Sean P Clarke

Sean P Clarke
New York University | NYU · Rory Meyers College of Nursing

PhD

About

208
Publications
72,671
Reads
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18,693
Citations
Citations since 2016
46 Research Items
7465 Citations
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201620172018201920202021202202004006008001,0001,200
201620172018201920202021202202004006008001,0001,200
Additional affiliations
January 2019 - present
New York University
Position
  • Head of Faculty
July 2014 - December 2018
Boston College, USA
Position
  • Head of Faculty
July 2012 - June 2014
McGill University
Position
  • Professor, Susan E. French Chair, and Director, McGill Nursing Collaborative

Publications

Publications (208)
Article
Background Nurse practitioner (NP) education was originally reserved for experienced nurses, but it has gradually opened to nurses with little to no clinical experience at the registered nurse (RN) level as well as to non-nurses. The existence of multiple paths to NP training and practice raises questions about the role of generalist RN experience...
Article
Full-text available
Aims To explore nurses' experience and describe how they manage various contextual factors affecting the nurse-to-nurse handoff at change of shift. Design Qualitative descriptive study. Methods A convenience sample of 51 nurses from four medical and surgical care units at a university-affiliated hospital in Montreal, Canada, participated in one o...
Chapter
The nurse workforce—the nurses available to provide care to a group of patients or a population and the characteristics of these nurses—provides a critical context for the Quality Health Outcomes Model (QHOM). This chapter begins with a brief consideration of workforce issues within the QHOM. Two forces at the heart of workforce analysis (supply an...
Article
Background The U.S. health care system faces increasing pressures for reform. The importance of nurses in addressing health care delivery challenges cannot be overstated. Purpose To present a Nursing Health Services Research (NHSR) agenda for the 2020s. Method A meeting of an interdisciplinary group of 38 health services researchers to discuss fi...
Article
Aims and objectives To explore how change‐of‐shift handoffs relate to nurses’ clinical judgments regarding patient risk of deterioration. Background The transfer of responsibility for patients’ care comes with an exchange of information about their condition during change‐of‐shift handoff. However, it is unclear how this exchange affects nurses’ c...
Article
Background: Nurses begin forming judgments regarding patients' clinical stability during change-of-shift handoffs. Objectives: To examine the agreement between incoming and outgoing nurses' judgments of deterioration risk following handoff and compare these judgments to commonly used early warning scores (MEWS, NEWS, ViEWS). Methods: Following...
Article
Simulation followed by debriefing is increasingly common in clinical nursing education. Yet, limited studies have compared approaches to debriefing—the portion of simulations where participants re-examine and make sense of their experience. In this study, 120 baccalaureate nursing students in Quebec were randomized to receive one of two types of de...
Article
A new study questions the effect on patient outcomes but is narrow in scope.
Article
Full-text available
Background The portability and multiple functionalities of mobile devices make them well suited for collecting field data for naturalistic research, which is often beset with complexities in recruitment and logistics. This paper describes the implementation of a research protocol using mobile devices to study nurses’ exchanges of patient informatio...
Article
Full-text available
Aim To explore the impact of an initiative to add unregulated nursing support workers to wards in acute care hospitals. Background Adding nursing support workers to existing nurse staffing may be one solution to reduce nursing workloads and improve outcomes. However, the effects of this addition on nurse, patient, and system outcomes are not well...
Article
Objective: To examine differences in the quality of care provided by primary care nurse practitioners (PCNPs), primary care physicians (PCMDs), or both clinicians. Data sources: Medicare part A and part B claims during 2012-2013. Study design: Retrospective cohort design using standard risk-adjustment methodologies and propensity score weighti...
Chapter
Life in healthcare organizations mirrors conditions in society and the economy more broadly. Markets are constantly in transformation, and thus businesses are forced to develop appropriate organizational governance mechanisms, policies, and structures in addition to attracting talented, well-trained knowledge workers. The survival of organizations...
