A STUDY OF CERTIFIED REGISTERED NURSE ANESTHETIST MANPOWER IN NEBRASKA: PART IV

A STUDY OF CERTIFIED A STUDY OF CERTIFIED REGISTERED NURSE REGISTERED NURSE

ANESTHETIST MANPOWER INANESTHETIST MANPOWER INNEBRASKA: PART IVNEBRASKA: PART IV

Investigator: Matthew D. Petta, BSN

Committee Chairperson: Sharon Hadenfeldt, CRNA, MS

Committee Member: James Cuddeford, CRNA, MA

Committee Member: Carol Elliott, CRNA, MPA

Department Chairperson: Carol Elliott, CRNA, MPA

Problem Statement

The current national shortage of anesthesia providers has been anticipated for some time. Many factors have helped sustain the shortage such as: lack of clinical educators and available clinical sites, increased demand for surgeries based on an aging population, dilution of anesthetists to a variety of surgical settings, and the older demographic age of providers limiting their production. Nebraska may exhibit a compounded shortage because rural areas encounter the most difficulty recruiting anesthetists.

Research QuestionsResearch Questions

What was the unmet need for CRNAs in Nebraska, including What was the unmet need for CRNAs in Nebraska, including Ambulatory Surgical Centers? Ambulatory Surgical Centers?

How was the need projected to change within the next five How was the need projected to change within the next five years as perceived by hospital administrators and years as perceived by hospital administrators and managers of Ambulatory Surgical Centers?managers of Ambulatory Surgical Centers?

How many CRNAs currently practicing in Nebraska How many CRNAs currently practicing in Nebraska expected to retire or relocate out of the state in the next expected to retire or relocate out of the state in the next five years? five years?

What was the age distribution of CRNAs in Nebraska?What was the age distribution of CRNAs in Nebraska? What was the average length of time required to recruit a What was the average length of time required to recruit a

CRNA to a practice setting in Nebraska? CRNA to a practice setting in Nebraska? What are the regional differences within Nebraska related What are the regional differences within Nebraska related

to the above factors? to the above factors? Where were CRNAs within the state educated? Where were CRNAs within the state educated?

Literature ReviewLiterature Review 29,000 CRNAs short by 2010. Hospital-based operations to increase from 22

million in 1990 to 28 million in 2010, excluding cesarean sections.

Approximately 37 million anesthetics, including obstetrical and outpatient procedures, are anticipated by the year 2010.

Ambulatory surgical center surgeries are projected to rise from 2 million in 1990 to 8 million in 2010. This corresponds to the greatest operative site increase of all sites, from 8.6% to 20.1%. Rosenbach, M.L., Cromwell, J., Pope, G.C., Butricia, B., &Pitcher, J.D. (1991). Study of nurse anesthesia manpower

needs. Journal of the American Association of Nurse Anesthetists,59(3), 233-240.

Cromwell, J., Rosenbach, M.L., Pope, G.C., Butrica, B., & Pitcher, J.D. (1991).CRNA manpower forecasts:1990-2010. Medical Care, 29(7), 628-644.

Literature Review ContinuedLiterature Review Continued

There were 105 anesthesia programs that closed between 1976 and 1996, which contributed to the decline in the number of practicing CRNAs. In 1976 there were 194 nurse anesthetist training programs. In 1996, there were 89.

In 2004, 15.2% of all nursesworking in advanced practiceroles requiring a master’s degreewere nurse anesthetists. This is aslight decrease compared to1996.

Fallacaro, M.D., Obst, T.E., &Manquing, C. (1996). The national distribution of Certified Registered Nurse Anesthetists across metropolitan and nonmetropolitan settings. Journal of the American Association of Nurse Anesthetists, 64(3), 237- 242.

Inglis, T. (2004). Nursing the trends: Nurses have more employment options than ever. American Journal of Nursing, 104(1), 25-31. Retrieved August 18, 2005, from Ovid database.

Twenty-nine percent of CRNAs who are 55 years of age or older reside in non-metropolitan counties. Since 18.7% of the total CRNA pool lives in non-metropolitan areas, it could be reasoned that rural areas would have a higher percentage of loss due to retirement than metropolitan areas in the next 10 years.

