National Sample Survey of Nurse Practitioners
version 02/17/12
Section I. NP Education, Licensure and Workforce Participation
1. Do you have a current certification, licensure, or other legal recognition from a State Board of Nursing to practice as a Nurse Practitioner (NP)?
Yes
No If No go to #52 on page 7
2. In which state(s) do you currently have certification/licensure/recognition to practice as an NP? List up to 3
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3. Which educational program(s) did you complete for your NP preparation? Check all that apply.
Bachelor’s degree
Master’s degree
Post Master’s Certificate
Certificate Program (no master’s degree)
Doctor of Nursing Practice degree
Other
4. In what year did you complete your initial NP education program? |__|__|__|__|
5. In which area(s) have you ever received certification from a national certifying organization for NPs? Check all that apply.
Acute care adult
Acute care pediatric
Adult
Gerontology
Family
Pediatric
Neonatal
Psych/mental health
Women’s health
Other (please specify)
None
6. Are you employed in any positions that require state certification/ licensure/recognition to practice as an NP?
Yes If Yes go to #8
No
7. If you are not working as an NP, what are the reasons? Check all that apply.
Overall lack of NP jobs/practice opportunities
Lack of NP jobs/practice opportunities in desired location
Lack of NP jobs/practice opportunities in desired type of facility
Lack of NP jobs/practice in desired specialty
Limited scope of practice for NPs in the state where practice is desired
Denied NP job due to lack of experience or qualification
Inadequate salary/compensation
Working outside the nursing field (please describe)
Maternity/parenting/family leave
Poor health or disability
Choose not to work at this time
Retired
Other
8. Do you volunteer as an NP?
Yes
No If No go to #10
9. How many hours per month do you volunteer as an NP?
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Section II. All Nursing Employment
10. Do you work for pay in nursing, as a Registered Nurse (RN) or as an NP?
Yes
No If No go to #52 on page 7
11. Your principal position is the RN or NP position in which you work the most hours per week. Please report only nursing positions for which you are paid. Do not include volunteer positions or adjunct faculty status.
Describe your principal position. Check one.
NP position
NP in clinical practice
Faculty in an NP education program
Faculty in another type of education program requiring an NP credential
Researcher requiring an NP credential
Administrator requiring an NP credential
Other (please describe)
Non-NP nursing position
RN staff nurse
Faculty in a non-NP nursing education program
Administrator/Manager
Patient care coordinator
Other
APRN role (please
specify)
Researcher
Consultant
Other (please describe)
12. In what type of setting do you practice in your principal position? Check only one.
Ambulatory Settings
Private physician office/practice
Private NP office/practice
Nurse Managed clinic
Retail based clinic
Urgent care clinic
Ambulatory surgery center
Federal clinic (FQHC, VA, Military, NIH, HIS)
Hospital Setting
Hospital inpatient unit
Hospital outpatient clinic (not an ED)
Hospital emergency department
Hospital–other (please specify)
Federal Hospital (Military, VA, NIH, IHS)
Long Term and Elder Care
Long-term care facility
Hospice
Home care agency
Public or Community Health
Community clinic
Correctional facility
Health department
Mental health center
Rural health clinic
Other Settings
Academic (university/college) education program
Health maintenance organization/managed care
Occupational/employee health
School/college health service
13. What is the ZIP code where you practice in your principal position?
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14. In your principal position do you use an electronic health record (EHR) or electronic medical record (EMR) system? Do not include billing record systems.
Yes
No
Don’t know
15. In your principal position are there plans for installing a new EHR or EMR system within the next 18 months?
Yes
No
Don’t know
Other (please describe)
16. In a typical week, how many hours do you work in your principal position?
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17. Please estimate your 2011 pre-tax annual earnings from your principal position. Include overtime, on-call earnings, and bonuses.
