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Annual Report
Registered Nurse Survey '07
Nurse Staffing &
Patient Outcomes
Projected RN Workforce in Hawaii 2005 - 2020
Nursing Education Programs
2005 - 2006
Nursing Education & Practice
Hawaii's Health in the
Balance: A Report on the
State of the Nursing Workforce

Hawaii State Center for Nursing

2528 McCarthy Mall
Webster Hall 432
Honolulu, Hawaii 96822 - Map -

Ph: (808) 956-5211
Fax: (808) 956-3257


ANNUAL REPORT 2007 (download pdf file)

Archives: 2005 | 2006

Report from Advisory Board | A. Act 198 | B. Strategic Plan | C. Fiscal Year 2007 Financial Statement | D. Nurse Leadership Program | E. Abstract: Projected Registered Nurse Workforce in Hawaii 05-20 | F. Hawai'i Partners In Nursing Project Report | G. Abstract: Nursing Education Programs 05-06




Projected Registered Nurse Workforce in Hawai‘i 2005 -2020


One of the primary goals of the Hawai‘i State Center for Nursing (HSCFN) is to establish “an ongoing system that assists in estimating the future registered nursing workforce supply and demand needs in Hawai‘i.” In accordance with the mission, the HSCFN utilized forecasting models and data relevant to the State of Hawai‘i to project future nursing needs.

Long range forecasting is described as ‘an estimate or prediction of the future’. Forecast data are a best estimate of likely trends and are an essential component of nursing workforce planning. In order to plan future workforce needs, workforce demand requirements and supply availability need to be adequately estimated, and workforce shortages or oversupply conditions need to be predicted. Forecasting requires that past and current trends in the demand for and supply of nursing workforce are carefully assessed. Predictors of levels and trends in demand and supply must be identified and models created that weigh these factors and use them to project future demand and supply. Whether these projections prove to be close to the values observed in the future depends on the degree to which historical trends provide a guide to the future and the influences of unforeseen external factors.

Forecasting workforce demand and supply is a complex endeavor with many factors potentially influencing current and future levels. An adequate forecasting model must take into consideration as many of these factors as possible, and must accurately estimate trends in the factors and the effect they will have on supply and demand in the future. In addition, good forecasting models allow for different future scenarios, since factors such as the economy (affecting supply and demand), the nation’s health (affecting demand), funding for nursing education (affecting supply), and retirement rates (affecting supply), can singularly or collectively change direction over time.

The final report: 1) describes the national Nursing Supply Model (NSM) and Nursing Demand Model (NDM); 2) describes the procedures used in updating and adjusting the two independent models to reflect the current Hawaiian workforce environment; 3) provides Hawai‘i specific estimates of current supply and demand; and 4) lists model limitations and 5) potential policy initiatives to reduce the impact of the shortage.

In this study, the National Center for Health Workforce Analysis (NCHWA) models were used to forecast the supply and demand of registered nurses (RNs) in Hawai‘i from 2005 - 2020. Preliminary estimates suggest that demand will grow from a current need for about 8,411 FTE RNs to more than 10,955 over the next 15 years. However, supply is projected to increase from an estimated 7,553 FTE RNs in 2005 to an estimated 8,286 by 2020. The models indicate that by the year 2020, Hawai‘i will have a shortage of approximately 2,669 FTE RNs, or about 24 percent demand shortfall.


Both immediate and long-term policy development is required to address this growing nursing shortage. We need to address the limited educational capacity issues faced by our nursing programs; to attract and ensure educational opportunities for people to the nursing profession. The advantage of such policies is that they add new nurses year after year. Thus, while the increase in any one year may be modest, the cumulative effect can be significant. Other factors such as reducing net annual out-migration and turnover rates; and attracting more people to nursing will have an accumulative effect.


Policies that affect participation within the existing pool of nurses may have a limited long-term impact while increasing the supply of nurses in the short term. Delaying time until retirement, reducing career changes and increasing the percentage of nurses working full time as opposed to part time are examples of such policies.

Data suggests that no individual policy is likely to alleviate the nursing shortage. Rather, eliminating the nursing shortage requires targeting a series of policy initiatives to ensure nursing supply. The most effective strategy may be one that stimulates supply among existing nursing workforce to address the current shortage and simultaneously increase supply through nursing education to minimize future shortages.


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