Striving to practice at the top of your scope as an NPD practitioner? Have another new educational initiative to roll out, but no one with the capacity to support it? Need to redistribute workload, but not sure how to approach the decision-making process?
Our organization developed a workload measurement tool, based on the scope and standards for NPD practice, to qualify and quantify the work of NPD practitioners and education support staff. This article describes three examples of how NPD division leaders use workload data to transform and elevate NPD practice at our academic medical and health science center and provides recommendations on how you can begin gathering workload data.
First, some background: Our health system employs a centralized model with NPD practitioners and education support staff reporting to NPD division leaders who hold the title “nurse manager.” The alternative job title for education support staff is professional development associate (PDA). A PDA is an individual who contributes to the overall functioning of continuing education and the NPD division (Harper & Maloney, 2022). Each day, our NPD practitioners and PDA staff record their daily work activities in our workload measurement tool that comprehensively captures, calculates, and trends workload data (Bauer et al., 2024; Dickinson et al., 2010). Productivity is expressed as a percentage and is also referred to as the utilization rate or workload capacity in business literature. Our goal for each education staff member is 80%, as literature suggests a utilization rate over 80% may lead to burnout and ultimately decreased productivity (Bauer et al., 2024; Zhao et al., 2023). Read more about our workload measurement tool in our JNPD article entitled Quantifying and qualifying nursing professional development practitioner workload (Bauer et al., 2024).
Example #1 – Managing Workload and Promoting NPD Practitioners to Function at Top of Scope
During monthly touchpoints with NPD division leaders, many NPD practitioners regularly express feeling overwhelmed with their workload and the need to work beyond the defined 40-hour work week to fulfill job responsibilities. Individual NPD division leaders review employee workload data to validate when staff members are working more than 40 hours per week, then evaluate trends in work effort. Work effort is defined by assessing where the most time is being spent and how the time is being spent.
The NPD division leaders use individual workload data to identify any work that is focused outside of the NPD practitioner's scope of practice, role, and responsibility. If unexpected and non-recommended duties are identified, the workload data then guides discussions on responsibilities that may be delegated to other people. Two examples of work that has been successfully delegated to other persons in our organization include (a) clinical supervisors assuming responsibility for maintaining orientation calendars for new hires, and (b) education support staff/PDAs completing clerical responsibilities and leading the set-up and take-down of learning activities. Reviewing individual monthly workload data provides NPD division leaders with the opportunity to reset expectations on the primary responsibilities of NPD practitioners and to collaboratively brainstorm strategies to promote NPD practitioners working at the top of the scope.
Example #2 – Creating a Sustainable Education Plan
At our local site, we experienced an immediate need to clarify the range of function and to upskill unlicensed assistive personnel (UAPs). The UAP range of function was not utilized consistently, and variability of knowledge and skillset existed. This led to the ask for a large, centralized training initiative to level set expectations in the role and to provide an opportunity to relearn knowledge and skills. Historically, different models had been used to meet UAP education and training needs across the system. The decentralized and fragmented training created variability in skillsets of UAPs across different inpatient units, thus limiting the agility of UAPs to float between areas to meet patient care needs.
In quarter four of 2023, NPD division leaders assigned UAP training to our orientation team with the intent for the new training to be integrated into the orientation and onboarding of all new UAPs. To align with a recently implemented team-based model, the UAP training initiative was assigned to the orientation team without thoroughly evaluating the team’s capacity to assume the work; the decision was made based upon existing team responsibilities as opposed to workload data.
Once the initial training was complete, evaluation of the process change determined that (a) the orientation team did not have capacity to assume ongoing professional development for UAPs, (b) a dedicated NPD practitioner was needed to support UAP education, and (c) obtaining an additional NPD practitioner to support UAP education wasn’t feasible. This challenge prompted NPD leaders to review the workload data of individual NPD staff and teams of NPD staff to identify who or what team had capacity to assume oversight of the training. Average daily division productivity data at the time was already at 95.12% which is higher than the desired rate of 80%.
