Protocol

Protocol for NSSRN Cognitive Testing_12082016.docx

Generic Clearance for Questionnaire Pretesting Research

Protocol

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Protocol for NSSRN Cognitive Testing

Greeting: Hello. My name is ________________, and I work in Survey Research for the Census Bureau Thank you for agreeing to help us today.

What: The National Sample Survey of Registered Nurses (NSSRN), sponsored by the Health Resources and Services Administration (HRSA), collects information from active RN licensees throughout the U.S. regarding education, employment, intentions regarding future nursing work, and demographic information. The purpose of the NSSRN is to estimate the supply, composition, and distribution of RNs on the national and state levels. Data collected by this survey assists policymakers and numerous stakeholders in assessing the status and trends of the U.S. nursing workforce.

The NSSRN hasn’t been conducted since 2008, and as the Census Bureau moves toward taking over the implementation of this survey in early 2018, the Demographic Statistical Methods Division’s (DSMD) Survey Methodology (SM) area has been evaluating and redesigning the questionnaire. Our goal is to design a questionnaire that collects high quality data without too much burden on our respondents. Before we finalize the questions, we wanted to test them with a few people who fit the target sample population to make sure the questions are easy to understand and answer.

How: In a couple of minutes I am going to ask you to fill out this survey just as you would if you had received the questionnaire without us here but with one major difference.

Think Aloud: I would like you to think aloud as you answer the questions. I am interested in your answers, but I am also interested in the process you go through in your mind when you answer the questions. I would like you to tell me everything that you are thinking and feeling as you go about answering each question.

Practice: Let’s do a practice question before we start. Please think aloud as you answer this question: How many windows are in your home? [PROBE]

Interruptions: I might stop you at a couple of points in the questionnaire and ask you some questions
about your answers, or about the questions themselves. I am also going to ask you some questions at the end of the questionnaire. There are no right or wrong answers, because only you know what you are thinking.

Confiden.: Our session today is completely confidential. We won’t associate your name with your
answers. Your responses will only be used to help us improve the questions before the survey goes out to the public. Your participation in this study is completely voluntary, and you can decline to answer any particular question.

Do you have any questions before we begin?

Let’s get started.



Logo for Department of Health and Human Services | 2008 National Sample Survey of Registered Nurses









The 2017 National Sample Survey of Registered Nurses (NSSRN) is being conducted by the Health Resources and Services Administration of the U.S. Department of Health and Human Services and is the ninth cycle of the survey.

Please complete and return this paper questionnaire in the envelope provided, OR respond online at www.respond.census.gov/nssrn. We appreciate your help with this important survey.

Please correct any errors in the name/address information below.





Shape3 Shape1 Shape2 Corrections to First Name Corrections to M.I.



Shape4 Corrections to Last Name

Shape5 Corrections to Number and Street First Name M.I. Last Name

Street Address

Shape6 Corrections to City/Town City, State Zip code



Shape9 Shape7 Shape13 Shape12 Shape11 Shape10 Shape8 Corrections to State Corrections to ZIP Code

If there are any corrections to the “State(s) State(s) Where Actively Licensed:

Where Actively Licensed”, please relist ALL of State 1, State 2, State 3

the states where you are actively licensed below.

Website URL: www.nssrn.org

Shape14 Access Code: [XXXXXXX] PIN# [X]

OMB NO.: XXXX-XXXX Exp. Date X/XX/XX


Shape15 Section A.

Eligibility and Education

  1. On December 31, 2017, were you actively licensed to practice as a registered nurse (RN) in any U.S. State or the District of Columbia (whether or not you were employed in nursing at that time)?

Shape16

YesGo to Question 2

Shape17

NoIf No, you do not need to complete this questionnaire. Please mark “no” and return this questionnaire so we know you are not eligible.


  1. Shape18 In what U.S. State were you issued your first RN license?

Shape19

State: Year:


  1. Which type of nursing degree or nursing credential qualified you for your first U.S.

RN license? Mark one box only.

Shape20

Diploma Program

Shape21

Associate Degree

Shape22

Bachelor's Degree

Shape23

Master's Degree

Shape24

Doctorate degree – nursing (PhD)

Shape25

Doctorate degree – nursing (DNP)

Shape26

Doctorate degree – nursing other

Shape27

Other


  1. Shape28 In what month and year did you graduate from this nursing program?

Shape29

Month: Year:


  1. Where was this program located?

Shape30 Shape31 Shape32

In the United StatesPrint state abbreviation

Shape33

Outside the United StatesPrint name of foreign country, or U.S. territory.

Shape34






  1. Please indicate all post-high-school degrees you received before starting your first RN educational program.

Mark all that apply.

Shape35

Associate Degree

Shape36

Bachelor's Degree

Shape37

Master's Degree

Shape38

Doctorate

Shape39

Other certificate

Shape40

None


  1. Have you ever been licensed as a Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN) in the U.S.?

Shape41

Yes

Shape42

No


Probes:

  • In your own words, what specifically is this question asking?

  • If a respondent had graduated from an LPN program but never been employed, how would you think that person should answer this question?

8. Were you ever employed in any of the following health-related jobs before completing your first RN education?

Mark all that apply.

Shape43 Shape44

Nursing Aide or Nursing Assistant

Home health aide or assistant

Shape45

Licensed Practical or Vocational Nurse

Shape46

Community health worker

Shape47

Midwife

Shape48

Other health-related job

Shape49

Not employed in any health-related jobs before RN





  1. How did you finance your first RN education? Mark all that apply.

Shape50

Self Financed

Shape51

Employer tuition reimbursement plan

Shape52

Veterans Administration employer tuition plan

Shape54 Shape53

Health Resources and Services Administration Support (e.g., National Health Service Corps, Nurse Corps loan repayment, Faculty loan repayment, etc.)