The age distribution of currently practicing CRNAs hampers their ability to alleviate the shortage. Over 49% of nurse anesthetists were fifty years of age or older in 2003 (Grogono, 2003); and in 2010, 65.9% of nurse anesthetists are predicted to be fifty years old or greater (Rosenbach, et al. 1990).

Literature Review ContinuedLiterature Review Continued

Fallacaro, M.D., Obst, T.E., &Manquing, C. (1996). The national distribution of Certified Registered Nurse Anesthetists across metropolitan and nonmetropolitan settings. Journal of the American Association of Nurse Anesthetists, 64(3), 237-242.

Rosenbach, M.L., Cromwell, J., Pope, G.C., Butricia, B., &Pitcher, J.D. (1991). Study of nurse anesthesia manpower needs. Journal of the American Association of Nurse Anesthetists,59(3), 233-240.

Grogono, A.W. (2003). Resident numbers and total graduating from residencies and nurse anesthesia schools in 2003: continuing shortages expected. American Society of Anesthesiologists Newsletter, 67(11), 1-11.

MethodologyMethodologyMailed QuestionnaireMailed Questionnaire

A response rate of 50% is needed to consider the A response rate of 50% is needed to consider the questionnaire adequate, while 70% or more is questionnaire adequate, while 70% or more is considered very adequate considered very adequate

Eliminates interviewer biasEliminates interviewer bias Eases ability to reach subjects who are difficult to Eases ability to reach subjects who are difficult to

contact per telephone or in person contact per telephone or in person Assures confidentiality, personalizes materials, Assures confidentiality, personalizes materials,

with follow up reminders as an effective method with follow up reminders as an effective method to encourage completion of the mailed to encourage completion of the mailed questionnaire questionnaire

Self addressed, stamped return envelopes Self addressed, stamped return envelopes facilitate response. facilitate response.

Respondents do not fear the possibility of Respondents do not fear the possibility of repercussion due to their response and are more repercussion due to their response and are more likely to be honest likely to be honest

Large amounts of anonymous data can be Large amounts of anonymous data can be obtained with easeobtained with ease

Methodology ContinuedMethodology Continued

One questionnaire was mailed to CRNAs licensed to One questionnaire was mailed to CRNAs licensed to practice in Nebraska. The purpose was to assess the supply practice in Nebraska. The purpose was to assess the supply of CRNAs within the state. of CRNAs within the state.

The second questionnaire was mailed to all hospital The second questionnaire was mailed to all hospital administrators and/or department of anesthesia managers administrators and/or department of anesthesia managers within the hospitals in Nebraska designated acute care within the hospitals in Nebraska designated acute care hospitals. The purpose of the second questionnaire was to hospitals. The purpose of the second questionnaire was to assess the demand for CRNAs within the state. assess the demand for CRNAs within the state.

An addition to the previous studies was the inclusion of An addition to the previous studies was the inclusion of outpatient surgical centers within Nebraska. The intent was outpatient surgical centers within Nebraska. The intent was to derive similar information related to the demand for to derive similar information related to the demand for CRNAs elicited from hospital administrators and/or CRNA CRNAs elicited from hospital administrators and/or CRNA managers in the past. managers in the past.

SubjectsSubjects

Subjects of this study included all CRNAs Subjects of this study included all CRNAs who have a license to practice within the who have a license to practice within the state of Nebraska, and who reside in state of Nebraska, and who reside in Nebraska. Only hospital administrators Nebraska. Only hospital administrators and/or anesthesia department managers, and/or anesthesia department managers, who belong to the NAHHS, received the who belong to the NAHHS, received the questionnaires, with the exclusion of the questionnaires, with the exclusion of the Veteran Administration hospital. Veteran Administration hospital. Ambulatory surgical centers also received Ambulatory surgical centers also received the questionnaires addressed to the the questionnaires addressed to the manager of anesthesia services.manager of anesthesia services.

LimitationsLimitations

The potential for bias depending on a low The potential for bias depending on a low response rate.response rate.