Chapter
The concepts at the heart of this book originated more than 35 years ago and stemmed from repeated observations of a single troublesome phenomenon: cyclical nurse shortages in hospitals. Inquiries to deal with nurse workforce problems occurred alongside growing research findings suggesting that clinical nurses and other professionals were at risk o...
Chapter
A 10-year research program systematically examined organizational features of nurses’ workplaces in relation to nurse and patient outcomes. Its major results have been published in peer-reviewed international journals and presented here with replicated analyses and largely new datasets. First, a set of measures of nurse practice environment feature...
Chapter
In this chapter, the intuitive link between balanced, healthy, and supportive psychosocial work environments and a variety of vitally important patient, nurse, and organizational outcomes is discussed with reference to a number of clearly defined and well-researched concepts. Among the essential concepts that ground the rest of the book is the noti...
Book
This book explores the various features of work environments that affect nurses' experiences of their work, their interactions with co-workers and patients, and ultimately health care quality and patient outcomes. Using a broad and comprehensive approach, the authors identify the most extensively researched and best-understood concepts in the field...
Article
Background: Improving patient safety within health care organizations requires effective leadership at all levels. Purpose: The objective of this study was to investigate the effects of nurse managers' transformational leadership behaviors on job satisfaction and patient safety outcomes. Methods: A random sample of acute care nurses in Ontario...
Article
Purpose: While professional nursing, like other health professions, has a recognized educational base and a legal scope of practice that is remarkably consistent across societies, there are important variations even within the same institution or organization in the extent to which professional nurses engage in the full range of activities for whi...
Article
Sharps injury rates are proportionally higher in perioperative areas than in other practice settings. The hands-free technique (HFT) has been shown to decrease the hazards of sharps injuries when passing sharps during surgery. We reviewed and synthesized research studies regarding compliance with the HFT and factors facilitating its use using a key...
Article
Context: State scope of practice (SoP) laws impose significant restrictions on the services that a nurse practitioner (NP) may provide in some states, yet evidence about SoP limitations on the quality of primary care is very limited. Method: This study uses six different classifications of state regulations and bivariate and multivariate analyse...
Article
Background Studies suggest nurse practitioners are heavily represented among primary care providers for vulnerable Medicare beneficiaries. Purpose To compare quality indicators among three groups of vulnerable beneficiaries managed by MDs and NPs. Methods Retrospective cohort design examining 2012 and 2013 Medicare claims for 3 beneficiary groups...
Article
Objective: To examine variation in the cesarean birth rates of women cared for by labor and delivery nurses. Design: Retrospective cohort study. Setting: One high-volume labor and delivery unit at an academic medical center in a major metropolitan area. Participants: Labor and delivery nurses who cared for nulliparous women who gave birth to...
Article
Full-text available
Background Evidence internationally suggests that staffing constraints and non-supportive work environments result in the rationing of nursing interventions (that is, limiting or omitting interventions for particular patients), which in turn may influence patient outcomes. In the neonatal intensive care unit (NICU), preliminary studies have found t...
Article
Objective: The aim of this study is to document the enacted (actual) scope of practice (SOP) of nurses in pediatric settings in relation to education level and position. Background: Baccalaureate-prepared staff nurses routinely carry out only a fraction of the activities essential for quality of care and patient safety they have been educated fo...
Article
Full-text available
Aim: To assess the impact of adding nursing support workers to ward staffing. Background: Nurses' capacity to provide safe care is compromised by increased workloads and nursing shortages. Use of unregulated workers is an alternative to increasing the number of regulated nurses. The impact of adding nursing support workers on patient, nurse and...
Article
Table 1. Attitudes and Perceptions: Remediation and Return to Safe Practice (N = 1,285 to 1,292)
Article
Background: Nurse practitioners (NPs), if utilized to their optimal potential, could play a key role in meeting the growing demand for primary care. Purpose: The purpose of this study was to propose a comprehensive model for maximizing NP contributions to primary care which includes the factors affecting NP care and patient outcomes and explains...
