Faculty

Amy Stimpfel headshot

Amy Stimpfel

Assistant Professor

1 212 992 9387

433 First Avenue
Room 658
New York, NY 10010
United States

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Professional overview

Amy Witkoski Stimpfel, PhD, RN joined the Rory Meyers College of Nursing as an assistant professor in 2013, following a T-32 post-doctoral fellowship in the Center for Health Outcomes and Policy Research at the University of Pennsylvania. Dr. Witkoski Stimpfel's research is focused on identifying modifiable conditions in nurses’ work environment that influence nurse well-being, such as occupational injuries and burnout, and clinical outcomes, such as quality of care and patient satisfaction. Her scholarship uses theories and methodologies from health services research, occupational health and safety, sleep/chronobiology, and nursing. Dr. Witkoski Stimpfel is currently the Co-Program Director of the NIOSH-funded doctoral training program in Occupational and Environmental Health Nursing.

Education

University of Pennsylvania, 2011, PhD
University of Pennsylvania, 2009, MS
Villanova University, 2006, BSN

Honors and awards

At-large member, Advisory Committee of the Interdisciplinary Research Group on Nursing Issues (IRGNI) (2017)
T32 Post-doctoral fellowship, National Institute of Nursing Research (2011)
T01 Pre-doctoral fellowship, National Institute for Occupational Safety and Health (2009)
Cum laude graduate, Villanova University (2006)
Inducted into Sigma Theta Tau International Honor Society (2005)
Connelly-Delouvrier Scholarship for International Nursing in Ireland (2005)

Specialties

Nursing workforce

Professional membership

AcademyHealth
American Nurses Association
American Organization of Nurse Executives
Eastern Nursing Research Society
Sigma Theta Tau International
Sleep Research Society

Publications

Publications

A comparison of scheduling, work hours, overtime, and work preferences across four cohorts of newly licensed Registered Nurses

Stimpfel, A., Fletcher, J., & Kovner, C. (2019). Journal of Advanced Nursing. 10.1111/jan.13972
Abstract
Aims: To conduct a comparative analysis of four cohorts of newly licensed Registered Nurses and their work schedule, daily shift length, weekly work hours, second job, and weekly overtime hours. Nurses also reported their preferences regarding work schedule and daily shift length. Design: We used a retrospective, comparative design analysing four cross-sectional surveys from new nurses first licensed between 2004–2015. Methods: Using state licensure lists, nurses who were first licensed between 1 August 2004 and 31 July 2005 were randomly sampled using a nested design in 23 geographical areas in 13 states and Washington, DC. The same sampling strategy was conducted for subsequent cohorts in January 2009, 2012, and 2016. We sent a mailed survey measuring demographics, education, work attributes, and attitudes to participants with a $5 incentive, following methods by Dillman. Results: There were no statistically significant differences in average weekly work hours (39.4 hrs) or holding more than one job for pay (11.6–14.6% across all cohorts). There were statistically significant differences in overtime across cohorts and shift length by unit type. The preferred shift length was 12 hrs and day shift was the preferred work schedule. Conclusion: New nurses are predominantly scheduled for 12-hrs shifts and nearly half work weekly overtime, trends that have remained relatively stable over the past 10 years. Nurse managers, policy-makers, and researchers should pay attention to new nurses’ schedule and shift preferences and guard against mandatory overtime hours.

Factors Predicting Adoption of the Nurses Improving Care of Healthsystem Elders Program

Stimpfel, A., & Gilmartin, M. (2019). Nursing Research, 68(1), 13-21. 10.1097/NNR.0000000000000327
Abstract
Background Registered nurses are often underprepared with the knowledge and skills to care for hospitalized older adult patients. One strategy to bridge this gap is for hospitals to adopt the Nurses Improving Care for Healthsystem Elders (NICHE) program: A nurse-led interdisciplinary organizational intervention to improve care of hospitalized older adults. Objectives This study aimed to identify the market, organizational and managerial, and sociotechnical factors associated with the adoption of NICHE among U.S. hospitals in order to understand factors that promote and inhibit the adoption of models to improve care for elders and to provide a basis for future studies that evaluate the effects of NICHE participation on patient outcomes. Methods We used an observational, retrospective design, linking three national administrative data sources, in a secondary analysis. Data included the 2012-2013 American Hospital Association Annual Survey, NICHE database, and the American Nurses Credentialing Center Magnet database. Multivariate logistic regression models were completed at the hospital level (n = 3,506). Results Statistically significant variables associated with hospital adoption of the NICHE program include using a medical home model, being in a network, having a pain services program, being in an urban location, and having over 100 beds. Discussion Understanding factors that promote the adoption of organizational interventions like NICHE holds promise for accelerating the use of evidence-based clinical practices to promote health, function, and well-being for older hospitalized adults. Our results provide a foundation for assessing the effects of NICHE participation on patient outcomes by identifying factors that account for membership in NICHE.