Anesthetics that are administered Anesthetics that are administered outside of the hospitals and ambulatory outside of the hospitals and ambulatory surgical centers identified would not be surgical centers identified would not be included in the assessment of the included in the assessment of the demand for CRNAs. For instance, those demand for CRNAs. For instance, those procedures performed in doctor’s offices procedures performed in doctor’s offices would not be assessed in this research.would not be assessed in this research.

The Veteran Administration hospital in The Veteran Administration hospital in Omaha was not included in this study.Omaha was not included in this study.

AssumptionsAssumptions

The respondents would be willing The respondents would be willing and able to provide accurate and able to provide accurate information.information.

The respondent interpretation of The respondent interpretation of information was appropriate.information was appropriate.

The respondents were honest in The respondents were honest in answering the questions.answering the questions.

ProcedureProcedure

The first mailing included cover letters, the The first mailing included cover letters, the respective questionnaires, and an respective questionnaires, and an addressed return envelope with postage.addressed return envelope with postage.

Mailed questionnaires were returned to the Mailed questionnaires were returned to the secure BryanLGH School of Nurse secure BryanLGH School of Nurse Anesthesia office.Anesthesia office.

The respondent’s confidentiality was The respondent’s confidentiality was maintained by: assigning tracking numbers maintained by: assigning tracking numbers on the back of returned envelopes, on the back of returned envelopes, maintaining a locked office, keeping the maintaining a locked office, keeping the information confidential, and only reporting information confidential, and only reporting group data. group data.

Procedure ContinuedProcedure Continued

The follow up letters were mailed The follow up letters were mailed three weeks from the first mailing. three weeks from the first mailing.

A three week interval was used A three week interval was used between the second and third between the second and third mailing. mailing.

A third and final mailed questionnaire A third and final mailed questionnaire was sent to those CRNAs who have was sent to those CRNAs who have not responded to the second mailing. not responded to the second mailing.

Procedure ContinuedProcedure Continued

The third attempt for the ambulatory surgical The third attempt for the ambulatory surgical centers and hospitals included a phone call to the centers and hospitals included a phone call to the facility. The phone numbers were found in phone facility. The phone numbers were found in phone registries. registries.

The questionnaires were completed on the phone The questionnaires were completed on the phone by the researcher, who asked all the questions by the researcher, who asked all the questions verbatim from the questionnaire. verbatim from the questionnaire.

After several attempts to contact persons able to After several attempts to contact persons able to accurately and willingly complete the survey over accurately and willingly complete the survey over the phone were unsuccessful, the author halted the phone were unsuccessful, the author halted further attempts.further attempts.

All information was transcribed to a spreadsheet All information was transcribed to a spreadsheet computer program computer program

RegionsRegions

School of Nurse AnesthesiaMarch 1, 2005Dear CRNA:

I am a senior in the BryanLGH Medical Center School of Nurse Anesthesia program. I am researching nurse anesthesia manpower in the state of Nebraska with the aid of the Nebraska Association of Nurse Anesthetists (NANA). This is my master’s degree thesis project.

Participation in the survey is voluntary. Please complete the enclosed questionnaire and return it in the envelope provided within the next two weeks if you wish to participate. If you did not administer anesthesia in the state of Nebraska in 2004, please answer question #1 accordingly. Then, return the questionnaire with the envelope provided.

The current research will allow me to determine supply and demand of nurse anesthetists in Nebraska. The research will be compared to studies performed in 1991, 1995, and 2000; so manpower trends over the past fifteen years will be determined. Compiled results will be shared with the NANA. A copy of the complete results of the survey can be obtained through the BryanLGH Medical Center School of Anesthesia. All information will be kept confidential.

Thank you for completing the questionnaire. Your assistance is greatly appreciated.Sincerely,Matthew D. Petta, RN, BSN

InstrumentsInstruments

CRNA MANPOWER STUDYNURSE ANESTHETIST SURVEY1. Did you administer anesthesia in Nebraska in 2004? Yes _____ No _____If you answered “no,” please return the questionnaire with the remaining questions unanswered .2. Approximately how many anesthetics did you administer in 2004? __________3. Approximately how many hours per week do you average for direct anesthesia care, including in-house call, department management, and nurse anesthesia education? __________4. In what type of practice setting do you work?