Shape55

Other federal traineeship, scholarship, or grant

Shape56

Federally-assisted loan

Shape57 Shape58

Other type of loan

Shape59

State/local government scholarship or grant

Shape60

Non-government scholarship or grant

Shape61

Other resources



  1. Did you earn any additional academic degrees after graduating from your initial registered nurse education program that you described in Question 3? Do not include degrees you are currently working towards.

Shape62

YesPlease complete all rows of the table below for each degree you earned

Shape63

NoGo to Question 12a on page X


Nursing Degrees


Associates Degree in Nursing

Bachelor's degree in nursing

Master's in nursing

Another Master's in nursing

Doctorate

in nursing

(PhD, ScD, DNS, ND, DNP)

10a. In what year did you receive this degree?

Group 759_0

Group 741_0

Group 750_0

Group 664_0

Group 734_0

10b. In what U.S. state or country was this educational program located?

Rectangle 211_0

Rectangle 213_0

Rectangle 220_0

Rectangle 221_0

Rectangle 222_0

10c. Was 50% or more of the coursework for this degree through correspondence or online?



Rectangle 374_0

Yes

Rectangle 398_0

No



Rectangle 371_0

Yes

Rectangle 373_0

No



Rectangle 439_0

Yes

Rectangle 440_0

No



Rectangle 441_0

Yes

Rectangle 442_0

No



Rectangle 443_0

Yes

Rectangle 464_0

No

10d. What was the primary focus of this degree?

Enter two-digit code from table below.

Group 74_0


Group 1156_0


Group 224_0


Group 990_0

Group 1049_0

Non-nursing Degrees





Associates degree in non-nursing field

Bachelor's degree in non-nursing field

Master's in non-nursing field

Another Master's in non-nursing field

Doctorate in non-nursing field (PhD, JD, MD, EdD)

10e. In what year did you receive the degree?

Group 1093_0

Group 1098_0

Group 1103_0

Group 1108_0

Group 1113_0

10f. In what U.S. state or country was this educational program located?

Rectangle 1060_0

Rectangle 1079_0

Rectangle 1080_0

Rectangle 1081_0

Rectangle 1082_0

10g. Was 50% or more of the coursework for this degree through correspondence or online?



Rectangle 1083_0

Yes

Rectangle 1084_0

No




Rectangle 1085_0

Yes

Rectangle 1086_0

No




Rectangle 1087_0

Yes

Rectangle 1088_0

No




Rectangle 1089_0

Yes

Rectangle 1090_0

No




Rectangle 1091_0

Yes

Rectangle 1092_0

No


10h. What was the primary focus of this degree? Enter two-digit code from table below.

Group 986_0


Group 987_0


Group 1134_0


Group 1137_0

Group 1140_0


01 Clinical Practice

02 Administration/Business/Management

03 Education

04 Public health/community health

05 Law

06 Biological or Physical Sciences

07 Humanities, Liberal Arts, or Social Sciences

08 Research

09 Other health field

10 Other non-health field




  1. After graduating from the first nursing program, which you described in Question 3, have you completed a formal educational program preparing you as a Nurse Practitioner, Clinical Nurse Specialist, Nurse-Midwife, or Nurse Anesthetist?

Shape64

Yes

Shape65

NoGo to Question 12a on page X

Probe:

Was this question easy or hard to answer?



Nurse Practitioner (NP)

Clinical Nurse Specialist (CNS)

Nurse-Midwife (NM)

Nurse Anesthetist (NA)

11a. You received preparation as a…?

Shape66

Shape67

Shape68

Shape69

11b. How long was the program?

  1. Less than 8 months

  2. 8-12 months

  3. 13-36 months

  4. 37 months or more

Shape73 Shape72 Shape71 Shape70

Shape80 Shape89 Shape86 Shape87 Shape88 Shape82 Shape83 Shape84 Shape85 Shape81 Shape79 Shape78 Shape77 Shape76 Shape75 Shape74

Shape93 Shape92 Shape91 Shape90

Shape94

11c. What was the highest credential you received in that program?

1. Certificate/Award

2. Bachelor’s Degree

3. Master’s Degree

4. Post-Master’s Certificate

5. Doctorate - PhD

6. Doctorate - DNP

Shape95

Shape99 Shape98 Shape97 Shape96

Shape100 Shape104 Shape101 Shape102 Shape103

Shape105

11d. In what year did you receive this credential?

Shape106

Shape107

Shape108

Shape109



12a. During the fall term of 2017, were you enrolled in a formal education program leading to an academic degree or certificate?

Shape110

Yes, in nursing

Shape111

Yes, in a non-nursing field

Shape112

NoSKIP to Section B

Probe: What do you think ‘fall term of 2017’ refers to?


12b. Were you a full-time or part-time student?

Shape113

Full-time student

Shape114

Part-time student








12c. What percentage of your coursework in this program was distance-based (online or correspondence)?

Shape115

≤ 50%

Shape116

> 50%


12d. What type of degree or certificate were you working toward in this program?

Mark one box only.

Shape117

Associate Degree

Shape118

Bachelor's Degree

Shape119

Master's Degree

Shape120

Doctorate degree – nursing (PhD)

Shape121

Doctorate degree – nursing (DNP)

Shape122

Doctorate degree – nursing other

Shape123

Post-Master's Certificate

Shape124

Other Certificate


Section B.

Shape125 Principal Nursing Employment


13a. On December 31, 2017, were you employed or self-employed in nursing? Employed in nursing includes working for pay in nursing, even if on temporary leave.

Shape126

Yes

Shape127

NoSKIP to Section D on page XX


For all the questions in this section (Questions 13b – 44), your principal nursing position is the nursing position, on December 31, 2017, in which you spent the largest share of your working hours.


