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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


Projected Registered Nurse Workforce
in Hawai’i 2005 - 2020
January 2007 (download pdf file)

Summary & Introduction | I. Nursing Supply Model | II. Nursing Demand Model

III. Projecting RN Shortage | IV. Limitations | V. Recommendations

VI. Conclusions | VII. References


IV. Limitations of the NSM and NDM Models


The creation of these two complex models was an ambitious undertaking. The models allow forecasting of RN supply and demand to the year 2020 at both the national and state levels. Nonetheless, major limitations of the models include:


• The two models are independent of each other. The NDM makes projections without considering the potential supply of nurses and vice versa.


• The capacity to refine and update the models is dependent on the availability of reliable data and adequate resources.


• Parts of both models are static. For example, in the NSM, the probability of cross-state migration is based on historical patterns and fails to consider the current shortage of RNs in each state. The NDM has limited ability to model substitution between types of nurses and between nurses and other healthcare workers. The NDM also has limited ability to capture the interaction of healthcare settings (e.g., home health as a viable substitute for nursing home facilities), while other settings might be complementary (e.g., increased use of outpatient services leads to increased use of home health services).


• Accuracy of projections are reduced by a number of factors:

- The level of aggregation (e.g., national projections will likely be more accurate than state projections).

- Sample size (e.g., larger states will likely be more accurate compared to smaller states).

- The projection horizon (e.g., projections for the year 2005 will likely be more accurate than the projections for 2020).

- The determinants of nursing supply and demand (i.e., currently there is no consensus on what are the most important determinants of nurse supply and demand, nor is there a consensus on the future value of these determinants).


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