Article
This is the protocol for a review and there is no abstract. The objectives are as follows: To enhance and extend the recent Cochrane effectiveness review of protocolized weaning (Blackwood 2010) by synthesizing evidence from qualitative research to identify contextual factors that impact on the use of ventilator weaning protocols for critically ill...
Article
Enacted scope of practice is a major issue for nursing administrators, given the potentially negative effect on accessibility, continuity, safety and quality of care, job satisfaction, and organizational costs of nurses working at reduced scope. Optimal deployment of nurses to a fuller enacted scope of nursing practice holds much promise for addres...
Article
The purpose of this study was to calculate the event rate for inpatients in the radiology department (RD) developing instability leading to calls for medical emergency team (MET) assistance (MET-RD) compared with general ward (MET-W) patients. A retrospective comparison was done of MET-RD and MET-W calls in 2009 in a US tertiary hospital with a wel...
Article
Context:: In rural areas of Canada, people with acute coronary syndromes (ACS) can wait up to 32 hours for transfer for diagnostic cardiac catheterization (CATH). While awaiting CATH, it is critical that pain and anxiety management be optimal to preserve myocardial muscle and minimize the risk of further deterioration. Objectives:: The aim of th...
Article
Employers are essential partners with health professions regulators in ensuring public safety and are critical to the success of discipline monitoring programs. However, working with discipline orders and the regulatory process often causes confusion and stress for employers.This article reviews the perspectives of regulators and employers regardin...
Article
Background: Post-cardiac surgery surgical site infections (SSIs) pose devastating consequences in terms of morbidity and mortality to patients. Objective: To examine current risk factors and best practice perioperative care for prevention of SSI following cardiac surgery through the lens of the demographic/clinical characteristics of patients wh...
Article
Much has been written about interventions to improve the nursing work environment, yet little is known about their effectiveness. A Delphi survey of nurse experts was conducted to explore perceptions about workplace interventions in terms of feasibility and likelihood of positive impact on nurse outcomes such as job satisfaction and nurse retention...
Article
Background: Cardiac pain and/or discomfort arising from acute coronary syndromes (ACS) can often be severe and anxiety-provoking. Cardiac pain, a symptom of impaired myocardial perfusion, if left untreated, may lead to further myocardial hypoxia, which can potentiate myocardial damage. Evidence suggests that once ACS patients are stabilized, their...
Article
Organizational climate in healthcare settings influences patient outcomes, but its effect on nursing care delivery remains poorly understood. In this mixed-methods study, nurse surveys (N = 292) were combined with a qualitative case study of 15 direct-care registered nurses (RNs), nursing personnel, and managers. Organizational climate explained 11...
Article
The Patient Protection and Affordable Care Act (PPACA, 2010) and the Institute of Medicine's (IOM, 2011) Future of Nursing report have prompted changes in the U.S. health care system. This has also stimulated a new direction of thinking for the profession of nursing. New payment and priority structures, where value is placed ahead of volume in care...
Article
Rural patients can wait up to 32 hours for transfer to cardiac catheterization (CATH) for events related to acute coronary syndrome (ACS). Pain arising from myocardial ischemia can be severe and anxiety-provoking. Pain management during this time should be optimized in order to preserve vulnerable myocardial muscle. This qualitative focus group stu...
Article
Ensuring the safety of hospitalized patients remains a major challenge for healthcare systems, and nursing services are at the center of hospital care. Yet our knowledge about safety of nursing care is quite limited. In fact, most earlier studies examined one, or at most two, indicators, thus presenting an incomplete picture of safety at an institu...
Article
AIM: To explore the mechanisms through which nurse practice environment dimensions are associated with job outcomes and nurse-assessed quality of care. Mediating variables tested included nurse work characteristics of workload, social capital, decision latitude, as well as burnout dimensions of emotional exhaustion, depersonalization, and personal...
Article
At a time of profound challenges in health care delivery and professional education characterized by imperatives to improve quality, responsiveness to client needs and efficient use of existing resources, the relationship between nursing education and service is in deep need of reinforcement and rethinking. Important directions for the future inclu...
