Allison P Squires

Faculty

Prof. Allison P Squires headshot

Allison P Squires

FAAN PhD RN

Professor

1 212 992 7074

433 First Ave
New York, NY 10010
United States

Accepting PhD students

Allison P Squires, Ph.D., FAAN, RN, is a professor and the Director of the Global Consortium of Nursing and Midwifery Studies, or GCNMS. The GCNMS is an 82-country research consortium collaborating on research capacity-building projects in nursing and midwifery globally. The consortium's current research study is examining the long-term effects of the COVID-19 pandemic on the nursing and midwifery workforces globally to understand how to improve global pandemic response implementation protocols for the largest frontline workforce cadre. Domestically, her research focuses on improving immigrant and refugee health outcomes with a special interest in addressing inequities in health outcomes resulting from language discordance during a healthcare encounter. For both, she is an expert in contextual considerations of global health care services implementation.

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 200 publications, including 140+ in peer-reviewed journals. She serves as an associate editor of the top-ranked International Journal of Nursing Studies since 2012. She was the 2019–2020 Distinguished Nurse Scholar in Residence for the National Academy of Medicine where she worked on the consensus study "Future of Nursing 2020–2030: Charting a Path to Achieve Equity". In 2023, she received the Outstanding Mentor Award from the Interdisciplinary Research Group on Nursing Issues interest group of Academy Health.

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 U.S. healthcare system. Her practice has since shifted largely to community-based nursing roles as a volunteer.

Prof. Squires received her Ph.D. at Yale University, MSN at Duquesne University, and BSN with a minor in Latin American Studies 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 Rory Meyers College of Nursing at NYU, she holds affiliated faculty appointments/affiliations with the Department of General Internal Medicine at the Grossman School of Medicine, the Center for Latin American Studies, and the Center for Drug Use and HIV Research.

She is currently accepting Ph.D. 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 Pennsylvania
PhD - Yale University
MSN - Duquesne University
BSN - University of Pennsylvania

Global
Immigrants
Gerontology
Health Services Research

Academy Health
American Nurses Association
Consortium of Universities for Global Health
Interdisciplinary Research Group on Nursing Issues (Academy Health)
National Council for Interpreting in Health Care
Sigma Theta Tau International

Chair of the Nursing Section of the New York Academy of Medicine (2022)
Co-Chair, American Academy of Nursing's Global Health Expert Panel (2021)
Chair of the Nursing Section of the New York Academy of Medicine (2021)
Vice-Chair, Global Health and Health Care Interest Group for Academy Health (2020)
Co-Chair, American Academy of Nursing's Global Health Expert Panel (2020)
Chair, Interdisciplinary Research Group on Nursing Issues for Academy Health (2020)
Chair of the Nursing Section of the New York Academy of Medicine (2020)
Distinguished Nurse Scholar in Residence, National Academy of Medicine (2020)
Vice-Chair, Global Health and Health Care Interest Group for Academy Health (2019)
Co-Chair, American Academy of Nursing's Global Health Expert Panel (2019)
Chair, Interdisciplinary Research Group on Nursing Issues for Academy Health (2019)
Chair of the Nursing Section of the New York Academy of Medicine (2019)
Distinguished Nurse Scholar in Residence, National Academy of Medicine (2019)
Chair, Global Health and Health Care Interest Group for Academy Health (2019)
Outstanding Scholarly Contribution to Gerontological Nursing Practice, International Journal for Older People Nursing (2018)
Chair of the Nursing Section of the New York Academy of Medicine (2018)
Chair, Global Health and Health Care Interest Group for Academy Health (2018)
Prose Award, “A New Era in Global Health” (W. Rosa, Ed.) (2018)
Vice Chair, Interdisciplinary Research Group on Nursing Issues for Academy Health (2018)
Fellow Ambassador to the Media, New York Academy of Medicine (2017)
Distinguished Alumna, Duquesne University (2015)
Fellow, American Academy of Nursing (2015)
Fellow, New York Academy of Medicine (2014)
Fellow, Yale World Fellows Program (2003)