13b. Had you been working for this employer for less than 5 years?

Shape128

Yes

Shape129

NoSKIP to Question 14

13c. How long were you actively looking for new employment before accepting a position with this employer?

Shape130 Shape131

1-6 months

7-12 months

Shape132

More than a year



  1. Were you required to maintain an active RN license in order to hold your principal nursing position held on December 31, 2017?

Shape133

Yes

Shape134

No








  1. Where was the location of the principal nursing position you held on December 31, 2017? If you are not employed in a fixed location, enter the location that best reflects where you practice.

Shape135

City/Town:

Shape136

County

Shape137

State (or country

if not U.S.A.)

Shape138

ZIP



  1. In the principal nursing position you held on December 31, 2017, which of the following best describes your employment situation? Mark one box only.

Shape139

Employed through an employment agency as a traveling nurse

Shape140

Employed through an employment agency, but not as a traveling nurse

Shape141

Employed by the organization or facility at which you were working

Shape142

Self-employed, per-diem, or working as-needed

Probe:

Are any of these response options unclear?


  1. Which one of the following best describes the employment setting of the principal nursing position you held on December 31, 2017?

Mark one box only.

Hospital (not mental health)

Shape143

Inpatient

Shape144

Emergency department

Shape145

Hospital ambulatory care department (outpatient, surgery, clinic, etc.)

Shape146

Hospital ancillary unit

Shape147

Hospital, nursing home unit

Shape148

Hospital Critical access

Shape149

Hospital other (administration)

Other inpatient setting

Shape150

Nursing home unit in hospital

Shape151

Rehabilitation facility/ long-term acute

care

Shape152

Inpatient mental health

Shape154 Shape153

Correctional facility

Inpatient hospice

Shape156 Shape155

Other inpatient setting, Specify:

Shape157


Clinic/Ambulatory

Shape158

Private medical practice, clinic, physician office etc

Shape159

Public clinic (Rural health center, FQHC, Indian Health service, Tribal Clinic etc.)

Shape160

School health service (K-12 or college)

Shape161

Outpatient mental health/substance abuse

Shape162

Urgent care (not hospital based)

Shape163

Ambulatory surgery center (free standing)

Shape164

Nurse managed health center

Shape166 Shape165

Other, Specify:

Other types of setting

Shape167

Occupational health or employee health service

Shape168

Public health or community health agency (not a clinic)

Shape169

Government agency other than public/communityhelth or corrections

Shape170

Outpatient dialysis center

Shape171

University or college academic department

Shape172

Home health agency/service

Shape173

Case management/disease management

Shape174

Call center/telenursing center

Shape176 Shape175

Other, Specify:


  1. For the principal nursing position you held on December 31, 2017, did you work full-time or part-time? Mark one box only.

Shape177

Full-time (including full-time for an academic year)

Shape178

Part-time (including working only part of the calendar or academic year)


  1. Shape179 For the principal nursing position you held on December 31, 2017, how many months did you normally work per year?

months per year






  1. Next we will ask for information about the number of hours you worked in a typical week for the principal nursing position you held on December 31, 2017.

Hours

(enter 0 if none)

Shape180

a. Number of hours worked, including all overtime and on-call hours, except on-call hours that were

stand-by only


Shape181

b. Number of hours you stated above in “a” that were paid as overtime


  1. For the principal nursing position you held on December 31, 2017, please estimate the percentage of your time spent in the following activities during a typical workweek. Do not use decimals.

Shape182

a. Patient care and charting

Shape184 Shape183

%

b. Non-nursing tasks

(housekeeping, locating supplies)

Shape186 Shape185

%

c. Consultation with agencies and/or professionals

Shape187 Shape188

%

d. Supervision and management

Shape189 Shape190

%

e. Administration

Shape191 Shape192

%

f. Research

Shape194 Shape197 Shape198 Shape199 Shape193 Shape196
Shape195

%

%

%

%

%

g. Teaching, precepting or orienting students or new hires (include preparation time)

Shape200 Shape201

%

h. Other

Total 100


Probe:

  • Did you find this task difficult? (Why?)

  • Do you think there are common employment scenarios that would make this more difficult?/Do you think nurses with a position different than yours might find it difficult to answer this question?


22a. For the principal nursing position you held on December 31, 2017, in what level of care or type of work did you spend most of your time? Mark all that apply.

Shape202 Shape203 Shape204 Shape205 Shape206

General or specialty inpatient

Care coordination

Patient Navigator

Critical/intensive care

Step-down, transitional, progressive, telemetry

Shape207

Sub-acute care

Shape208

Informatics

Shape210 Shape209

Emergency

Urgent care

Shape211 Shape212 Shape213

Rehabilitation

Long-term care/nursing home

Surgery (including ambulatory, pre-operative, post-operative, post-anesthesia)

Shape214

Ambulatory care (including primary care, outpatient settings, except surgical)

Shape215 Shape216

Ancillary care (radiology, laboratory)

Home health/Hospice

Shape217

Public health/community health

Shape218

Education

Shape219

Business, administration, review

Shape220

Research

Shape222 Shape221

Other, Specify

22b. Did the principal nursing position you held on December 31, 2017, include any patient care?

Shape223

Yes

Shape224

NoGo to Question 23



Shape225

22c. For the principal nursing position you held on December 31, 2017, please estimate the percentage of your patient care time spent with each population below. Do not use decimals.

Shape226

Adult

Geriatric

Shape227

Pre-natal

Shape228

Newborn or

Neonatal

Shape229

Pediatric and/or

Shape230 Shape231

%

Adolescent

Total 100


Probe:

  • Did you find this task difficult? (Why?)

  • Do you think there are common employment scenarios that would make this more difficult?/Do you think people with a different employment/position might find it difficult to answer this question?



