Allison P Squires, PhD, FAAN, RN, is an associate professor and director of the Florence S. Downs PhD Program in Nursing Research & Theory Development at NYU Rory Meyers College of Nursing. She was the 2019–2020 Distinguished Nurse Scholar in Residence for the National Academy of Medicine where she worked on the consensus study for the next Future of Nursing 2020–2030 report. An internationally recognized health services researcher, Prof. Squires has led or participated in studies covering 38 countries, with current active projects Mexico, Ghana, and the European Union. She is also leading the international arm of a COVID-19 study that examines how the global pandemic has affected clinical nursing practice on the frontlines. Domestically, her research focuses on improving immigrant and refugee health outcomes with a special interest in breaking down language barriers during the healthcare encounter.
Prof. Squires has consulted with the Migration Policy Institute and the World Bank on nursing and health workforce issues and produced several major policy analyses with their teams. A prolific writer, Squires has authored over 150 publications, including 100+ in peer-reviewed journals. She serves as an associate editor of the International Journal of Nursing Studies (the top- ranked nursing journal in the world), the research editor for the Journal of Nursing Regulation, and an Associate Editor for BMC Health Services Research.
Prior to entering academia full time, Squires worked as a staff nurse in solid organ transplant and as a staff educator for 11 years in the US healthcare system.
Prof. Squires completed her PhD at Yale University, MSN at Duquesne University, and BSN at the University of Pennsylvania. She completed a Post-Doctoral Fellowship in Health Outcomes Research at the University of Pennsylvania. In addition to her primary appointment at the College of Nursing, she holds affiliated faculty appointments with the Grossman School of Medicine, Center for Latin American Studies, and the Center for Drug Use and HIV Research at NYU.
She is currently accepting PhD students and/or post-doctoral fellows/associates with interests in the following areas: 1) global health, 2) migration & immigrant health, and 3) health services and workforce research.
Post-Doctoral Fellowship - University of PennsylvaniaPhD - Yale UniversityMSN - Duquesne UniversityBSN - University of Pennsylvania
Academy HealthAmerican Nurses AssociationConsortium of Universities for Global HealthInterdisciplinary Research Group on Nursing Issues (Academy Health)National Council for Interpreting in Health CareSigma Theta Tau International
Honors and awards
Faculty Honors AwardsChair, New York Academy of Medicine (2021)Co-Chair, American Academy of Nursing's Global Health Expert Panel (2021)Co-Chair, American Academy of Nursing's Global Health Expert Panel (2020)Chair, Interdisciplinary Research Group on Nursing Issues for Academy Health (2020)Distinguished Nurse Scholar in Residence, National Academy of Medicine (2020)Vice-Chair, Global Health and Health Care Interest Group for Academy Health (2020)Chair, New York Academy of Medicine (2020)Vice-Chair, Global Health and Health Care Interest Group for Academy Health (2019)Chair, New York Academy of Medicine (2019)Co-Chair, American Academy of Nursing's Global Health Expert Panel (2019)Chair, Interdisciplinary Research Group on Nursing Issues for Academy Health (2019)Distinguished Nurse Scholar in Residence, National Academy of Medicine (2019)Chair, Global Health and Health Care Interest Group for Academy Health (2019)Prose Award, “A New Era in Global Health” (W. Rosa, Ed.) (2018)Vice Chair, Interdisciplinary Research Group on Nursing Issues for Academy Health (2018)Outstanding Scholarly Contribution to Gerontological Nursing Practice, International Journal for Older People Nursing (2018)Chair, Global Health and Health Care Interest Group for Academy Health (2018)Fellow Ambassador to the Media, New York Academy of Medicine (2017)Fellow, American Academy of Nursing (2015)Distinguished Alumna, Duquesne University (2015)Fellow, New York Academy of Medicine (2014)Fellow, Yale World Fellows Program (2003)
Addressing burnout syndrome from a critical care specialty organization perspectiveAbstractBackground: Health care specialty organizations are an important resource for their membership; however, it is not clear how specialty societies should approach combating stress and burnout on an organizational scale. Objective:To understand the prevalence of burnout syndrome in AmericanThoracic Society members, identify specialty-specific risk factors, and generate strategies for health care societies to combat burnout. Methods: Cross-sectional, mixed-methods survey in a sample of 2018 AmericanThoracic Society International Conference attendees to assess levels of burnout syndrome, work satisfaction, and stress. Results: Of the 130 respondents, 69% reported high stress, 38% met burnout criteria, and 20% confirmed chaotic work environments. Significant associations included sex and stress level; clinical time and at-home electronic health record work; and US practice and at-home electronic health record work. There were no significant associations between burnout syndrome and the selected demographics. Participants indicated patient care as the most meaningful aspect of work, whereas the highest contributors to burnout were workload and electronic health record documentation. Importantly, most respondents were unaware of available resources for burnout. Conclusions: Health care specialty societies have access to each level of the health system, creating an opportunity to monitor trends, disseminate resources, and influence the direction of efforts to reduce workplace stress and enhance clinician well-being.
