Reinvigorating a key research program: the NLN's collection of LPN/LVN educational statistics.

As Congress debates health care reform and states experiment with health insurance and health care delivery overhauls, the nation has become increasingly aware of the looming nursing shortage, which has already preoccupied health care researchers for decades. In turn, anxiety over nursing shortage projections has brought the dearth of nurse educators into sharp relief as researchers and policymakers of all stripes scramble to identify bottlenecks in the nursing workforce supply pipeline. Simply put, to produce more nurses we will need more nurse faculty, and to produce more nurse faculty we will need to expand and accelerate the academic progression of nurses at every stage of education toward achieving a graduate-level degree. Concerns about the nursing workforce have led the NLN to reexamine its data collection program on LPN/LVN education. The collection of high quality data is critical to understanding not just our current LPN workforce, but also to gauging the size and attributes of this labor pool from which many of our future RNs and graduate-prepared nurses will emerge. In fact, approximately one out of every five licensed nurses in the United States is an LPN. Moreover, of the 2.9 million RNs in the United States in 2004, 484,000 (or 17 percent) previously held an LPN license (US Department of Health and Human Services [DHHS], 2006). For a significant number of RNs, the LPN license does not appear to be a credential that is merely picked up en route to RN licensure. The Health Resources and Services Administration (HRSA) 2004 National Sample Survey of Registered Nurses found that of the RNs who were ever licensed as LPNs, over three quarters (an estimated 364,527) had been actively employed as LPNs/LVNs prior to beginning their initial nursing education (DHHS). Given the import of LPN/LVN education to both nursing and the NLN mission, last summer the NLN's public policy research area undertook a comprehensive review of the LPN/LVN component of its Annual Survey of Schools of Nursing. The goal was to evaluate three aspects of the NLN's research program: a) the quality of data on LPN/LVN programs that we have collected in the past; b) the suitability of our current research methodology for obtaining valid, high quality LPN educational data; and c) changes to our research design and methodology that might potentially improve both data quality and survey response rates among schools offering LPN/LVN programs. What We Know Data on the LPN workforce in general have been of uneven quality throughout the years. One of the most comprehensive reports on' licensed practical and vocational nurses, conducted for HRSA in 2004, found wide disparities in estimates of the size of the LPN/LVN workforce produced by key agencies and organizations (Seago, Spetz, Chapman, Dyer, & Grumbach, 2004). Those figures ranged from a low of 596,000 LPNs counted in the 2000 US Census, to more than 889,000 LPNs estimated by the National Council of State Boards of Nursing (NCSBN) to be actively working during the same year. Similarly, the quality of information on LPN/LVN education on a national level has also suffered in recent years. Although the NLN's migration to an electronic survey platform created efficiencies in the collection of nursing education data overall, the technology, and perhaps the less individualized approach that came with it, does not appear to have garnered the same advantages for LPN data collection as it has for the collection of data on the nation's RN programs. In particular, the NLN has encountered two major challenges since moving to an electronic data collection platform: a) inadequate response rates, and b) persistent difficulties ensuring that prelicensure RN students who are eligible to sit for the NCLEX-PN exam due to an LPN exit option are counted in our student census surveys. Getting in Touch with LPN/LVN Programs Research on nursing education has been greatly facilitated by the tremendous strides made by schools in terms of access to technology since the mid-1990s. …