Hospital employed ______ CRNA group _____ Anesthesiologist group _____

Self employed ______ Other _____5. During your TYPICAL workweek, at how many facilities do you administer anesthesia? __________ 6. If you typically deliver anesthesia at more than one facility, please estimate the number of hours you spend at each:

FACILITY #1 _____ FACILITY #2 _____

FACILITY #3 _____ FACILITY #4 _____7. Are any of these facilities freestanding outpatient surgical centers? Yes _____ No _____8. Do you anticipate increasing your work commitment in the next five years? (For example, changing from part-time to full-time, or adding another facility to your present area of practice)Yes _____ No _____9. Do you anticipate decreasing your work commitment in the next five years? Yes _____ No _____ 10. Do you expect to relocate out-of-state in the next five years? Yes _____ No _____11. Do you expect to retire from delivering anesthesia services in the next five years? Yes _____ No _____12. Please state your county of residence. __________13. Please state your county or counties of anesthesia service delivery: ____________________14. Please check your age in years:< 30 _____ 50-59 _____

30-39 _____ 60-69 _____

40-49 _____ > 70 _____ 15. What is the name of the Nurse Anesthesia program where you were educated? __________


Year 2005 2000 1995 1991

CRNAs 236 298 212 233

Respondents 204 251 174 188

Response % 86.4 % 84 % 82 % 81 %

Statewide CRNA Response Rate

Region Respondents

I 62

II 29

III 15

IV 34

V 49

Non Response 7

Not Active 8

2005 204

Regional CRNA Respondents

School of Nurse AnesthesiaMarch 1, 2005 Dear Hospital Administrator,

I am a senior in the BryanLGH Medical Center School of Nurse Anesthesia program. I am researching nurse anesthesia manpower within the state of Nebraska with the aid of the Nebraska Association of Hospitals and Health Systems (NAHHS). This is my master’s degree thesis project.

The enclosed questionnaire is to be completed by the head of the anesthesia department, or the head of the group or person that provides anesthesia at your hospital. Participation in the survey is voluntary. Please have the questionnaire completed and returned in the envelope provided within the next two weeks if you wish to participate.

The research will allow me to determine current supply and demand of nurse anesthetists in Nebraska. The research will be compared to studies performed in 1991, 1995, and 2000, so manpower trends over the last fifteen years will be determined. Compiled results will be shared with the NAHHS. A copy of the complete results of the survey can be obtained through the BryanLGH Medical Center School of Nurse Anesthesia. All questionnaires will be kept confidential.

Thank you for completing the questionnaire. Your assistance is greatly appreciated.Sincerely,Matthew D. Petta, RN, BSN


HOSPITAL SURVEYPlease state the county in which your hospital is located. _______________________________How many acute care beds does your hospital currently have? ___________________________Around how many procedures in 2004 required anesthesia services? ______________________How many anesthesiologists provide anesthesia services? ______________________________Does your hospital employ CRNA’s directly? Yes _____ No _____If you answered “yes”:How many full-time equivalents for CRNA’s are in the present budget? ________ How many equivalents are filled? ___________How many equivalents are vacant? __________Are anesthesia services provided in your hospital by CRNAs who are not hospital employees?Yes _____ No _____ If “yes,” please state the arrangement by which these services are provided. (For example, self-employed CRNA, anesthesiologist-employed CRNA, CRNA group, locum tenens, etc.)______________________________________________________________How many full-time equivalent positions for CRNA’s are in the group? _____How many equivalents are filled? _____How many equivalents are vacant? _____Have CRNA’s been actively recruited (with advertisement or an agency for example) in the past two years? Yes _____

If “yes,” how many months did it take to fill a CRNA position? ______________If you are still looking to fill a CRNA position, how many months have you been recruiting? ___________________ No _____Do you anticipate increasing CRNA positions in the next five years? Yes _____, and by how many? __________ No _____Do you anticipate decreasing CRNA positions in the next five years? Yes _____ , and by how many? __________No _____