Assessing providers’ approach to hypertension management at a large, private hospital in Kampala, UgandaAbstractBackground: Hypertension is increasingly prevalent in Uganda and its clinical management remains subop-timal across the country. Prior research has elucidated some of the factors contributing to poor control, but little is known about providers’ approaches to hypertension management and perceptions of barriers to care. This is particularly true in private health care settings – despite the fact that the private sector provides a substantial and growing portion of health care in Uganda. Objective: Our exploratory, pragmatic qualitative study aimed to examine the factors affecting the quality of hypertension care from the perspective of providers working in an urban, private hospital in Uganda. We focused on the organizational and system-level factors influencing providers’ approaches to management in the outpatient setting. Methods: We conducted interviews with 19 health care providers working in the outpatient setting of a 110-bed, private urban hospital in Kampala, Uganda. We then coded the interviews for thematic analysis, using an inductive approach to generate the study’s findings. Findings: Several themes emerged around perceived barriers and facilitators to care. Providers cited patient beliefs and behaviors, driven in part by cultural norms, as key challenges to hypertension control; however, most felt their own approach to hypertension treatment aligned with international guidelines. Providers struggled to collaborate with colleagues in coordinating the joint management of patients. Furthermore, they cited the high cost and limited availability of medication as barriers. Conclusions: These findings offer important strategic direction for intervention development specific to this Ugandan context: for example, regarding culturally-adapted patient education initiatives, or programs to improve access to essential medications. Other settings facing similar challenges scaling up management of hypertension may find the results useful for informing intervention development as well.
Factors Associated with Timely Initiation and Intensity of Home Health Care Following Hospital DischargeMa, C., & Squires, A. (2020). Nursing Research.
Graduate level health professions education: how do previous work experiences influence perspectives about interprofessional collaboration?AbstractUnderstanding how previous experiences with interprofessional education and collaboration inform health care provider perspectives is important for developing interprofessional interventions at the graduate level. The purpose of this study was to examine how previous work experiences of graduate level health professions students inform perspectives about interprofessional education and collaboration. Drawing from program evaluation data of two separate graduate level interprofessional education interventions based in primary care and home health care, we conducted a qualitative secondary data analysis of 75 interviews generated by focus groups and individual interviews with graduate students from 4 health professions cadres. Using directed content analysis, the team coded to capture descriptions of interprofessional education or collaboration generated from participants’ previous work experiences. Coding revealed 173 discrete descriptions related to previous experiences of interprofessional education or collaboration. Three themes were identified from the analysis that informed participant perspectives: Previous educational experiences (including work-based training); previous work experiences; and organizational factors and interprofessional collaboration. Experiences varied little between professions except when aspects of professional training created unique circumstances. The study reveals important differences between graduate and undergraduate learners in health professions programs that can inform interprofessional education and collaboration intervention design.
Health Equity Research in Nursing and Midwifery: Time to Expand Our WorkStolldorf, D., Germack, H. D., Harrison, J., Riman, K., Brom, H., Cary, M., Gilmartin, H., Jones, T., Norful, A., & Squires, A. (2020). Journal of Nursing Regulation, 11(2), 51-61. 10.1016/S2155-8256(20)30110-1
Regulación de la enfermería en México: actores, procesos y resultadosAbstractThis paper aims to analyze the regulatory structure of nursing in Mexico through its legislation and perspectives of participant stakeholders. A case study was undertaken using qualitative and quantitative data sources, as well as from the review of official documents. The analysis included data from the sources according to the four realms proposed by the Moran & Wood (1993) model. The more advanced realm was the market entry since the state regulates entry through a license of practice. The regulation of competition is weak, showing very reduced areas of autonomous practice. The labor market is offering a wide variety of entry options with clear signs of deterioration. The dominant payment mechanism is salary, showing a structure that incorporates a component that does not impact on pensions at the end of the labor cycle. The regulation of nursing is a component of its professionalization, and as such, it is understood as a multidimensional consolidating process, particularly realms related to the regulation of competition, market structure, and payment mechanisms, in which nursing representatives should play a more active role in the future.