NPD leaders determined no single NPD staff member nor team had capacity to support ongoing UAP professional development. NPD leaders presented the problem, the workload
data, and potential solutions at a team meeting. Through problem-solving aided by workload data as evidence of individual and team capacity, NPD staff proposed a more collaborative approach to UAP professional development—a workgroup was created and teams supporting inpatient units were asked to identify a person (an NPD practitioner or education support staff/PDAs) to represent their team on the workgroup. One year later, the workgroup has educated, in classroom and experiential learning environments, more than 200 UAPs. Workgroup team members have remained consistent, education plans are in place for UAP new hire orientation and professional development in 2025, and the average daily division productivity data from quarter four of 2023 to quarter three of 2024 showed a minimal increase from 95.12% to 96.30%.
Example #3 – Balancing Work Effort Between Inpatient and Outpatient Areas
Clinical leaders in ambulatory areas expressed concerns that their NPD practitioners were dedicating more time to meeting inpatient staff education needs than outpatient staff education needs. NPD division leaders reviewed 12 months of workload data to validate the clinical leaders’ perceptions. Based upon the data, NPD practitioners were committing an average daily effort of 3.8 Full Time Employee (FTE; 1 FTE equals 40 hours per week) time to ambulatory areas based on staff volumes, which was 4.7 FTEs less than Harper et al.’s (2022) recommended NPD practitioner to staff ratio. This realization prompted a deeper dive into NPD practitioner roles and responsibilities and eventual development of a team-based model to redistribute work and decrease duplicative efforts between inpatient and outpatient areas. Additionally, the workload data guided discussions with ambulatory leaders about NPD practitioner work aligning with NPD scope and standards and the need to engage NPD leaders early in planning for growth of practice areas to ensure adequate education support. One year post implementation, the team-based model resulted in an average daily NPD practitioner FTE of 4.2 dedicated to ambulatory areas, which is an increase of 0.4 FTE or 16 hours per week of support in ambulatory areas.
Our Recommendations for Your Actions
NPD division leaders facing similar challenges, whether from a single site or a system, can begin gathering workload data by creating a shared web-based spreadsheet for staff to record daily workload effort in 15-minute increments. The spreadsheet could be structured with clinical area, department, division, or program names to identify the location of the work, the NPD Practice Model throughputs to categorize the work, and subcategories to describe the type of work such as designing education or clerical tasks. A shared web-based workbook promotes transparency in workload data amongst staff and assists NPD leaders in calculating and trending data for individual education staff members and education teams. Refer to Bauer et al. (2024) for additional details on how to create a tool for gathering NPD workload data, including tips on creating reference materials and strategies for implementation.
Additionally, restructuring your NPD division into teams may assist in managing workload challenges. NPD practitioners and education support staff could be organized based on the number of clinical areas and staff-supported, such as work in support of clinical areas and central programs and care across the continuum for inpatient and ambulatory areas. A team-based model assisted in identifying duplicative work efforts, improving satisfaction, and decreasing burnout in our NPD practitioners and education support staff.
Take the Next Steps
If you and your NPD team is challenged to function at the top of the scope of NPD practice, to meet ever-changing education needs, and manage workload across inpatient and outpatient areas, you may consider gathering workload data and restructuring your division. Workload data is one piece of information that guides decisions on the assignment and redistribution of work. When considered in conjunction with a team-based model, workload data has also assisted in making sure we have the right staff, doing the right work, at the right time, and in the right work environment which are all essential considerations for managing NPD staff (World Health Organization, 2023).