$ |__|, |__|__|__|, |__|__|__|.00 per year
18. Do you have a National Provider Identifier (NPI) number?
Yes
No If No go to #20
19. Do you bill under your NPI number?
Yes
No
20. How satisfied are you with each of the following aspects of your principal position?
|
Very Satisfied |
Satisfied |
Dissatisfied |
Very Dissatisfied |
Not Applicable |
Proportion of time in patient care |
1 |
2 |
3 |
4 |
5 |
Patient load |
1 |
2 |
3 |
4 |
5 |
Patient mix |
1 |
2 |
3 |
4 |
5 |
Amount of paperwork required |
1 |
2 |
3 |
4 |
5 |
Level of autonomy |
1 |
2 |
3 |
4 |
5 |
Number of hours worked, including overtime
|
1 |
2 |
3 |
4 |
5 |
Salary/benefits |
1 |
2 |
3 |
4 |
5 |
Sense of value for what you do |
1 |
2 |
3 |
4 |
5 |
Respect from physician colleagues |
1 |
2 |
3 |
4 |
5 |
Respect from other colleagues |
1 |
2 |
3 |
4 |
5 |
Amount of administrative support |
1 |
2 |
3 |
4 |
5 |
Opportunities for professional development |
1 |
2 |
3 |
4 |
5 |
Input into organizational/practice policies |
1 |
2 |
3 |
4 |
5 |
21. What is your overall level of satisfaction with your principal position?
Very Satisfied
Satisfied
Dissatisfied
Very Dissatisfied
22. Do you plan to leave your principal position?
Yes, will leave in 2012
Yes, will leave in 1-2 years
No plans to leave in next 2 years
Undecided
23. Approximately when do you plan to retire from nursing and NP work?
In 2012
In 1-2 years
In 3-5 years
In 6-10 years
More than 10 years from now
Undecided
24. Aside from the principal position you just described, are you working for pay in any other nursing, RN or NP positions?
Yes
No If No go to #30 on page 5
25. Your secondary position is the RN or NP position in which you work the second greatest number of hours per week. Please report only nursing positions for which you are paid. Do not include volunteer positions or adjunct faculty status.
Describe your secondary position. Check only one.
NP position
NP in clinical practice
Faculty in an NP education program
Faculty in another type of education program requiring an NP credential
Researcher requiring an NP credential
Administrator requiring an NP credential
Other (please describe)
Non-NP nursing position
RN staff nurse
Faculty in a non-NP nursing education program
Administrator/Manager
Patient care coordinator
Other
APRN role (please
specify)
Researcher
Consultant
Other (please describe)
26. In what type of setting do you practice in your secondary position? Check only one.
Ambulatory Settings
Private physician office/practice
Private NP office/practice
Nurse Managed clinic
Retail based clinic
Urgent care clinic
Ambulatory surgery center
Federal clinic (FQHC, VA, Military, NIH, IHS)
Hospital Setting
Hospital inpatient unit
Hospital outpatient clinic (not an ED)
Hospital emergency department
Hospital–other (please specify)
Federal Hospital (Military, VA, NIH, IHS)
Long Term and Elder Care
Long-term care facility
Hospice
Home care agency
Public or Community Health
Community clinic
Correctional facility
Health department
Mental health center
Rural health clinic
Other Settings
Academic (university/college) education program
Health maintenance organization/managed care
Occupational/employee health
School/college health service
Other (please describe)
27. What is the ZIP code where you practice in your secondary position?
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28. In a typical week, how many hours do you work in your secondary position?
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29. Please estimate your 2011 pre-tax annual earnings from your secondary position. Include overtime, on-call earnings, and bonuses.
$ |__|, |__|__|__|, |__|__|__|.00 per year
Section III. NP Employment Only
30. Your NP position may have been described as a principal or secondary position in Section II. In this section, we will gather additional details only on your NP employment. Do you work for pay as an NP?
Yes
No If No go to #52 on page 7
Your main NP position is the one in which you work the most hours per week, if you work more than one NP job.
31. Check the one term below that best describes the specialty of the practice/facility in which you work for your main NP position.
Not working in a clinical specialty
Primary Care Specialties
Internal Medicine
Family Practice
Geriatrics
General Pediatrics
Pediatric Subspecialties
Internal Medicine Subspecialties
Adolescent Medicine
Cardiology
Endocrinology
Gastroenterology
Hematology / Oncology
Infectious Disease
Pulmonary/Respiratory
Renal/Nephrology
Rheumatology
OB/GYN Women’s Health
General Surgery
Surgical Specialties
Urology
Orthopedics
Other (specify)
Other
Allergy& Immunology
Dermatology
Emergency Care
Hospitalist
Intensive Care
Long Term Care
Neonatal
Neurology
Occupational Health
Palliative Care/Pain Management
Psychiatry/Mental Health
Rehabilitation
School Health
Urgent Care
Wound/Ostomy
Other (specify)