Will you or have you recruited an anesthesiologist because of difficulty in recruiting a CRNA? Yes _____ No _____


Year 2005 2000 1995 1991

Surveys Mailed 90 82 94 95

Returns 68 67 70 85

Response % 75.6 82 74 89

Statewide Hospital Response Rate

RegionRegion RespondentsRespondents

II 55

IIII 1818

IIIIII 1010

IVIV 1919

VV 1616

20052005 6868

Regional Hospital Respondents

Surveys MailedSurveys Mailed 1717

ReturnsReturns 99

Response %Response % 52.952.9

Statewide Ambulatory Outpatient

Surgical Center Response Rate

Research Question 1Research Question 1

What was the unmet need for What was the unmet need for CRNAs in Nebraska, including CRNAs in Nebraska, including Ambulatory Surgical Centers?Ambulatory Surgical Centers?

* Full-time equivalent** Freestanding Ambulatory Surgical Centers

Region N# of

FTEs *%

I 2 21.0 9.5

II 2 26.0 7.7

III 1 18.0 5.6

IV 5 63.0 7.9

V 1 35.0 2.9

FASCs** 1 10.0 10.0

2005 12 173.0 6.9

2000 15.5 203.5 8

1995 4.9 177 3

1991 11 149 7

FTE* CRNA Vacancy Rate

0

50

100

150

200

250

REGION

NUMBER OF FTE* CRNAs

* Full-time equivalent** Includes FASCs


How was the need projected to How was the need projected to change within the next five years as change within the next five years as perceived by hospital administrators perceived by hospital administrators and managers of Ambulatory and managers of Ambulatory Surgical Centers? Surgical Centers?

Region n

I 7.0

II* 11.0

III 6.0

IV 10.0

V 8.5

Surgical Centers 2

2005 44.5

Number of Administrators or Managers Who PredictedIncrease in CRNA Positions Within Five Years

•Region II reported the only decrease in positions, which is not shown in this table


How many CRNAs currently How many CRNAs currently practicing in Nebraska expected to practicing in Nebraska expected to retire or relocate out of the state in retire or relocate out of the state in the next five years? the next five years?

Region n %

I 5 7.9

II 3 10.3

III 1 6.6

IV 4 11.8

V 7 14.3

2005 20 10.6

2000* 25 13

1995** 21 13

1991*** 24 15

CRNAs Planning to Retire in the next Five Years

* Includes the number of Nebraska CRNAs who live in a state that physically borders Nebraska** Those Planning to retire by the end of 1999*** Those planning to retire by the end of 1995

Region n % of CRNAs

I 6 9.7

II 2 6.9

III 2 13.3

IV 4 11.8

V 6 12.2

2005 20 10.6

CRNAs Planning to Relocate by the End of 2010

0

5

10

15

20

25

30

35

% O

F C

RN

As

<200 200-399 400-599 600-799 800-899 >900

NUMBER OF ANESTHETICS

RETIRING/RELOCATING CRNAs - NUMBER OF ANESTHEICS

%

0

10

20

30

40

50

60

<20 20-29 30-39 40-49 50-59 >59NUMBER OF HOURS

RETIRING/RELOCATING CRNAs - NUMBER OF HOURS PER WEEK

%


What was the age distribution of What was the age distribution of CRNAs in Nebraska? CRNAs in Nebraska?

Age n %

40-49 0 0

50-59 6 30

60-69 11 55

>70 3 15

Age Distribution of Retiring CRNAs

AGE DISTRIBUTION OF CRNAs

0%

20%

40%

60%

80%

100%

I II III IV V 2005 2000* 1995 1991

REGION

>59

50-59

40-49

<40

* Includes the number of Nebraska CRNAs who live in a state that physically borders Nebraska


What was the average length of time What was the average length of time required to recruit a CRNA to a required to recruit a CRNA to a practice setting in Nebraska? practice setting in Nebraska?