Infection Prevention and Control in Liberia 5 Years After Ebola: A Case Study

Ridge, L. J., Stimpfel, A. W., Klar, R. T., Dickson, V. V., & Squires, A. P. (2021). Workplace Health and Safety, 69(6), 242-251. 10.1177/2165079921998076
Abstract
Abstract
Background: Effective management of health emergencies is an important strategy to improve health worldwide. One way to manage health emergencies is to build and sustain national capacities. The Ebola epidemic of 2014 to 2015 resulted in greater infection prevention and control (IPC) capacity in Liberia, but few studies have investigated if and how that capacity was sustained. The purpose of this study was to examine the maintenance of IPC capacity in Liberia after Ebola. Methods: For this case study, data were collected via direct observation of nurse practice, semistructured interviews, and document collection. Data were collected in two counties in Liberia. Data were analyzed using directed content and general thematic analysis using codes generated from the safety capital theoretical framework, which describes an organization’s intangible occupational health resources. Findings: Thirty-seven nurses from 12 facilities participated. Ebola was a seminal event in the development of safety capital in Liberia, particularly regarding nurse knowledge of IPC and facilities’ investments in safety. The safety capital developed during Ebola is still being applied at the individual and organizational levels. Tangible resources, including personal protective equipment, however, have been depleted. Conclusions/Application to Practice: IPC capacity in Liberia had been sustained since Ebola but was threatened by under-investments in physical resources. Donor countries should prioritize sustained support, both financial and technical, in partnership with Liberian leaders. Occupational health nurses participating in disaster response should advocate for long-term investment by donor countries in personal protective equipment, access to water, and clinician training.

Kairos care in a Chronos world: Midwifery care as model of resistance and accountability in public health settings

Niles, P. M., Vedam, S., Witkoski Stimpfel, A., & Squires, A. (2021). Birth, 48(4), 480-492. 10.1111/birt.12565
Abstract
Abstract
Background: In the United States (US), pregnancy-related mortality is 2–4 times higher for Black and Indigenous women irrespective of income and education. The integration of midwifery as a fundamental component of standard maternity services has been shown to improve health outcomes and service user satisfaction, including among underserved and minoritized groups. Nonetheless, there remains limited uptake of this model in the United States. In this study, we examine a series of interdependent factors that shape how midwifery care operates in historically disenfranchised communities within the Unites States. Methods: Using data collected from in-depth, semi-structured interviews, the purpose of this study was to examine the ways midwives recount, describe, and understand the relationships that drive their work in a publicly funded urban health care setting serving minoritized communities. Using a qualitative exploratory research design, guided by critical feminist theory, twenty full-scope midwives working in a large public health care network participated. Data were thematically analyzed using Braun & Clarke's inductive thematic analysis to interpret data and inductively identify patterns in participants’ experiences. Findings: The overarching theme “Kairos care in a Chronos World” captures the process of providing health-promoting, individualized care in a system that centers measurement, efficiency, and pathology. Five subthemes support the central theme: (1) the politics of progress, (2) normalizing pathologies, (3) cherished connections, (4) protecting the experience, and (5) caring for the social body. Midwives used relationships to sustain their unique care model, despite the conflicting demands of dominant (and dominating) medical models. Conclusion: This study offers important insight into how midwives use a Kairos approach to maternity care to enhance quality and safety. In order to realize equitable access to optimal outcomes, health systems seeking to provide robust services to historically disenfranchised communities should consider integration of relationship-based strategies, including midwifery care.

