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The number of registered nurses in Pima County exceeds the national average, but there is still a critical shortage here that could affect the quality of health care in years to come, an Arizona Hospital and Healthcare Association study finds.

Statewide, with a population that's growing older and an increasing number of registered nurses reaching retirement age, Arizona will need about 49,000 new registered nurses by 2017, that study says.

The study was conducted by HealthWorks, the recently formed research arm of the Arizona Hospital and Healthcare Association, in response to national studies that showed Arizona lagged behind the national average in nurse population.

Health care officials confirmed the study's conclusion that Pima County is facing a severe nursing crunch despite having a higher than average number of nurses.

Many registered nurses in Pima County work in nursing homes, for private practices or other places outside of hospitals, said Richard Polheber, the chief executive officer of Carondelet Holy Cross Hospital in Nogales.

Most hospitals use traveling nurses to fill open positions, said Canda Byrne, president of the Tucson chapter of the Arizona Nurses Association. That means the hospital has to deal with the added cost of paying a company that moves nurses to Pima County from out of state and finds housing for them, she said.

"I'm not saying Pima County has a poor quality of health care," Byrne said. "But it's more difficult for nurses to give the quality of health care they want to provide."

Arizona has 681 registered nurses per 100,000 population, which compares with a national average of 825 registered nurses per 100,000 population, according to a national study conducted in 2004.

Here is the breakdown of why, according to the study, Arizona needs 49,000 new nurses in the next nine years.

● Arizona will need an additional 20,000 registered nurses to keep pace with population growth and close the gap between the state and national average.

● More than a third of Arizona's current registered nurses are older than 55 and about 10,000 registered nurses will be needed to replace them as they retire.

● About 3.5 percent of registered nurses leave the profession in Arizona each year, and 19,000 registered nurses will be needed to fill the void.