AACN Fact Sheet - Nursing Emergency (2023)

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It is predicted that there will be a shortage of registered nurses (RNs) in the US, which is expected to worsen as baby boomers age and the need for medical care grows. To make matters worse, nursing schools across the country are struggling to expand capacity to meet growing nursing needs.American Association of Colleges of Nursing (AACN)works with schools, legislators, care organizations and the media to raise awareness of this health issue. AACN uses its resources to shape legislation, identify strategies, and form collaborations to address the shortage.

Current and projected shortage indicators

  • According to the Bureau of Labor StatisticsEmployment forecasts 2021-2031, the Registered Nursing (RN) workforce is expected to grow by 6% over the next decade. The nursing workforce is expected to increase from 3.1 million in 2021 to 3.3 million in 2031, an increase of 195,400 nurses. The Bureau also projects 203,200 RN jobs each year through 2031, when retirement and retirement will account for the number of nurses needed in the United States.
  • MontagBLS Handbook Career Prospects. By 2031, about 30,200 new APRNs will be needed each year, which will be prepared in master's and doctoral programs to meet the growing need for care.
  • In accordance withUS Registered Nurses Bulletin and Shortage PredictionAppeared in the September/October 2019 issue of the magazineAmerican Journal of Medical Quality, RN deficiency is expected to spread across the country by 2030. In this state analysis, the authors predict significant RN shortages in 30 states with the greatest shortages in the western United States.
  • In April 2022 Dr. David Auerbach and colleaguespublished an analysis of the nursing staffShehealth issues, which found that the total supply of registered nurses fell by more than 100,000 from 2020 to 2021, the largest drop in the past four decades. A significant number of nurses who retired were under the age of 35 and the majority worked in hospitals.
  • The Institute of Medicine in its landmark report onThe future of carecalled for increasing the number of nurses with a bachelor's degree in the workforce to at least 80% to increase patient safety. The current nursing workforce does not meet these recommendations, with only 65.2% of registered nurses at undergraduate or graduate level following thelatest employee surveyconducted by the National Council of State Nursing Councils.

Factors that contribute to the lack of care

Nursing school enrollments are not growing fast enough to meet projected demand for RN and APRN services.

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While enrollment in Bachelor of Nursing programs increased by 3.3% in 2021, the AACN reported declines in PhD and Master of Nursing programs of 0.7% and 3.8%, respectively. These trends raise concerns about the ability of nursing schools to meet projected demand for nursing services, including the need for more nursing educators, researchers and primary care providers.

Nursing school faculty shortages limit enrollment in the nursing program.

  • According to the AACN report on2021-2022 Enrollment and Graduation in the Undergraduate and Graduate Programs in Nursing, US nursing schools rejected 91,938 eligible applications (non-applicants) for undergraduate and graduate nursing programs in 2021 due to inadequate faculty, clinical locations, classrooms, and clinical instructors, and budget constraints.

A significant proportion of the nursing workforce is approaching retirement age.

  • after aNational Nursing Survey 2020A study conducted by the National Council of State Boards of Nursing found that the median age of a registered nurse is 52, which could portend a big surge in the next 15 years.
  • in onehealth issuesThe blogdr Peter Buerhaus and colleagues, published in May 2017, predict that by 2030 more than 1 million registered nurses will retire.

Changing demographics show that more nurses are needed to care for our aging population.

Compounded by the pandemic, staff shortages are increasing nurses' stress levels, affecting their job satisfaction and forcing many nurses to leave the profession.

  • According to information published on Nurse.comNurse Salary Survey Report 2022, 29% of nurses of all license types are considering leaving in 2021, up from 11% in 2020. More reasonable workload.
  • In March 2022, the American Nurses Foundation and American Nurses Association released the results of theirCOVID-19 Impact Assessment Survey, which found that 52% of nurses are considering leaving their current position, mainly due to staff shortages, work that negatively impacts health and well-being, and an inability to provide quality care. Additionally, 60% of critical care workers feel burned out and 75% feel stressed, frustrated and exhausted.
  • In September 2021, the American Association of Critical Care Nurses reportedsearch resultsThis shows that 66% of critical care workers considered leaving care after their experience during the pandemic.

Influence of the nursing team on patient care

Many scientific studies point to the link between appropriate RNs and safe patient care.

