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Our Publications

Recent Publications (2018-2019)

Aiken LH, Sloane DM, Barnes H, Cimiotti J. 2018. Nurses’ and patients’ appraisals show patient safety in hospitals remains a concern. Health Affairs 37(11). 

We studied 535 hospitals in four large states at two points in time between 2005 and 2016 to determine the extent to which their work environments improved, and whether positive changes were associated with greater progress in patient safety. Download

Aiken LH, Sloane DM, Ball J, Bruyneel L, Rafferty AM, Griffiths P.  2018.  Patient satisfaction with hospital care and nursing in England: An observational study. BMJ Open (In the top 5% of all research outputs scored by Altmetric).

The objective of the study is to inform healthcare workforce policy decisions by showing how patient perceptions of hospital care are associated with confidence in nurses and doctors, nurse staffing levels and hospital work environments. Download

Aiken LH, Cerón C, Simonetti M, Lake ET, Galiano A, Garbarini A, Soto P, Bravo D, Smith, HL. 2018. Hospital nurse staffing and patient outcomes. Revista Médica Clínica las Condes Mayo 2018 Vol. 29(3): 322-327.

A program of international research by the Center for Health Outcomes and Policy Research at the University of Pennsylvania, USA, was undertaken to determine whether variation in hospital registered nurse (RN) staffing across hospitals contributed to poor patient outcomes. Download


Aiken LH, Dahlerbruch J, Todd B, Bai G. 2018. The Graduate Nurse Education Demonstration: Implications for Medicare policy. New England Journal of Medicine 378:2360-2363.

CHOPR researchers call for modernizing the way Medicare pays for training nurses, and highlight a successful new model of cost-effectively training more advanced practice nurses to practice community-based primary care. Download

Barnes H, Richards MR, Martsolf G, & McHugh MD. 2018. Rural and non-rural primary care physician practices increasingly rely on nurse practitioners. Health Affairs 37(6):908-914. (Health Affairs reports the paper is on the “2018 Top 10 Most Shared”  list)

Little is known about trends in NP presence in primary care practices, or about how state policies such as scope-of-practice laws and expansion of eligibility for Medicaid may encourage or inhibit the use of NPs. We found increasing NP presence in both rural and nonrural primary care practices in the period 2008–16. Download 

Brooks Carthon J, Hatfield L, Plover C, Dierkes A, Davis L, Hedgeland T, Sanders A, Visco F, Holland S, Ballinghoff J, Del Guidice M, Aiken LH.  2018. Association of nurse engagement with patient safety. Journal of Nursing Care Quality. DOI:10.1097/NGO.0000000000000334.

Our study examined the relationship between the level of engagement, staffing, and assessments of patient safety among nurses working in hospital settings and found that interventions to improve nurse engagement and adequate staffing serve as strategies to improve patient safety. Download

Lasater K, McHugh MD, Sloane DM, Aiken LH.  2018. Quality of end of life care and its association with nurse practice environments in US hospitals.  JAGS Journal of American Geriatric Society.  DOI: 10.111/jgs.15671.

Most nurses gave their hospitals an unfavorable evaluation of end‐of‐life care overall (58%) and said patients often experience painful procedures that were unlikely to change their outcome (53%). Download

Sloane DM, Smith HL, McHugh MD, Aiken LH.  2018. Effect of changes in hospital nursing resources on improvements in patient safety and quality of care: A panel study.  Medical Care. 56:1001-1008. 

Changes within hospitals in nursing resources were associated with significant changes in quality of care and patient safety. Improvements in work environment of 1 SD decrease odds of unfavorable quality care and patient safety by factors ranging from 0.82 to 0.97. Download

Awards and Honors

Our faculty, fellows and colleagues have written some of the most highly cited and downloaded papers on hospital organization, nurse workforce and patient outcomes.