32. Are you a hospitalist in your main NP position?
Yes
No
33. Thinking about your main NP position, what percent of your time do you spend on each of the following?
Patient Care/ Documentation |
Teaching/ Precepting/ Orienting |
Supervision/ Management/ Administration |
Other |
Total |
% |
% |
% |
% |
100% |
34. Do you provide direct patient care in your main NP position?
Yes
No If No go to #47 on page 7
35. Thinking about your main NP position, for how many of your patients do you provide the following services?
|
Most Patients |
Some Patients |
Few Patients |
No Patients |
Diagnosis, treatment, and management of acute illnesses |
1 |
2 |
3 |
4 |
Diagnosis, treatment, and management of chronic illnesses |
1 |
2 |
3 |
4 |
Conduct physical examinations and obtain medical histories |
1 |
2 |
3 |
4 |
Order, perform, and interpret lab tests, x-rays, EKGs, and other diagnostic studies |
1 |
2 |
3 |
4 |
Prescribe drugs for acute and chronic illnesses |
1 |
2 |
3 |
4 |
Provide preventative care, including screening and immunizations |
1 |
2 |
3 |
4 |
Perform procedures |
1 |
2 |
3 |
4 |
Counsel and educate patients and families |
1 |
2 |
3 |
4 |
Provide care coordination |
1 |
2 |
3 |
4 |
Make referrals |
1 |
2 |
3 |
4 |
Participate in practice improvement activities |
1 |
2 |
3 |
4 |
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36. Which of the following best describes your billing arrangements for your main NP position?
Bill under my provider number
Bill under my clinic/facility number
Bill under a physician’s provider number
No billing, cash only
No billing, grant supported/free clinic
Other (please describe)
37. How often is a physician present on site to discuss patient problems as they occur in your main NP position?
0% of the time
1%-25% of the time
26%-50% of the time
51%-75% of the time
76%-100% of the time
38. What type of professional relationship do you have with the physician(s) in your main NP position? Check all that apply.
No physician in my practice
Collaborate with a physician at another site
Collaborate with a physician on site
Equal colleagues/no hierarchy
S/he is the medical director who oversees all of our practice and I am accountable to the medical director, as are all other providers
Hierarchical/supervisory in which I must accept his/her clinical decision about the patients I see
Physician sees and signs off on the patients I see
Other (please describe)
39. To what extent would you agree or disagree with the following: In my main NP position I am allowed to practice to the fullest extent of my state’s legal scope of practice.
Strongly Agree
Agree
Disagree
Strongly Disagree
40. To what extent would you agree or disagree with the following: In my main NP position, my NP skills are being fully utilized.
Strongly Agree
Agree
Disagree
Strongly Disagree
41. How are you paid in your main NP position?
Annual salary
By the hour
Percentage of billing
Other (please specify)
42. Now please think about all of your NP positions. In a typical week, how many patients do you see? |__|__|__|
43. Thinking about all of your NP positions, do you have a panel of patients that you manage, where you are the primary provider?
Yes
No If No go to #45
44. Across all of your NP positions, how many patients are on your panel?
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45. Do you take evening or weekend call for any of your NP positions?
Yes
No
46. Do you have hospital admitting privileges?
Yes
No
47. Do you have malpractice insurance?
Yes
No If No go to #49
48. Who pays for your malpractice insurance?
Self
Employer
Both
49. Do you have prescriptive authority?
Yes If Yes go to #51
No
50. Why don’t you have prescriptive authority?
In process of applying
MD or other NP writes all my prescriptions
Other (please explain)
51. Do you currently have a personal drug enforcement administration (DEA) number?
Yes
No
Section IV. Demographic Characteristics
52. Are you…
Male
Female
53. What is your year of birth? |__|__|__|__|
54. Are you of Latino or Hispanic ethnicity?
Yes
No
55. Which one or more of the following would you use to describe your race? Check all that apply.
American Indian or Alaska Native
Asian
Black or African-American
Native Hawaiian or Other Pacific Islander
White
56. What is your marital status?
Never Married
Married
Separated
Divorced
Widowed
57. Please check all educational degree(s) you have earned.
Diploma in Registered Nursing
Associate degree – Nursing
Associate degree – Non-nursing
Baccalaureate degree – Nursing
Baccalaureate degree – Non-nursing
Master’s degree – Nursing
Master’s degree – Non-nursing
Doctorate of Nursing Practice (DNP)
PhD or other Doctorate – Nursing
Doctorate – Non-nursing
Other
58. In
what year did you obtain your initial
U.S. licensure as an RN?
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59. What is your home address ZIP
code: |___|___|___|___|___|
60. Would you be willing to share your e-mail address to receive the results of the survey?
If so, please provide it here:
Thank you so much for completing this questionnaire!
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Authority of the federal agency, HRSA, to collect the information requested, the purpose and use of this information and the voluntary nature of participation, the extent to which information provided will be treated as private or confidential appears in the first communications with potential participants (in advance letters, brochures, and instruments), whether conveyed verbally and/or in written form. Public Burden Statement: An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB control number for this project is 0915-XXXX. Public reporting burden for this collection of information is estimated to average 20 minutes per response, including the time for reviewing instructions, searching existing data sources, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: HRSA Reports Clearance Officer, 5600 Fishers Lane, Room 10-33, Rockville, MD 20857 |
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| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | CAHPS |
| Author | long_m |
| File Modified | 0000-00-00 |
| File Created | 2021-01-31 |