Language barriers between nurses and patients: A scoping review

Gerchow, L., Burka, L. R., Miner, S., & Squires, A. (2021). Patient Education and Counseling, 104(3), 534-553. 10.1016/j.pec.2020.09.017
Abstract
Abstract
Objective: Global migration and linguistic diversity are at record highs, making healthcare language barriers more prevalent. Nurses, often the first contact with patients in the healthcare system, can improve outcomes including safety and satisfaction through how they manage language barriers. This review aimed to explore how research has examined the nursing workforce with respect to language barriers. Methods: A systematic scoping review of the literature was conducted using four databases. An iterative coding approach was used for data analysis. Study quality was appraised using the CASP checklists. Results: 48 studies representing 16 countries were included. Diverse healthcare settings were represented, with the inpatient setting most commonly studied. The majority of studies were qualitative. Coding produced 4 themes: (1) Interpreter Use/Misuse, (2) Barriers to and Facilitators of Quality Care, (3) Cultural Competence, and (4) Interventions. Conclusion: Generally, nurses noted like experiences and applied similar strategies regardless of setting, country, or language. Language barriers complicated care delivery while increasing stress and workload. Practice Implications: This review identified gaps which future research can investigate to better support nurses working through language barriers. Similarly, healthcare and government leaders have opportunities to enact policies which address bilingual proficiency, workload, and interpreter use.

Leading Policy and Practice Change During Unprecedented Times: The Nursing Health Services Research Response

Germack, H., Cary, M., Gilmartin, H., Girouard, S., Jones, T. M., Martin, B. J., Norful, A. A., Anusiewicz, C. V., Riman, K. A., Schlak, A. E., Squires, A., Estrada, L. V., Gazarian, P., Gerchow, L., Ghazal, L. V., Henderson, M. D., Mitha, S., Mpundu, G., Nikpour, J., … Stolldorf, D. P. (2021). Journal of Nursing Regulation, 12(2), 56-60. 10.1016/S2155-8256(21)00057-0

Learning the language of health equity

Squires, A., & Thompson, R. (2021). Research in Nursing and Health, 44(6), 869-871. 10.1002/nur.22192

Nurses and physicians attitudes towards factors related to hospitalized patient safety

Malinowska-Lipień, I., Micek, A., Gabrys, T., Kózka, M., Gajda, K., Gniadek, A., Brzostek, T., & Squires, A. (2021). PloS One, 16(12). 10.1371/journal.pone.0260926
Abstract
Abstract
Introduction The attitudes of healthcare staff towards patients' safety, including awareness of the risk for adverse events, are significant elements of an organization's safety culture. Aim of research To evaluate nurses and physicians' attitudes towards factors influencing hospitalized patient safety. Materials and methods The research included 606 nurses and 527 physicians employed in surgical and medical wards in 21 Polish hospitals around the country. The Polish adaptation of the Safety Attitudes Questionnaire (SAQ) was used to evaluate the factors influencing attitudes towards patient safety. Results Both nurses and physicians scored highest in stress recognition (SR) (71.6 and 80.86), while they evaluated working conditions (WC) the lowest (45.82 and 52,09). Nurses achieved statistically significantly lower scores compared to physicians in every aspect of the safety attitudes evaluation (p<0.05). The staff working in surgical wards obtained higher scores within stress recognition (SR) compared to the staff working in medical wards (78.12 vs. 73.72; p = 0.001). Overall, positive working conditions and effective teamwork can contribute to improving employees' attitudes towards patient safety. Conclusions The results help identify unit level vulnerabilities associated with staff attitudes toward patient safety. They underscore the importance of management strategies that account for staff coping with occupational stressors to improve patient safety.

Peer-Assisted Lifestyle (PAL) intervention: a protocol of a cluster-randomised controlled trial of a health-coaching intervention delivered by veteran peers to improve obesity treatment in primary care