22d. For the principal nursing position you held on December 31, 2017, in what type of clinical specialty did you spend most of your patient care time?

Mark all that apply.

Shape233 Shape234 Shape235 Shape236 Shape237 Shape238 Shape232

General medical surgical

Critical care

Cardiac or cardiovascular care

Chronic care

Dermatology

Emergency or trauma care

Endocrinology

Shape240 Shape241 Shape242 Shape243 Shape239

Gastrointestinal

Gynecology (women's health)

Hospice

Infectious/communicable disease

Labor and delivery

Shape244

Neurological

Shape245

Obstetrics

Shape246

Occupational health

Shape247 Shape248 Shape249 Shape250

Oncology

Ophthalmology

Orthopedics

Otolaryngology (Ears, Nose and Throat)

Shape251

Primary care

Shape252

Psychiatric or mental health (substance abuse and counseling)

Shape253

Pulmonary/respiratory

Shape254

Radiology (diagnostic or therapeutic)

Shape255

Renal/dialysis

Shape256

Urology

Shape258 Shape257

Other specialty for a majority of my time

Shape259

Specify:


  1. In your principal nursing position did you use an Electronic Health Record (EHR) or Electronic Medical Record (EMR) system? Do not include billing record systems.

Shape260

Yes

Shape261

No

Shape262

Don't know


  1. To what extent did you participate in team-based care?

Shape263 Shape264 Shape265

To a great extent

Somewhat

Very little

Shape266

Not at all

Probe:

What does “team-based care” mean to you?



  1. What type(s) of training have you received to facilitate team-based care?

Mark all that apply.

Shape267

Online educational videos offered by your place of employment

Shape268

Formal classroom training at your place of employment

Shape269

Informal training (e.g., on the job)

Shape270

Formal classroom training at your college or university

Shape271 Shape272

No training at all

Shape273

Other, Specify


  1. To what extent are you confident in your ability to effectively practice in interprofessional teams?

Shape274

To a great extent

Shape275

Somewhat

Shape276 Shape277

Very little

Not at all


  1. To what extent can you effectively use Health Information Technology in your practice to manage the health of your patient population?

Shape278

To a Great Extent

Shape279 Shape280 Shape281

Somewhat

Very Little

Not at All









  1. In the principal nursing position you held on December 31, 2017, to what extent have you observed your organization emphasizing the following:


To a Great Extent

Somewhat

Very little

Not at all

Team work

Shape282

Shape283

Shape284

Shape285

Care coordination

Shape286 Shape287 Shape288 Shape289




Discharge planning

Shape290 Shape291 Shape292 Shape293




Team-based care

Shape294 Shape295 Shape296 Shape297




Evidence- based practice


Shape298

Shape299

Shape300

Shape301






  1. Thinking about the changes to the health care system created by the Affordable Care Act, what impact do think the change has had on the following aspects of patient care?


Made better

Made worse

Had no effect

Safety

Shape302

Shape303

Shape304

Timeliness

Shape305

Shape306

Shape307

Effectiveness

Shape308

Shape309

Shape310

Efficiency

Shape311

Shape312

Shape313

Equity

Shape314

Shape315

Shape316

Patient centeredness

Shape317 Shape318 Shape319



Assuring that the nation has an adequate supply of nurses

Shape320 Shape321 Shape322




  1. If all nurses could join together to address one of the following health care problems, in your opinion which is the most important for nurses to address?

Mark only one.

Shape323 Shape324

Racial and ethnic disparities in health care

Number of Americans without health insurance

Shape325

Violence in America

Shape326

Drug and alcohol abuse

Shape327 Shape328

Obesity in children and adults

Chronic illness











  1. What additional training opportunities would help you do your job better? Mark all that apply.

Shape329

Evidence-based care

Shape330 Shape331

Patient-centered care

Team-based integrated care

Shape333 Shape332

Practice management and administration

Social determinants of health

Working in an underserved community

Shape334 Shape335

Caring for medically complex/special needs patients

Shape336

Population based health

Shape337 Shape338

Quality improvement

Value based care


  1. Using a scale from 1 to 5 with 1=Novice and 5=Expert, please rate your competency in the following areas of population health

Shape339

Monitoring health status to identify and solve community health problems

Shape340

Diagnosing and investigating health problems and hazards in the community

Shape341

Informing and educating people about health issues

Shape342

Mobilizing community partnerships and actions to identify and solve health problems

Developing policies and plans that support individual and community health efforts

Enforcing laws and regulations that protect health and ensure safety

Linking people to needed health care and assuring the provision of health care when otherwise unavailable

Shape343 Shape344

Assuring competent public and personal health care workforce

Evaluating effectiveness, accessibility and quality of health care services

Shape345

Researching new and innovative solutions to health problems

Probe:

What does Population Health mean to you?

  1. Shape346 Using a scale from 1 to 5 where 1 means "not very prepared" and 5 means "very prepared" please rate how prepared you feel to care for the patient population at your site.



  1. In your principal nursing position on December 31, 2017, did your practice use telehealth?

YesSKIP to Question 36

No

Probe:

In your own words, what is telehealth?


  1. Why didn’t your practice use telehealth? Mark all that apply.

Costs are too high

Staff lacks technical knowledge

Resistance from staff

Licensing barriers

Insufficient connectivity bandwidth

Don't know

  1. Did you personally use some form of telehealth in your principal nursing position on December 31, 2017?

Yes

No


  1. How satisfied are/were you with the principal nursing position you held on December 31, 2017?

Extremely satisfied

Moderately satisfied

Moderately dissatisfied

Extremely dissatisfied


  1. Please estimate your 2017 annual earnings from your principal nursing position. Include overtime and bonuses, but exclude sign-on bonuses.

