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An Analysis of Advanced Practice Nurses in the Lower Mississippi Delta

An Analysis of Advanced Practice Nurses in the Lower Mississippi Delta. Ellen Odell, DNP, ACNS-BC, RN Tom Kippenbrock, EdD , RN Bill Buron, PhD, GNP/FNP-BC, APN Presentation for the 21 st Annual Nursing Excellence and Evidence-Based Practice Pi Theta Chapter, STTI, April 2012.

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An Analysis of Advanced Practice Nurses in the Lower Mississippi Delta

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  1. An Analysis of Advanced Practice Nurses in the Lower Mississippi Delta Ellen Odell, DNP, ACNS-BC, RN Tom Kippenbrock, EdD, RN Bill Buron, PhD, GNP/FNP-BC, APN Presentation for the 21st Annual Nursing Excellence and Evidence-Based Practice Pi Theta Chapter, STTI, April 2012

  2. Presentation Objectives • The participant will explain the healthcare system currently overburdened by rising costs and a limited number of primary care providers • The participant will explain the research design methods related to this study findings • The participant will discuss the relationship between advance practice nurses and the rural and underserved communities

  3. Current Trends of APNs in Primary Care • Definition of Primary Care • Definition of APNs • Access to Healthcare and PCP • Current • Health Provider Shortage Area (HPSA) • Future demand • Patient Protection and Affordable Care Act

  4. Consensus Model for APRN Regulation • https://www.ncsbn.org/aprn.htm

  5. Before we answer…a little history about data sources • What is a Health Provider Shortage Area? • http://hpsafind.hrsa.gov/ • http://hpsafind.hrsa.gov/HPSASearch.aspx • 4 State Mississippi River Delta Region • Determination of Rural vs. Urban • Population > 50,000 • Facts about county population • Health statistics • Educational level • Poverty level

  6. 2011 rankings of Delta states on selected economic determinants Source: www.americanshealthrankings.org

  7. 2011 rankings of Delta states on selected health determinants Source: www.americanshealthrankings.org

  8. 2011 rankings of Delta states on selected health outcomes Source: www.americanshealthrankings.org

  9. Research Questions • What proportion of APNs practice in communities that are designated as HPSAs? • In what geographic settings (urban vs. rural) do APNs practice? • What are the APNs’ work place setting and practices? • What is the relationship between the race of the APN and the population served? • Is there a relation between APN variables and population disparity variables?

  10. Methodology • Quantitative Design • University of Arkansas IRB Approval • Purchase of mailing addresses from State Boards of Nursing • Tennessee • Arkansas • Louisiana • Mississippi

  11. Data Sources • US Census Bureau • County Population Data • Determination of Rural vs. Urban • Health Resources and Services Administration (HRSA) • Health Provider Shortage Area (HPSA) • 24 item survey

  12. Survey Development • Background • Content • Demographics • Face validity

  13. Sample Survey Questions • Demographics • Gender • Age • Race • Education level • Degree • Income

  14. Sample Survey Questions • Type of APN • Practice Specialty • Practice • Years of practice • Years in current job • Employer type • Private practice (physician’s office, clinic) • Public health clinic/Rural health centers • Hospital/medical center • Prescriptive authority • Location

  15. Population and Sample • Purposive sample • 6986 postcards mailed • APNs (NP, CNS, CNM) • Second reminder mail out • 526 responses (return rate of 7.5%)

  16. ResultsDemographics Subjects by Practice States

  17. Gender Age

  18. Race

  19. Education Level

  20. Income

  21. Type of APN

  22. Practice Specialty

  23. Employer Type

  24. Prescriptive Authority • Nurse Practitioner • Clinical Nurse Specialist • Certified Nurse Midwives • 92% of our sample have RX authority

  25. Practice Location

  26. References America’s health rankings: A call to action for individuals and their communities. (2011). Minnetonka, MN: United Health Foundation. Retrieved at http://www.americashealthrankings.org/SiteFiles/Reports/AHR%202011Edition.pdf Consensus model for APRN regulation: Licensure, accreditation, certification & education. (2008). Retrieved at http://www.aacn.nche.edu/education-resources/APRNReport.pdf Greenhalgh, T. (2007 ) Primary health care: Theory and practice. Malden,MA: Blackwell Publishing. MacDonald, J., Herbert, R., & Thibeault, C. (2006). Advanced practice nursing: Unification through a common identity. Journal of Professional Nursing, 22(3), 172-179. The 2012 statistical abstracts: The national data book. (2011). US Census Bureau. Retrieved at http://www.census.gov/compendia/statab/.

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