About NSP I

The Nurse Support I program is a non-competitive grant to hospitals to fund projects that address the individual needs of the hospitals as they relate to nurse recruitment and retention. It is not the intent of NSP I to fund existing programs that are more appropriately funded through employee fringe benefit programs or to duplicate what is available in rates for traditional hospital-based services or operations.

Goals of the NSP I Program

In recent years, there has been intense focus on the healthcare industry to provide high quality care and improve patient health outcomes. In 2010, the Institute of Medicine (IOM) published a groundbreaking report which laid out 8 recommendations to address the increasing demand for high quality and effective healthcare service, and provided an action-oriented blueprint for the future of nursing. Four of the recommendations were incorporated into the scope of the NSP I program:

  • IOM Recommendation 3: Implement nurse residency programs.
  • IOM Recommendation 4: Increase the proportion of nurses with a baccalaureate degree to 80 percent by 2020.
  • IOM Recommendation 6: Ensure that nurses engage in lifelong learning.
  • IOM Recommendation 7: Prepare and enable nurses to lead change to advance health.

Evidence has shown that highly qualified nursing workforce is linked to improved patient outcomes, low nursing turnover, and increased satisfaction among nursing staff. Incorporating the IOM recommendations into the scope of the NSP I program provides guidance to improve the standards for all hospital-based nurses in Maryland. In an effort to raise the bar for Maryland nurses, the NSP I programs are encouraged to focus on three areas:

  • Education and career advancement. This area includes initiatives that increase the number of advance degree nurses; nursing residency programs; leadership initiatives and succession planning.
  • Patient quality and satisfaction. This are includes data collection efforts that can demonstrate the link between improved nursing competency and better patient outcomes.
  • Advancing the practice of nursing. This area includes activities that advance the practice of nursing, such as staff driven evidenced-based research in nursing, attendance at symposiums and research conferences, as well as achieving or maintaining Magnet status.

Application Process, Implementation and Evaluation

Hospitals submit proposals for programs that address their specific workforce needs. HSCRC grants hospitals leeway as to how the programs are implemented, as long as the programs are aligned with the goals of the NSP I program. A multi-stakeholder evaluation committee reviews the proposals and works with hospitals to ensure compliance to the overall goals of the NSP I program. Hospitals submit annual reports that quantitatively describe outcomes of their program. In addition, HSCRC provides ongoing oversight through site visits and auditing of program budgets.

Administration of NSP I program

The NSPI program is administered by the HSCRC staff. HSCRC is responsible for:

  1. Developing metrics and reporting guidelines for NSP I
  2. Monitoring and evaluation of hospital-specific NSP I programs
  3. Collection and distribution of funds to hospitals for the NSP I programs and to MHEC for distribution to NSPII-funded programs

Funding of the NSP I Program

Funds are added to each hospital’s rates. Hospitals receive either:

  1. 0.1% of the hospital’s gross regulated patient revenue for the prior year or
  2. The requested grant amount, if less than the 0.1% of the hospital’s gross regulated patient revenue.

All 42 acute care hospitals, as well as Sheppard Pratt and Mt Washington Children’s Hospital, have been funded by the program at varying times during its existence. Between FY 2001 through FY 2013, approximately $80.6 million to have been funded in rates to support NSP I programs.