References
- Bauer, J. M., Pfeilsticker, A. J., Pearson, J. A., Loesche, A. H., Grimsley, A., Peterson, K. S., ... & Duprey, C. L. (2024). Quantifying and qualifying nursing professional development practitioner workload. Journal for Nurses in Professional Development, 40(1), E21-E26. https://doi.org/10.1097/NND.0000000000001004
- Dickson K. L., Cramer A. M., & Peckham C. M. (2010). Nursing workload measurement in ambulatory care. Nursing Economics, 28(1), 37– 43. https://pubmed.ncbi.nlm.nih.gov/20306877/
- Harper, M. G., & Maloney, P. (Eds.). (2022). Nursing professional development: Scope & standards of practice (4th ed.). Association for Nursing Professional Development.
- Harper M. G., Maloney P., Aucoin J., & MacDonald R. (2022). Findings from the 2021 organizational value of nursing professional development practice study. Part 1: Overview and descriptive data. Journal for Nurses in Professional Development, 38(5), 259–264. https://doi.org/10.1097/NND.0000000000000920
- World Health Organization. (2023). Workload indicators of staffing needs: User’s manual, second edition. Workload indicators of staffing need: user’s manual, Second edition - Google Play Books
- Zhao, M., Qiu, D., & Zeng, Y. (2023). How much workload is a ‘good’ workload for human beings to meet the deadline: human capacity zone and workload equilibrium. Journal of Engineering Design, 34(8), 644-673. https://doi.org/10.1080/09544828.2023.2249216
Disclaimer: The views and opinions expressed in this article are solely those of the contributor and do not necessarily reflect the official policy or position of ANPD.
Jennifer Berry, MSN, RN, CNRN
Manager of Nursing Professional Development, Mayo Clinic Arizona
Jennifer Berry, MSN, RN, CNRN, is a nurse manager in the Department of Nursing, Division of Nursing Professional Development at Mayo Clinic Arizona. Ms. Berry has over 30 years of nursing experience both in the United States and internationally. She spent 15 years as a nursing professional development practitioner supporting neurosciences and otorhinolaryngology. Ms. Berry has a passion for nursing professional development and has led several initiatives to advance the practice, including the development of a team-based model.

Katherine S. Peterson, PhD, MSN, RN, CNE
Assistant Professor of Nursing, Mayo Clinic College of Medicine
Dr. Peterson is an assistant professor of nursing at the Mayo Clinic College of Medicine. Dr. Peterson is committed to fostering academic-practice partnerships to build the workforce of the future and interprofessional education to ensure health professions students graduate collaborative practice ready.
Dr. Peterson has overseen an academic-practice partnership pre-licensure nursing program and student nurse transition to practice programs, co-led interprofessional education activities for nursing, medicine, and allied health learners across the pre- to post-professional continuum, and served as a nursing liaison to Mayo Clinic Alix School of Medicine in Arizona. In her tenure as manager of nursing academic affairs at Mayo Clinic Arizona, the Mayo Clinic/Arizona State University collaborative pre-licensure nursing program received an American Association of Colleges of Nursing’s Exemplary Academic-Practice Partnership Award.

Gina W. Sargent, DNP, RN, NPD-BC
Manager of Nursing Professional Development, May Clinic College of Medicine
Gina W. Sargent, DNP, RN, NPD-BC, is an instructor in nursing at the Mayo Clinic College of Medicine. Dr. Sargent is a board-certified leader in nursing professional development with nursing education experience spanning both academia and nursing practice over the last fourteen years. She currently is a manager of nursing professional development for Mayo Clinic Arizona and previously served as the director of education for a large hospital system in Tucson, Arizona.
Dr. Sargent has taught health care policy and nursing informatics for eight years to graduate students at Chamberlain University. Her doctoral work centered around novice nurse advocacy, and she has mentored many nurses seeking higher education and career growth. Dr. Sargent was nominated by her peers and selected as a Fabulous 50 nurse in 2019 by the Tucson Nurses Week Foundation. Dr. Sargent’s interests include promoting and expanding nursing professional development practice, nurse recognition, advocacy, mentorship, and driving nursing excellence.