Unit Utilization of Internationally Educated Nurses and Collaboration in U.S. Hospitals.AbstractMa, C., Ghazal, L., Chou, S., Ea, E., & Squires, A. (2020). Nursing Economic$, 38(1), 33-40.Employing internationally educated nurses (IENs) to address the nursing workforce shortage is common in many countries, including the United States. This study examined the relationship between unit utilization of IENs and collaboration in U.S. hospitals. Results indicated more IENs on a unit did not significantly affect the collaboration among nurses and between nurses and physicians. The presence of IENs significantly influenced unit nursing characteristics, such as education attainment and unit tenure.
Assessing geriatric capacity building needs in public hospitals in MexicoAbstractAims: To conduct a needs assessment of public hospitals in Mexico to determine workforce specific capacity building needs in the care of older people. Background: The older population in Mexico is growing rapidly. The healthcare system and workforce may not be prepared to handle the needs of older people, especially those with chronic illnesses who are also disadvantaged socioeconomically. Determining workforce and system needs is important to strategically develop capacity. Methods: A needs assessment using a pragmatic qualitative approach structured this study. Semi-structured interviews and focus groups were conducted with healthcare professionals at five public hospitals in Mexico. Directed content analysis techniques analysed the data. Results: Ninety-two healthcare professionals participated in the study. Three themes emerged, including geriatric service delivery, social changes and human resources for health. Participants reported a lack of gerontology knowledge and related clinical skills deficits to provide care for hospitalised elders and expressed emotional distress related to the lack of resources in their institutions. All healthcare professionals expressed strong concern at the social toll the ageing population had on families. The support of government organisations emerged as a facilitator for adoption of geriatric care principles. Conclusions: This qualitative study uncovered important data to inform the implementation of quality improvement and capacity building models for older people care in Mexico. There appears to be strong potential for a culturally appropriate translation of high-income country older people care models within the Mexican healthcare context. Implications for practice: Findings suggests there is a need to increase geriatric capacity building among helathcare professionals in Mexico. This will be an important step in improving care for hospitalised older people.
Content Validation of the Arabic Translation of the Practice Environment Scale of the Nursing Work Index-RevisedAbstractBackground and Purpose: There is no reliable and valid version of the Practice Environment Scale of the Nursing Work Index-Revised (PES-NWI-R) in Arabic. The purpose of this study was to describe the systematic instrument translation and validation of the PES-NWI-R. Methods: Using the Content Validity Indexing-based approach, 32 expert nurses from four countries in the Eastern Mediterranean Region (Jordan, Oman, Saudi Arabia, and United Arab Emirates) participated in the validation of this translation. Results: The content validity index score of the overall scale was excellent (0.87 for the relevancy, and 0.95 for the quality of Arabic translation). Conclusion: Our study supported the content validity of the Arabic version of the instrument which provided the first valid Arabic translation of the instrument.
Detecting Disparities in Medication Management Among Limited English Proficient and English Proficient Home Health PatientsAbstractAccording to the U.S. census Bureau, close to 20% of the U.S. population speaks a language other than English at home. Home health care (HHC) patients who speak English less than very well or have limited English proficiency (LEP) are at an increased risk for medication mismanagement and serious health consequences. The purpose of this study was to examine if there were differences in medication management between English-speaking patients and patients with LEP receiving HHC services. Data for this cross-sectional observation study were collected from 2010 to 2014. Medication management was measured by two items in the Centers for Medicare and Medicaid Services–mandated Outcomes Assessment Information Set (OASIS). All patients in the database who were taking medications and had a valid admission and discharge assessment from HHC were included in the analysis. Inverse probability of treatment weighting (IPTW) with a marginal structural model was used to address potential imbalances in observed patient characteristics when estimating the effect of having LEP or being an English-speaking HHC patient on changes in medication management over the course of a HHC episode. Estimates from marginal structural model with inverse probability weighting indicate that being LEP was associated with less improvement in medication management and increased likelihood of getting worse over the course of a HHC episode. This study is one of the first to demonstrate that patients with LEP experience disparities in medication management when compared to English-speaking patients in HHC.