Shape349 Shape348 Shape347 $ .00 per year




  1. Were you represented by a labor union or collective bargaining unit in the principal nursing position you held on December 31, 2017?

Shape350

Yes

Shape351

No


40a. Have you left the principal nursing position you held on December 31, 2017?

Shape352

Yes SKIP to Question 44

Shape353

No


40b. Have you considered leaving, or do you plan to leave the principal nursing position you held on December 31, 2017?

Shape354

Yes

Shape355

NoSKIP to Question 43

Shape356

UndecidedSKIP to Question 41


40c. When do you plan to leave this position?

Shape357

Less than one year from now

Shape358

1-3 years from now

Shape359

More than 3 years from now


40d. Do you plan to work in nursing after you leave this position?

Shape361 Shape360

Yes

Shape362

No

Shape363

Unsure


  1. How long do you plan to work in this geographic area?

Less than a year

1-2 years

3-5 years

More than 5 years

Not sure


Probe:

What do you consider your ‘geographic area?”






  1. Which of the following reasons would contribute to your decision to leave your principal nursing position?

Mark all that apply.

Shape364 Shape365 Shape366

Patient population

Burnout

Stressful work environment

Shape367

Lack of advancement opportunities

Shape368

Lack of collaboration/communication between health care professionals

Shape369

Lack of good management or leadership

Career advancement/promotion

Shape370 Shape371 Shape372

Inadequate staffing

Interpersonal differences with colleagues or supervisors

Shape373

Physical demands of job

Shape374

Better pay/benefits

Shape375

Scheduling/inconvenient hours/too many hours

Shape376

Relocating to different geographic area

Shape377

Sign-on bonus offered

Shape378

Going back to school

Shape379

Retiring

Shape380

Disability / Illness

Shape381

Spouse's employment opportunities

Shape382

Children's schooling

Shape383

Length of commute

Shape384

Career change

Shape385 Shape386

Other, Specify:


  1. What factors contribute to your decision to remain in your principal nursing position? Mark all that apply.

Availability of loan repayment financial support

Ability to provide full scope of services

Commitment to underserved communities

Salary and benefits

Opportunities for advancement

Cost of living

Experience at site

Balanced schedule/hours

Use of electronic Health record system

Use of telehealth

Availability of training opportunities

Availability of resources to do my job well

Sense of community with peers

Proximity to extended family/parents/siblings

Proximity to spouse's employment opportunities

Proximity to desirable school district

Difficulty finding another job

Length of commute

Shape387

Other, Specify:




  1. Approximately when do you plan to retire from nursing?

In 2018

In 1-2 years

In 3-5 years

More than 5 years from now

Undecided




Shape388 Section C.

Secondary Employment in Nursing


  1. Aside from the principal nursing position you just described, did you hold any other positions in nursing for pay on December 31, 2017?

Shape389

Yes

Shape390

No SKIP to Section D


  1. Which of the following best describes your employment with the other nursing position(s) held on December 31st, 2017?

Mark all that apply.

Shape391

Employed through an employment agency as a traveling nurse

Shape392

Employed through an employment agency, but not as a traveling nurse

Shape393

Employed by the organization or facility at which you are working

Shape394

Self-employed, per diem, or working as needed


  1. What type of work setting(s) best describe where you worked for the other nursing position(s) held on December 31st, 2017?

Mark all that apply.

Shape398 Shape397 Shape396 Shape395

Hospital

Shape402 Shape401 Shape400 Shape399

Nursing home/Extended care facility

Academic education program

Home health setting

Public or community health setting

Long-term acute care

Mental Health/ substance Abuse

School health service

Shape403

Occupational health

Shape404

Ambulatory care setting

Shape406 Shape405

Insurance claims/benefits

Telehealth, telenursing or call center

Shape407

Other




  1. In your additional nursing position(s) held on December 31, 2017, please indicate how much you worked, and where the job was located:


Weeks Per Year

Average hours per week, during weeks of work

Locations of where most of work was done

(state or country)

Additional job #1




Additional job #2




All other jobs




  1. Please estimate your 2017 annual earnings from all your other nursing position(s). Do not include earnings from your principal nursing position.

Shape408 $ , , .00 per year



Shape409


Section D.

Nurse Practitioners



  1. On December 31, 2017, did you have a current certification, licensure, or other legal recognition from a State Board of Nursing to practice as a Nurse Practitioner (NP)?

Yes

NoSKIP to Section E



Probe: In this question, is it clear that we are asking about certifications, and from the State Board of Nursing?



51. In which area(s) have you ever received certification from a national certifying organization for NPs? Mark all that apply.

Shape410

Acute Care adult

Shape411

Acute Care pediatric

Shape412

Adult

Shape418 Shape417 Shape416 Shape415 Shape414 Shape413

Family

Gerontology

Neonatal

Pediatric

Psychiatric & Mental Health

Shape419

Women's Health

Shape421 Shape420

Other, Specify

  1. To what extent did your master's or doctoral training prepare you to be an independent practitioner?

To a Great Extent

Somewhat

Very Little

Not at All

Probe:

What does ‘independent practitioner’ mean to you?


  1. Did you complete an NP post-graduate residency program?

Yes

No




  1. Do you have a National Provider Identifier (NPI) number?

Yes

NoSKIP to Question 56


  1. Do you or have you ever billed under your NPI number?

Yes

No






  1. On December 31, 2017, were you employed in any positions that required state certification/licensure/recognition to practice as an NP?

Shape422

Yes

Shape423

NoSKIP to Q 74


For the next several questions, please think about all of the NP positions you held on December 31, 2017.


  1. To what extent would you agree or disagree with the following: In my NP position(s), I am allowed to practice to the fullest extent of my state's legal scope of practice.

Strongly agree

Agree

Disagree

Strongly disagree


  1. To what extent would you agree or disagree with the following: In my NP position(s), my NP skills are being fully utilized.

