11/20/2013
◦ completed an advanced graduate-level education
program (MS or DNP)
◦ passed a national certification examination in order
to practice as
Connie W. Delaney, PhD, RN, FAAN, FACMI
Dean, University of Minnesota School of Nursing
Mary L. Chesney, PhD, RN, CNP
Director of Doctor of Nursing Practice Program
University of Minnesota School of Nursing
RNs who have:
Clinical Nurse Specialist (CNS)
Nurse Anesthetist (CRNA)
Nurse Midwife (CNM)
Nurse Practitioner (CNP)
Have advanced knowledge and skills to:
◦
◦
◦
◦
◦
◦
Deliver safe, effective patient care
Diagnose and treat health problems
Prescribe medications & perform procedures
Order & interpret laboratory tests
Provide health promotion and prevention counseling
Coordinate care, refer patients to other health care providers, and
advocate for patients in the complex health care environment.
Licensed MN RNs – 115,820
Licensed MN RNs with APRN Certification
APRN Role
Number
CNP
3,658
CRNA
1,680
CNS
544
CNM
281
Total
6,163 (5.3% of licensed
RNs)
Based on MN BoN data from 11-15-13
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11/20/2013
Training Programs in Minnesota
120
100
80
60
40
20
0
College of
Mayo Clinic Metropolitan
Minnesota
Minnesota
Saint Mary's St. Catherine University of Winona State
St.
State
State
State
University of
Scholastica
University
University,
University,
Minnesota
Mankato
Moorhead
University
MN
University
Academic
Health
Center
CLINICAL TRAINING SITES
ELIGIBLE FTEs
4 key messages
IOM Recommendation to remove APRN
practice barriers
◦ Recommended strategy – states should enact
national APRN Consensus Model
MN S.F. 511/H.F.435
Autonomous APRN practice states more likely to
have APRNs practicing in rural, underserved areas
(Skillman et al., 2012)
“By 2010 states with the least restrictive
regulations of NP practice had a 2.5-fold greater
likelihood of patients’ receiving their primary care
from NPs than did the most restrictive states” (Kuo,
Loresto, Rounds, & Goodwin, 2013, p. 1236)
Auerbach et al., (2013) modeling of nursemanaged health centers & medical home with ▲NP
& PA use
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11/20/2013
AAMC projects national shortages in 2020 of
91,500 physicians (45,400 PCP and 46,100
subspecialists)
MN Projects 900,000 to 1.1million more MNs will
have access to care beginning January 2014 (M.A.
expansion & MN-Sure)
128 Primary care HPSAs and 41 Mental Health
HPSAs in MN
Trends - increasing use of NPs and PAs as
hospitalists and E.D. coverage
17 % of MN’s population in rural areas; 10-11 % of
PCP workforce in rural areas (MDH, Sep 2013)
PCP NPs intent to stop practicing in MN in the next
5 years (MDH, Sep 2013):
◦ 34 and younger – 19%
Discussion
◦ 34 to 44 - 7%;
◦ 45 to 54 4%;
◦ 55+: 31%
Warrants further study of all APRN graduates
3
11/20/2013
Aurerbach, D. I., Chen, P. G., Friedberg, M. W., Reid, R., Lau, C., Buerhaus, P.
I., & Mehrotra, A. (2013). Nurse-managed health centers and patientcentered medical homes could mitigate expected primary care physician
shortages. Health Affairs, 32, 1933-1941
Croman, J. (Sep 5, 2013) Mnsure ushers new era of health coverage options.
Retrieved from
http://www.kare11.com/news/health/article/1038077/587/EXTRA-MNsureushers-in-new-era-of-health-coverage-options
Kuo, Y. F., Loresto, F. L., Rounds, L. R., & Goodwin, J. S. (2013). States with
the least restrictive regulations experienced the largest increase in patients
seen by nurse practitioners. Health Affairs, 32, 1236-1243
MDH Office or Rural Health and Primary Care (Sep 2013). Minnesota’s
primary care workforce, 2011-2012. Retrieved from
http://www.health.state.mn.us/divs/orhpc.
Skillman, S. M., Kaplan, L., Fordyce, M. A., McMenamin, P. D., & Doescher, M.
P. (2012). Understanding advanced practice registered nurse distribution in
urban and rural areas of the United States using national provider identifier
data. Seattle, WA: WWAMI Rural Health Research Center
4