39 40-49 50-59 60 and Over




40

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