Strongly agree

Agree

Disagree

Strongly disagree


  1. Across all of the NP positions you held on December 31, 2017, about how many patients did you see in a typical week?

Number (3 digits)


60. Did you have a panel of patients that you managed, where you were the primary provider?

Yes

No SKIP to Question 66a


Shape424

61. Across all of those NP positions, about how many patients were on your panel?


Shape425

62. What percentage of your panel were patients from racial/ethnic minority groups?




Shape426

63. What percentage of your panel were patients with limited English proficiency?



64. Were the majority of your patients reimbursed through:

Mark only one.

Fee-for-service

Capitated (HMO)

Other

Don’t Know

Probe: Was this easy or hard to answer?


65. What percentage of your patient panel was covered by the following types of insurance?

Private Insurance

Medicare, for people 65 and older, or people with certain disabilities

Medicaid, Medical Assistance, or any kind of government-assistance plan for those with low incomes or a disability

TRICARE or other military health care

VA

Indian Health Service

Self-pay/Uninsured

Other

Probe: Was this easy or hard to answer?


Probe: Did you understand that the timeframe for the last several questions was 12/31/17, even though the date was not mentioned in every question?


66a. Were you a Nurse Practitioner prior to 2010?

Yes

NoSKIP to Question 67




66b. Did your overall patient population size increase, decrease, or stay the same since 2010?

Increased

Decreased

Stayed the same

I don’t know

  1. Did you have hospital admitting privileges on December 31, 2017?

Yes

No


  1. Were you covered by malpractice insurance on December 31, 2017?

Yes

NoSKIP to Question 70


  1. Who paid for your malpractice insurance?

Self

Employer

Both


  1. Did you have prescriptive authority?

Yes SKIP to question 72

No


  1. Why didn't you have prescriptive authority? Mark all that apply.

Was in the process of applying

MD or other NP wrote all of my prescriptions

State Scope of Practice regulations

Other (specify)


  1. On December 31, 2017 did you have a personal drug enforcement administration (DEA) number?

Yes

No


  1. In any of your NP positions, did you have the title Hospitalist?

YesSKIP to Section F

No SKIP to Section F


Please SKIP to section F



  1. What are the reasons that you were not working as a Nurse Practitioner on December 31, 2017? Mark 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

Lack of experience or qualification

Inadequate salary/compensation

Working outside the nursing field

Maternity/parenting/family leave

Poor health or disability

Choose not to work at this time

Retired

Shape427

Other, Specify


Shape428

Section E.

Nurses Not Working in Nursing


If you were working for pay in nursing on December 31, 2017, please go to Section F on page XX.


  1. What are your intentions regarding paid work in nursing?

Mark one box only.

Shape429

Have returned to nursing since December 31, 2017

SKIP to Section F on page XX

Shape430

Plan to return to nursing in the future, not looking for work now

SKIP to Question 78

Shape431

No future intention to work for pay in nursing

SKIP to Question 79a

Shape432

Undecided at this time

SKIP to Question 79a

Shape433

Actively looking for work in nursing

Probe:

Was this easy or hard to answer?


  1. Shape434 How long have you been actively looking for paid work in nursing? Enter zero if less than one month.

months (if one or more)


  1. Are you looking for a position that is full-time or part-time?

Shape435

Full-time SKIP to Question 79a

Shape436

Part-time SKIP to Question 79a

Shape437

Either SKIP to Question 79a


  1. When do you plan to return to paid work in nursing? Enter zero if less than one year.

Shape438

years


79a. Have you ever been employed or self employed in nursing?

Shape439 Shape440

Yes

NoSKIP to Question 80



79b. How long has it been since you were last employed or self-employed as a nurse?

Shape441

Enter zero if less than one year

years


  1. What are the primary reasons you were not working in a nursing position for pay on December 31, 2017? Mark all that apply.

Shape442 Shape443 Shape444

Retired

Taking care of home and family

Burnout

Shape445

Stressful work environment

Shape446

Scheduling/inconvenient hours/too many hours

Shape447

Physical demands of job

Shape449 Shape448

Disability/Illness

Shape450

Inadequate staffing

Shape451

Salaries too low/better pay elsewhere

Shape452

Skills are out-of-date

Shape453

Liability concerns

Shape454

Lack of collaboration/communication between health care professionals

Shape455

Inability to practice nursing on a professional level

Shape456

Lack of advancement opportunities

Shape457

Lack of good management or leadership

Shape458

Career change

Shape459

Difficult to find a nursing position

Shape460

Went back to school

Shape461

Other

Shape462

Section F.

Prior Nursing Employment


Shape463
  1. Since receiving your first U.S. RN license, how many years have you worked in nursing? Count only the years in which you worked at least 6 months. Enter zero if less than one year.

years


82a. Have you left work in nursing for one or more years since becoming an RN?

Shape464

Yes

Shape465

No SKIP to question 83



Shape466

82b. For how many years? Enter zero if less than one year.

years


  1. Next, we are going to ask about your employment approximately one year ago. Were you employed in nursing on December 31, 2016?

Shape467

Yes

Shape468

No SKIP to Section G on page XX

  1. For the principal nursing position you held on December 31, 2016, did you work full-time or part-time? Mark one box.

Shape470 Shape469

Full-time (including full-time for an academic year)

Part-time (including working only part of the calendar or academic year)


  1. How would you describe the principal nursing position you held on December 31, 2016?

Shape472 Shape471

Same position and same employer as principal nursing position on December 31, 2017SKIP to Section G on page XX

Different position but same employer as principal nursing position held on December 31, 2017

Shape473

Different employer than principal nursing position held on December 31, 2017.