0

1

2

3

4

5

6

7

8

9

MO

NT

HS

Mean

* Ambulatory Surgical Centers

AVERAGE CRNA RECRUITMENT TIME

0

20

40

60

80

% o

f H

osp

itals

Yes No N/R

RESPONSE

RECRUIT ANESTHESIOLOGIST DUE TO DIFFICULTY IN CRNA

RECRUITMENT*

%

* Includes Freestanding Ambulatory Surgical Centers


What are the regional differences What are the regional differences within Nebraska related to the above within Nebraska related to the above factors? factors?

Region n %

I 0 0.0

II 14 82.4

III 8 80.0

IV 14 73.7

V 12 80.0

2005 48 72.7

2000 40 60

1995 44 63

1991 58 72

Hospitals With CRNAs as Only Anesthesia Providers

No

I

II

III

IV

V

Yes35%

31%

31%

22%

13%

3%

Percentage of CRNAs that Work at FASCs

with Regional Breakdown

* Includes the number of Nebraska CRNAs who live in a state that physically borders Nebraska** This was referred to as “staff relief” in the 1991 study. This was defined as not having primary employment in Nebraska, but provides occasional coverage in Nebraska.

CRNA Practice Settings

Practice Setting

I II III IV V 2005 2000* 1995 1991

Hospital 21.0% 27.6% 26.7% 2.9% 12.2% 16.9% 21% 46% 55%

Anesthesiologist Group

46.8% 35.5% 53.3% 14.7% 57.1% 42.3% 42% 29% 23%

Self-employed 6.5% 17.2% 0.0% 26.5% 12.2% 12.7% 21% 10% 2%**

CRNA Group 0.0% 13.8% 0.0% 52.9% 2.0% 12.2% 15% 15% 10%

Agency/Other 21.0% 3.4% 6.7% 2.9% 2.0% 9.0% 2%

Multiple 6.5% 0.0% 13.3% 0.0% 14.3% 6.9%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

% O

F C

RN

As

REGION

NUMBER OF FACILITIES PER

MONTH*

1 Facility 2 Facilities 3 or >

* Must have provided at least 8 hours per month to be included** Includes the number of Nebraska CRNAs who live in a state that physically borders Nebraska

36.0

37.0

38.0

39.0

40.0

41.0

42.0

43.0

44.0#

OF

HO

UR

S /

WE

EK

REGION

AVERAGE NUMBER OF HOURS WORKED PER CRNA WORK WEEK


0100200300400500600700800900

# O

F C

AS

ES

/ Y

EA

R

REGION

AVERAGE NUMBER OF ANESTHETICS PER CRNA


Region n % by Region

I 5 8.0

II 5 17.2

III 3 20.0

IV 14 41.2

V 3 6.1

2005 30 15.9

2000* 40 20

1995** 22 14

1991*** 23 14

* Includes the number of Nebraska CRNAs who live in a state that physically borders Nebraska** Those planning to increase work by the end of 1999*** Those planning to increase work by the end of 1995

CRNAs Planning to Increase Work by the End of 2010

Region n % by Region

I 15 24.2

II 7 24.1

III 3 20.0

IV 9 26.5

V 12 24.5

2005 46 24.3

2000* 54 28

1995** 33 21

1991*** 34 21

* Includes the number of Nebraska CRNAs who live in a state that physically borders Nebraska** Those planning to increase work by the end of 1999*** Those planning to increase work by the end of 1995

CRNAs Planning to Decrease Work by the End of 2010


Where were CRNAs within the state Where were CRNAs within the state educated? educated?

ProgramProgram nn ProgramProgram nn

Mount MartyMount Marty 5252 St. RaphaelSt. Raphael 11

BryanBryan 4444 St. Joe’s (PA)St. Joe’s (PA) 11

Creighton/St. Joe’sCreighton/St. Joe’s 2222 St. Luke’sSt. Luke’s 11

University of Nebraska Med CenterUniversity of Nebraska Med Center 77 GeorgetownGeorgetown 11

MayoMayo 44 Wayne StateWayne State 11

St. Mary’s (MN)St. Mary’s (MN) 44 George Washington George Washington 11

TrumanTruman 44 Case WesternCase Western 11

Texas WesleyanTexas Wesleyan 33 DrakeDrake 11

Minneapolis School of AnesthesiaMinneapolis School of Anesthesia 33 St. FrancesSt. Frances 11

