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Our Publications

Recent Publications (2018-2019)

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

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

Patient satisfaction with hospital care and nursing in England: An observational study. Aiken LH, Sloane DM, Ball J, Bruyneel L, Rafferty AM, Griffiths P.  BMJ Open 

The objective of the study is to inform healthcare workforce policy decisions by showing the association between  patient perceptions of hospital care and confidence in nurses and doctors, nurse staffing levels, and hospital work environments. (In the top 5% of all research outputs scored by Altmetric). Download

Hospital nurse staffing and patient outcomes. Aiken LH, Cerón C, Simonetti M, Lake ET, Galiano A, et al. Revista Médica Clínica las Condes Mayo 

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

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

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

Rural and non-rural primary care physician practices increasingly rely on nurse practitioners. Barnes H, Richards MR, Martsolf G, McHugh MD. Health Affairs 

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. Health Affairs reports the paper is on the “2018 Top 10 Most Shared”  list. Download 

Association of nurse engagement with patient safety. Brooks Carthon J, Hatfield L, Plover C, Dierkes A, Davis L, Hedgeland T, Sanders A, Visco F, et al. Journal of Nursing Care Quality. 

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

Electronic Health Record Adoption and Nurse Reports of Usability and Quality of Care: The Role of Work Environment. Kutney-Lee, A, Sloane, DM, Bowles, KH, Burns, LR. Aiken, LH. 2019. Applied Clinical Informatics

We examined relationships between electronic health record (EHR) adoption levels in hospitals, the quality of the work environment, nurses’ reports of EHR usability and quality of care. Download

The Association of the Nurse Work Environment and Patient Safety in Pediatric Acute Care.  Lake ET, Roberts KE, Agosto PD, Ely E, Bettencourt A, et al. Journal of Patient Safety 

Improving clinical work environments in hospitals holds promise for achieving a culture of patient safety that increases the reliability of care and prevents harm “ Download

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

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

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

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

CHOPR Authors are credited with writing some of the most highly cited scientific papers’ on hospital organization, nurse workforce and patient outcomes.

Medical Care

Winner of American Academy of Nursing Media Award. 

Lower Medicare mortality among a set of hospitals known for good nursing care.

Authors: Aiken LH, Smith HL, Lake ET.


Health Affairs

The 29 Most Influential Papers Published in Health Affairs in the first 25 Years and Winner of the American Academy of Nursing Media Award

Nurses’ reports on hospital care in five countries.

Authors: Aiken, LH, Clarke, S, Sloane, DM, Sochalski, J, et. al.


Top 5 Most Influential Research Articles of the Year, Robert Wood Johnson Foundation.  

Nurses’ widespread job dissatisfaction, burnout and frustration with health benefits signal problems for patient care.

Authors: McHugh, MD, Kutney-Lee, A,, Cimiotti, J, Sloane, DM, Aiken, LH. 


One of the Most Read Papers of the Year in Health Affairs

An increase in the number of nurses with Baccalaureate degrees is linked to lower rates of postsurgery mortality.

Authors: Kutney-Lee, A, Sloane, DM, Aiken, LH


Top 10 Most Read Papers of the Year in Health Affairs

Hospitals with higher nurse staffing had lower odds of readmissions penalties than hospitals with lower staffing

Authors: McHugh, MD, Berez, J, Small, D.


The Lancet

Scored in the top 5% of all research outputs by Altmetrics. 

Nurse Staffing and Education and Hospital Mortality in Nine European Countries 

Authors: Aiken LH, Sloane DM, Bruyneel L, et al.


Journal of the American Medical Association

Winner of the John P. McGovern Award from the American Association of Colleges of Nursing

Educational levels of hospital nurses and surgical patient mortality

Authors: Aiken, LH, Clarke, SP, Cheung, RB, Sloane, RB, Silber, JH


Winner of the AcademyHealth Article of the Year Award in Health Services Research and the American Academy of Nursing Media Award

Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction.

Authors: Aiken, LH, Clarke, SP, Sloane, DM, et al. 


Research in Nursing and Health

Top 10 Most Downloaded Research Papers

Magnet® hospital recognition linked to lower central line-associated bloodstream infection rates.

Authors: Barnes H, Rearden J, McHugh MD.


Nurse reported quality of care: a measure of hospital quality.

Authors: McHugh MD, Stimpfel AW.


Patient falls: association with hospital magnet status and nursing unit staffing.

Authors: Lake ETShang JKlaus SDunton NE.