  1. Shape474 What was the location of the principal nursing position you held on December 31, 2016? If you were not employed in a fixed location enter the location that best reflects where you practiced.

City/Town

Shape475


County


Shape476

State (or country

if not U.S.A.)


Shape477

ZIP

  1. What were the primary reason(s) for your employment change? Mark all that apply.

Patient Population

Burnout

Stressful work environment

Lack of advancement opportunities

Lack of collaboration/communication between health care professionals

Lack of good management or leadership

Career advancement/promotion

Inadequate staffing

Interpersonal differences with colleagues or supervisors

Physical demands of job

Better pay/benefits

Scheduling/inconvenient hours/too many hours

Relocated to different geographic area

Laid off/downsizing of staff/ reorganization/

Sign-on bonus offered

Personal/family

Went back to school

Retired

Disability / Illness

Spouse's employment opportunities

Children's schooling

Length of commute

Career change

Shape478

Other, Specify:


  1. Which one of the following best describes the employment setting of the principal nursing position you held December 31, 2016? Mark one box only.

Hospital (not mental health)

Inpatient

Emergency department

Hospital ambulatory care department (outpatient, surgery, clinic etc.)

Hospital ancillary unit

Hospital, nursing home unit

Hospital, Critical access

Hospital other (administration)

Other inpatient setting

Nursing home/extended care/skilled nursing facillity/ group home

Rehabilitation facility/ long-term acute care

Inpatient mental health

Correctional facility

Inpatient hospice

Shape479

Other inpatient setting, Specify

Shape480


Clinic/Ambulatory

Private medical practice, clinic, physician office, etc.

Public clinic (Rural health center, FQHC, Indian Health service, Tribal Clinic etc.)

School health service (K-12 or college)

Outpatient mental health/substance abuse

Urgent care (not hospital based)

Ambulatory surgery center (free standing)

Nurse managed health center

Shape481

Other, Specify

Other types of setting

Occupational health or employee health service

Public health or community health agency (not a clinic)

Government agency other than public/community health or corrections

Outpatient dialysis center

University or college academic department

Home health agency/service

Case management/disease management

Call center/telenursing center

Shape482

Other, Specify



Shape483 Section G.

National Practitioner Data Bank



  1. The National Practitioner Data Bank (NPDB), which includes the Healthcare Integrity and Protection Data Bank (HIPDB), is a nationwide repository of negative actions taken against healthcare professionals. Its primary function is to aid employers in making well-informed hiring decisions. Currently, certain entities are required to query the NPDB on physicians and dentists, prior to making hiring and clinical privileges decisions. Do you think the query requirement should be expanded to other healthcare professions?

Yes, it should be expanded to all healthcare professions.

Yes, it should be expanded to some but not all healthcare professions.

No, it should not be expanded.

Probe:

  • Do you understand what the NPDB is?

  • Were you familiar with it, prior to being given this definition?



  1. Have you been reported to the NPDB or the HIPDB?

Yes

NoSKIP to Question 93


  1. Who submitted the report?

State licensing board

Medical malpractice payer, such as an insurance company

Hospital

Federal agency

Other (Specify)

Unknown


  1. Did the NPDB report impact your career? Mark all that apply.

No, the report did not impact my career.

Yes, the report had a negative impact on my current position (e.g., reprimand, termination, etc.).

Yes, the report made it difficult to obtain employment.


  1. When making hiring decisions, do you feel that health care employers should consider prior negative health care related actions taken against prospective employees?

Yes, they should consider prior negative actions.

No, they should not consider negative prior actions.



  1. The NPDB collects reports on adverse actions taken against a physician that affect that physician’s clinical privileges. Many nurse practitioners currently perform job functions similar to primary care physicians. Do you feel the NPDB should also collect reports on adverse actions against a nurse practitioner that could affect their clinical privileges?

Yes, they should be reported

No, they should not be reported


  1. Do you think nurse practitioners who are supervised by a physician should be subject to the same reporting requirements as physicians, less strict reporting requirements, or more strict reporting requirements?

 

Less strict reporting requirements for nurse practitioners who are supervised by a physician,

More strict reporting requirements for nurse practitioners who are supervised by a physician,

The same reporting requirements as physicians.



Probe:

Was this easy or hard to answer? (If hard, why?

Shape484 Section H.

General Information


  1. Where did you reside on December 31, 2017? This information is critical for producing state/county estimates of the nursing workforce.

Shape485

City/Town:

Shape486

County

State (or country

Shape487

if not U.S.A.)

Shape488

ZIP

  1. Did you reside in the same city/town a year ago (December 31, 2016)?

Shape489

Yes SKIP to Question 99

Shape490

No


  1. Where did you reside on December 31, 2016? This information is critical for producing state/county estimates

Shape491

City/Town:

Shape492

County

Shape493

State (or country

if not U.S.A.)

Shape494

ZIP

Probe:

Was it immediately clear that the reference date shifted between question 98 and 99? Or did you need to re-read it to find the difference?



  1. What is your gender?

Shape496 Shape495

Male

Female


  1. What is the year of your birth?

Shape498 Shape497



101. Are you of Hispanic, Latino or Spanish origin?

Shape499

Yes

Shape500

No


102. What is your race?

Mark all that apply.

Shape501

White

Shape502

Black or African American

Shape503

Asian

Shape504

American Indian or Alaska Native

Shape505

Native Hawaiian or Other Pacific Islander

Shape506

Some other race


  1. What languages do you speak fluently, other than English? Mark all that apply.

Shape507

No other languages

Shape508

Spanish

Shape509

Filipino language (Tagalog, other Filipino dialect)

Shape510

Chinese language (Cantonese, Mandarin, other Chinese language)

Shape513 Shape512 Shape511

Russian

Korean

Vietnamese

Shape514

American Sign Language

Shape515

Other language(s)

  1. What is your marital status?

Shape516

Married or in domestic partnership

Shape517

Widowed, divorced, separated

Shape518

Never married


  1. Which of the following best describes the children/parents/dependents who either live at home with you or for whom you provide a significant amount of care? Mark all that apply.