Article
Full-text available
Revisiting scope of practice (SOP) policies for nurse practitioners (NPs) is necessary in the evolving primary care environment with goals to provide timely access, improve quality, and contain cost. This study utilized qualitative descriptive design to investigate NP roles and responsibilities as primary care providers (PCPs) in Massachusetts and...
Article
Full-text available
Objective: To examine the associations of four distinct nursing care organizational models with patient safety outcomes. Design: Cross-sectional correlational study. Using a standardized protocol, patients' records were screened retrospectively to detect occurrences of patient safety-related events. Binary logistic regression was used to assess...
Article
To examine relationships between practice environment ratings, workload, work engagement, job outcomes and assessments of quality of care in nursing personnel in psychiatric hospitals. Cross-sectional survey. A broad base of research studies in health care reveals important links between work environment factors, staff burnout and organisational ou...
Article
Aim: To study the relationships between nurse practice environment, workload, burnout, job outcomes and nurse-reported quality of care in psychiatric hospital staff. Background: Nurses' practice environments in general hospitals have been extensively investigated. Potential variations across practice settings, for instance in psychiatric hospita...
Article
Research in healthcare settings reveals important links between work environment factors, burnout and organizational outcomes. Recently, research focuses on work engagement, the opposite (positive) pole from burnout. The current study investigated the relationship of nurse practice environment aspects and work engagement (vigour, dedication and abs...
Article
Full-text available
Over the last decades, converging forces in hospital care, including cost-containment policies, rising healthcare demands and nursing shortages, have driven the search for new operational models of nursing care delivery that maximize the use of available nursing resources while ensuring safe, high-quality care. Little is known, however, about the d...
Article
Aims and objectives: To investigate the circumstances of nursing care eight hours before serious adverse events (=SAE's) on medical and surgical nursing units with subsequent in-hospital mortality in order to identify the extent to which these SAE's were potentially preventable. Background: The prevention of SAE 's in acute care is coming under...
Article
Aim: To investigate impacts of practice environment factors, nurse perceptions of workload and self-reported burnout at the unit-level on job outcomes and nurse-assessed quality of care in psychiatric hospitals. Background: Associations between practice environments and nurse and patient outcomes have been widely described in acute care hospital...
Article
: This project describes the development and testing of the actual scope of nursing practice questionnaire. : Underutilization of the skill sets of registered nurses (RNs) is a widespread concern. Cost-effective, safe, and efficient care requires support by management to facilitate the implementation of nursing practice at the full scope. : Literat...
Article
To explore the relationship between inpatient mortality and implicit rationing of nursing care, the quality of nurse work environments and the patient-to-nurse staffing ratio in Swiss acute care hospitals. Cross-sectional correlational design. Eight Swiss acute care hospitals examined in a survey-based study and 71 comparison institutions. A total...
Article
Full-text available
We sought to identify the characteristics of patients who experience medical emergency team calls in the radiology department (MET-RD) and the relationship between these characteristics and patient outcomes. Retrospective review of 111 inpatient MET-RD calls (May 2008-April 2010). Academic medical centre with a well established MET system. The char...
Article
Commentary on: Needleman J, Buerhaus P, Pankratz VS, et al. Nurse staffing and inpatient hospital mortality. N Engl J Med 2011;364:1037–45[OpenUrl][1][CrossRef][2][PubMed][3][Web of Science][4]. [1]: {openurl}?query=rft.jtitle%253DNew%2BEngland%2BJournal%2Bof%2BMedicine%26rft.stitle%253DNEJM%26rft.issn%253D0028-4793%26rft.aulast%253DNeedleman%26rf...
Article
To examine attitudes towards research and perceived barriers and facilitators of research utilisation in clinical practice in a broad cross-section of Spanish nurses. Nurses' attitudes towards research are critical in determining whether study findings are used to improve practice. Cross-sectional comparative survey in Hospitals, Primary Care Centr...