Wittleder, S., Smith, S., Wang, B., Beasley, J. M., Orstad, S. L., Sweat, V., Squires, A., Wong, L., Fang, Y., Doebrich, P., Gutnick, D., Tenner, C., Sherman, S. E., & Jay, M. (2021). BMJ Open, 11(2), e043013. 10.1136/bmjopen-2020-043013
Abstract
Abstract
INTRODUCTION: Among US veterans, more than 78% have a body mass index (BMI) in the overweight (≥25 kg/m2) or obese range (≥30 kg/m2). Clinical guidelines recommend multicomponent lifestyle programmes to promote modest, clinically significant body mass (BM) loss. Primary care providers (PCPs) often lack time to counsel and refer patients to intensive programmes (≥6 sessions over 3 months). Using peer coaches to deliver obesity counselling in primary care may increase patient motivation, promote behavioural change and address the specific needs of veterans. We describe the rationale and design of a cluster-randomised controlled trial to test the efficacy of the Peer-Assisted Lifestyle (PAL) intervention compared with enhanced usual care (EUC) to improve BM loss, clinical and behavioural outcomes (aim 1); identify BM-loss predictors (aim 2); and increase PCP counselling (aim 3).METHODS AND ANALYSIS: We are recruiting 461 veterans aged 18-69 years with obesity or overweight with an obesity-associated condition under the care of a PCP at the Brooklyn campus of the Veterans Affairs NY Harbor Healthcare System. To deliver counselling, PAL uses in-person and telephone-based peer support, a tablet-delivered goal-setting tool and PCP training. Patients in the EUC arm receive non-tailored healthy living handouts. In-person data collection occurs at baseline, month 6 and month 12 for patients in both arms. Repeated measures modelling based on mixed models will compare mean BM loss (primary outcome) between study arms.ETHICS AND DISSEMINATION: The protocol has been approved by the Institutional Review Board and the Research and Development Committee at the VA NY Harbor Health Systems (#01607). We will disseminate the results via peer-reviewed publications, conference presentations and meetings with stakeholders.TRIAL REGISTRATION NUMBER: NCT03163264; Pre-results.

A Scoping Review of the Evidence about the Nurses Improving Care for Healthsystem Elders (NICHE) Program

Squires, A., Murali, K. P., Greenberg, S. A., Herrmann, L. L., & D’Amico, C. O. (2021). Gerontologist, 61(3), E75-E84. 10.1093/geront/gnz150
Abstract
Abstract
Background and Objectives: The Nurses Improving Care for Healthsystem Elders (NICHE) is a nurse-led education and consultation program designed to help health care organizations improve the quality of care for older adults. To conduct a scoping review of the evidence associated with the NICHE program to (a) understand how it influences patient outcomes through specialized care of the older adult and (b) provide an overview of implementation of the NICHE program across organizations as well as its impact on nursing professionals and the work environment. Research Design and Methods: Six databases were searched to identify NICHE-related articles between January 1992 and April 2019. After critical appraisal, 43 articles were included. Results: Four thematic categories were identified including specialized older adult care, geriatric resource nurse (GRN) model, work environment, and NICHE program adoption and refinement. Specialized older adult care, a key feature of NICHE programs, resulted in improved quality of care, patient safety, lower complications, and decreased length of stay. The GRN model emphasizes specialized geriatric care education and consultation. Improvements in the geriatric nurse work environment as measured by perceptions of the practice environment, quality of care, and aging-sensitive care delivery have been reported. NICHE program adoption and refinement focuses on the methods used to improve care, implementation and adoption of the NICHE program, and measuring its impact. Discussion and Implications: The evidence about the NICHE program in caring for older adults is promising but more studies examining patient outcomes and the impact on health care professionals are needed.

Addressing burnout syndrome from a critical care specialty organization perspective

Cochran, K. L., Doo, K., Squires, A., Shah, T., Rinne, S., & Mealer, M. (2020). AACN Advanced Critical Care, 31(2), 158-166. 10.4037/aacnacc2020579
Abstract
Abstract
Background: 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, Uganda

Green, A. S., Lynch, H. M., Nanyonga, R. C., Squires, A. P., Gadikota-Klumpers, D. D., Schwartz, J. I., & Heller, D. J. (2020). Annals of Global Health, 86(1). 10.5334/aogh.2513
Abstract
Abstract
Background: 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.