United States Air ForceUnited States Air Force 33 Medical College of VirginiaMedical College of Virginia 11

University of KansasUniversity of Kansas 33 United States NavyUnited States Navy 11

University of IowaUniversity of Iowa 33 Colorado UniversityColorado University 11

University of TexasUniversity of Texas 33 University South Carolina University South Carolina 11

MercyMercy 22 St. Mary’s (NY)St. Mary’s (NY) 11

WesleyWesley 22 Middle TennesseeMiddle Tennessee 11

FriendsFriends 22 CharityCharity 11

Northwestern-MNNorthwestern-MN 22 St. John’sSt. John’s 11

University of Missouri @ K.C.University of Missouri @ K.C. 11 Murray State UniversityMurray State University 11

TriplerTripler 11 University of NY at BuffaloUniversity of NY at Buffalo 11

NEBRASKA CRNA TRAINING PROGRAM REPRESENTATION

OutstatePrograms*

Bryan

Creighton / St.Joe's

UNMC

NEBRASKAPROGRAMS

61% 39%

24%

12%

4%

NEBRASKA CRNA TRAINING

PROGRAM DISTRIBUTION

•Mount Marty trains 28.1% of all Nebraska CRNAs, thus having the most overall representation of any program

Manpower ForecastManpower Forecast&&

Additional FindingsAdditional Findings

Category Actual ResponseProjected Number with

100% Response

Retirees 20 23

Vacancies 12* 16*

New Positions 42.5* 57*

Relocate 17** 19

2005 91.5* 115*

2000 74 90

1995*** 57*** 68***

1991**** 58**** 68****

Number of Positions to be Filled in Nebraska Between 2005 and 2010

* Includes Ambulatory Surgical Centers** Reduced by three to account for those who were both retiring and relocating *** By 1999**** By 1995 and did not include CRNAs relocating out of Nebraska

Region I CharacteristicsRegion I Characteristics

Zero hospitals with CRNAs as sole Zero hospitals with CRNAs as sole providers reportedproviders reported

76.2% of CRNAs work at one facility76.2% of CRNAs work at one facility

Most procedures per hospital (5600)Most procedures per hospital (5600)

Region II CharacteristicsRegion II Characteristics

Most anticipated new positions (11)Most anticipated new positions (11)

Fewest relocating within five years Fewest relocating within five years (6.9%)(6.9%)

Least # of cases per year per CRNA Least # of cases per year per CRNA (689)(689)

Region III CharacteristicsRegion III Characteristics

Lowest retirement rate (6.6%)Lowest retirement rate (6.6%)

Highest relocation rate (13.3%)Highest relocation rate (13.3%)

Region IV CharacteristicsRegion IV Characteristics

CRNA group most popular arrangement CRNA group most popular arrangement (52.9%), and only region not primarily (52.9%), and only region not primarily anesthesiologist group employedanesthesiologist group employed

Only 26.5% work at one facilityOnly 26.5% work at one facility Highest hours worked per week (43.9)Highest hours worked per week (43.9) CRNAs to increase work commitment CRNAs to increase work commitment

within five years (42.4%)within five years (42.4%) 31% of CRNAs work at an ambulatory 31% of CRNAs work at an ambulatory

surgical centersurgical center

Region V CharacteristicsRegion V Characteristics

Lowest vacancy rate (2.9%)Lowest vacancy rate (2.9%) Highest retirement rate (14.3%)Highest retirement rate (14.3%) Most CRNAs >49 years of age (56.2%)Most CRNAs >49 years of age (56.2%) Lowest hours worked per week (39.4)Lowest hours worked per week (39.4) Most cases on average per year (860)Most cases on average per year (860) Increasing their work commitment within Increasing their work commitment within

five years (6.1%)five years (6.1%) 31% of CRNAs work at an ambulatory 31% of CRNAs work at an ambulatory

surgical centersurgical center

Questions?

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A STUDY OF CERTIFIED REGISTERED NURSE ANESTHETIST MANPOWER IN NEBRASKA: PART IV