  • In the July 2017 issue ofQuality and safety BMJ, The International Journal of Health Improvement, Dr. Linda Aiken and colleagues publishedResults of a study in intensive care clinicsin Belgium, England, Finland, Ireland, Spain and Switzerland, who found that a higher proportion of professional nurses at the bedside is associated with better patient and nurse outcomes. Reducing the skill mix in nursing by adding nurses without professional nursing qualifications can contribute to preventable deaths, undermine quality of care and contribute to nursing shortages.
  • In a study published in the journalQuality and safety BMJIn May 2013, researcher Heather L. Tubbs-Cooley and colleagues found that a larger number of patients was associated with a higher rate of hospital readmissions. The study found that when more than four patients were referred to a nurse at a children's hospital, the likelihood of readmission to the hospital increased significantly.
  • In the August 2012 issue ofAmerican Journal of Infection Control, Dr. Jeannie Cimiotti and colleagues found a significant association between a high patient-to-carer ratio and burnout in nurses with an increase in urinary tract infections and postoperative wound infections. In this study of Pennsylvania hospitals, researchers found that increasing a nurse's patient burden was associated with higher rates of infection in a single patient. The authors conclude that reducing nurse burnout can improve both nurse well-being and the quality of patient care.
  • In a study published in the April 2011 issue ofMedical supplies, found Dr. Mary Blegen and colleagues at the University of California, San Francisco found that higher nursing staffing levels were associated with fewer deaths, fewer failed rescue operations, lower infection rates, and shorter hospital stays.
  • In March 2011, Dr. Jack Needleman and colleagues present the results inNew England Journal of Medicine, suggesting that inadequate nursing staff was associated with higher patient mortality. These researchers analyzed the records of nearly 198,000 hospitalized patients and 177,000 eight-hour nursing shifts in 43 patient care units at major academic health centers. The data show that the risk of patient mortality was approximately 6% higher in understaffed units than in fully manned units. In the study, titled Nursing Faculty and Mortality in Inpatient Hospitals, the researchers also found that mortality risk increases as a nurse's workload increases due to high patient turnover.
  • A growing body of research clearly links bachelor's degree-trained nurses to lower mortality rates and rescue failures. The latest studies published in peer-reviewed journalsLook for health servicesim August 2008 uNursing Administration Magazinein May 2008 confirm the results of several previous studies linking educational attainment and patient outcomes. Efforts to address nurse shortages should focus on preparing more licensed nurses to ensure access to safe patient care.
  • It was published in March 2007Nursing staff and quality of patient care. Through this meta-analysis, the authors found that the shortage of registered nurses combined with increasing workload poses a potential threat to quality. Increases in RNs were associated with reductions in hospital-related mortality and rescue failures, and reductions in length of stay.
  • The lack of nurses trained to the high school level is affecting the quality of care and patient outcomes. In a study published September 24, 2003, inJournal of the American Medical Association (JAMA),dr Linda Aiken and her colleagues at the University of Pennsylvania identified a clear link between higher levels of nursing education and better patient outcomes. This large study found that surgical patients have a "significant survival advantage" when treated in hospitals with a higher proportion of registered nurses with a bachelor's degree or higher. In hospitals, a 10% increase in the proportion of nurses with a BSN qualification reduced the risk of patient death and rescue failure by 5%.

Efforts to counteract the nursing shortage

  • AACN is committed to working with the healthcare and education communities to train enough highly qualified nurses to meet the needs of the country's diverse patient population. To address nursing shortages, AACN advocates federal legislation and increased funding for nursing education (Title VIII, FAAN Act); promoting a post-licensing nursing residency program to retain nurses; Fostering innovation in nursing programs, including the development of accelerated programs (BSN and MSN graduate programs; bachelor's to doctoral degrees); and work with partner organizations to highlight careers in nursing, including those that require graduate-level preparation.
  • AACN has been active since 2010sicknessmCAS, the nationwide centralized application service for nursing education programs that prepare nurses for basic and advanced roles. One of the primary reasons for introducing NursingCAS was to ensure that all vacancies in nursing schools are filled to better meet the national need for RNs, APRNs and nursing faculty.
  • In June 2022, the National Council of State Legislatures issued apresentationOutlining the various legislative approaches states are using to address nursing shortages, including adjusting the scope of practice laws and providing financial incentives for teachers,
  • in a report aboutHow to Alleviate the Nursing Shortage in AmericaLaunched in May 2022, the Center for American Progress is calling for bold action to address the nursing shortage to ensure more patients have access to safe, quality nursing services. The report highlights how federal and state policymakers can address bottlenecks through coordinated planning, action and investment.
  • Many government initiatives are underway to address the shortage of registered nurses and nursing educators. For example, in October 2022, the University of Minnesota and the state of Minnesota partnered to create a new programCoalition for Equity and Excellence in Nursing, which will work with all state nursing schools, health professionals and other stakeholders to increase enrollment in nursing education programs, increase nursing equity and increase student success. Other initiatives are also underwayFloridamiLouisianaamong other states.
  • Nursing schools form strategic partnerships and seek private support to expand student capacity.

Current articles on the nursing shortage

Last update:October 2022


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