Shape519

Child(ren) less than 6 years old at home

Shape520

Child(ren) 6 to 18 years old at home

Shape521

Other adults at home (i.e., parents or dependents)

Shape522

Others living elsewhere (i.e., children, parents or dependents)

Shape523

None

Probe:

What is this question asking you to do?



  1. Including employment earnings, investment earnings, and other income of all household members, what was your 2017, pre-tax annual total household income? Mark one box only.

Shape524

$15,000 or less

Shape525

$15,001 to $25,000

Shape526

$25,001 to $35,000

Shape528 Shape527

$35,001 to $50,000

$50,001 to $75,000

Shape529

$75,001 to $100,000

Shape530

$100,001 to $150,000

Shape531

$150,001 to $200,000

Shape532

More than $200,000


Shape533

Section I.

License and Certification Detail


  1. Please provide any other names under which you may have held a nursing license.

Shape535 Shape534

First name M.I. Last Name

Shape536


Shape538 Shape537

First name M.I. Last Name

Shape539




  1. On December 31, 2017, which of the following skill-based certifications did you have? Mark all that apply.

Shape540

No skill-based certifications

Shape542 Shape541

Life Support (BLS, ALS, BCLS, etc.)

Resuscitation (CPR, NRP, etc.)

Shape544 Shape545 Shape546 Shape543

Emergency Medicine/Nursing (EMT, ENPC, etc.)

Trauma Nursing (TNCC, ATCN, ATN, etc.)

Critical Care Certificate

Shape547 Shape548

Other, Specify

Shape549 Shape550

Other, Specify






109. On December 31, 2017, did you have any current National nursing certifications as a Clinical Nurse Specialist, Nurse Midwife, or Nurse Anesthetist?

Shape551

Yes

Shape552

No SKIP to Section J on page XX


110a. On December 31, 2017, did you have a current certification as a Clinical Nurse Specialist (CNS)?

Shape554 Shape553

Yes

No SKIP to Question 111a


110b. Was this certification required by your employer for your job?

Shape555

Yes

Shape556

No


110c. Was this certification from a national certifying organization?

Shape557

Yes

Shape558

No


Shape559 110d. Which of the following Clinical Nurse Specialist (CNS) certifications did you have?

Shape560

Acute Care/Critical Care CNS

Shape561

Adult Health CNS

Shape562

Community Health/Public Health CNS

Shape563

Diabetes Management CNS

Shape564

Gerontological CNS

Shape565

Home Health CNS

Shape566

Hospice and Palliative Care CNS

Shape567

Medical-Surgical CNS

Oncology CNS

Shape568

Pediatric CNS

Shape569

Psychiatric & Mental Health CNS - Adult

Shape570

Psychiatric & Mental Health CNS - Child/Adolescent

Shape571

Psychiatric & Mental Health CNS - Family

Shape573 Shape572

Other, Specify:




111a. On December 31, 2017, did you have a current certification as a Nurse-Midwife (CNM)?

Shape575 Shape574

Yes

No SKIP to Question 112a



111b. Was this certification required by your employer for your job?

Shape576

Yes

Shape577

No


111c. Was this certification from a national certifying organization?

Shape578

Yes

Shape579

No






112a. On December 31, 2017, did you have a current certification as a Nurse Anesthetist (CRNA)?

Shape581 Shape580

Yes

No skip to Section J


112b. Was this certification required by your employer for your job?

Shape582

Yes

Shape583

No


112c. Was this certification from a national certifying organization?

Shape584

Yes

Shape585

No






Shape586

Section J.

Contact Information



113. Please provide your e-mail address and telephone number, as well as the best time of day to reach you. This information will only be used in the event that we need to contact you about any of your responses.

Shape587

E-mail address:

Telephone:

Shape588 Shape589 Shape591 Shape590

Home (Area Code) Telephone Number

Shape592

Work

Shape593

Cell


Shape594

Time of day/week best to contact you by phone:


Please return this survey and any duplicate surveys in the enclosed, postage-paid envelope.

We estimate that it will take about XX minutes per person to collect the information. This includes time for reviewing the instructions and completing and reviewing your answers. You may send comments regarding time estimates or any other aspect of this data collection process, including suggestions for reducing this burden, to Paperwork Reduction Project XXXX-XXXX, U.S. Census Bureau, 4600 Silver Hill Road, Room 7H054, Washington, DC 20233. You may also e-mail comments to [email protected]; use "Demo Survey Comments XXXX-XXXX" as the subject.

The U.S. Office of Management and Budget (OMB) approved this survey and gave it OMB approval number XXXX-XXXX; the expiration date is XX/XX/XXXX. Displaying this number shows that the Census Bureau is authorized to conduct this survey. If this number were not displayed, we could not request your participation. Please use this number in any correspondence concerning this survey.



Department of Health and Human Services logo

U.S. Department of Health and Human Services Health Resources and Services Administration logo

Debriefing questions

  1. What did you like about the questionnaire? What didn’t you like about the questionnaire?



  1. Overall, would you say the survey questions were easy or difficult to respond to? Which ones? Why?



  1. Were there any terms or phrases that you had trouble understanding?



  1. This survey has many skip patterns. Do you think these were identified clearly?





  1. Did the section headings help you navigate the survey?











  1. Do you think there are questions some people would find too sensitive to answer? Which ones?







  1. Were there any questions that you had trouble with that we haven’t talked about yet?







  1. Is there anything else you would like to tell us that you haven’t had a chance to mention yet?











Thank you very much for your help!





29


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