The association between nurse shift patterns and nurse-nurse and nurse-physician collaboration in acute care hospital units

Ma, C., & Stimpfel, A. (2018). Journal of Nursing Administration, 48(6), 335-341. 10.1097/NNA.0000000000000624
Abstract
OBJECTIVE The aim of this study was to examine the impact of nurse shift patterns on nurses' collaboration with nurses and physicians in US acute care hospital units. BACKGROUND Collaboration between nurses and other healthcare providers is critical for ensuring quality patient care. Nurses perform collaboration during their shift work; thus, nurse shift patterns may influence collaboration. However, there is a dearth of empirical evidence of the relationship between nurse shift patterns and collaboration of nurses with other healthcare providers. METHODS This is a cross-sectional study using data from 957 units in 168 acute care hospitals. Measures of collaboration include nurse-nurse collaboration and nurse-physician collaboration. Measures of shift patterns included shift length and overtime. Multilevel linear regressions were conducted at the unit level, controlling unit and hospital characteristics. RESULTS Overtime (more nurses working overtime or longer overtime hours) was associated with lower collaboration at the unit level; however, shift length was not. CONCLUSIONS Working overtime may negatively influence nurses' collaboration with other healthcare providers.

Bachelor's Degree Nurse Graduates Report Better Quality and Safety Educational Preparedness than Associate Degree Graduates

Djukic, M., Stimpfel, A., & Kovner, C. (2018). Joint Commission Journal on Quality and Patient Safety. 10.1016/j.jcjq.2018.08.008
Abstract
Background: Readiness of the nursing workforce in quality and safety competencies is an essential indicator of a health system's ability to deliver high-quality and safe health care. A previous study identified important quality and safety education gaps between associate- and baccalaureate-prepared new nurses who graduated between 2004 and 2005. The purpose of this study was to assess changes in nursing workforce quality and safety education preparedness by examining educational gaps between associate and bachelor's degree graduates in two additional cohorts of new nurses who graduated between 2007–2008 and 2014–2015. Methods: A cross-sectional, comparative design and chi-square tests were used to trend the quality and safety educational preparedness differences between associate and bachelor's degree nurse graduates from 13 states and the District of Columbia licensed in 2007–2008 (N = 324) and 2014–2015 (N = 803). Results: The number of quality and safety educational gaps between bachelor's and associate degree nurse graduates more than doubled over eight years. In the 2007–2008 cohort, RNs with a bachelor's degree reported being significantly better prepared than RNs with an associate degree in 5 of 16 topics. In the 2014–2015 cohort, bachelor's degree RNs reported being significantly better prepared than associate degree RNs in 12 of 16 topics. Conclusion: Improving accreditation and organizational policies requiring baccalaureate education for all nurses could close quality and safety education gaps to safeguard the quality of patient care.

Faculty and Student Perspectives on Mentorship in a Nursing Honors Program

Nelson, N., Lim, F., Navarra, A. M., Rodriguez, K., Witkoski, A., & Slater, L. Z. (2018). Nursing Education Perspectives, 39(1), 29-31. 10.1097/01.NEP.0000000000000197
Abstract
Honors programs in nursing can facilitate the professional development of high-achieving students, supporting their lifelong engagement in nursing practice, education, research, and health care policy issues. Strong mentoring relationships are commonly identified as essential to the success of nursing honors programs, but literature on mentoring relationships in an honors context is limited. The purpose of this study was to gain insight into faculty and student expectations for mentorship. Faculty and students shared similar expectations for both the mentor and mentee, highlighting key themes of engagement, facilitation, accountability, and collaboration as necessary for the success of an undergraduate nursing honors program.

The meaning of “capacity building” for the nurse workforce in sub-Saharan Africa: An integrative review

Ridge, L. J., Klar, R., Stimpfel, A., & Squires, A. (2018). International Journal of Nursing Studies, 86, 151-161. 10.1016/j.ijnurstu.2018.04.019
Abstract
Background: “Capacity building” is an international development strategy which receives billions of dollars of investment annually and is utilized by major development agencies globally. However, there is a lack of consensus around what “capacity building” or even “capacity” itself, means. Nurses are the frequent target of capacity building programming in sub-Saharan Africa as they provide the majority of healthcare in that region. Objectives: This study explored how “capacity” was conceptualized and operationalized by capacity building practitioners working in sub-Saharan Africa to develop its nursing workforce, and to assess Hilderband and Grindle's (1996) “Dimensions of Capacity” model was for fit with “capacity's” definition in the field. Design: An integrative review of the literature using systematic search criteria. Data sources searched included: PubMed, the Cumulative Index for Nursing and Allied Health Literature Plus, the Excerpt Medica Database, and Web of Science. Review methods: This review utilized conventional content analysis to assess how capacity building practitioners working in sub-Saharan Africa utilize the term “capacity” in the nursing context. Content analysis was conducted separately for how capacity building practitioners described “capacity” versus how their programs operationalized it. Identified themes were then assessed for fit with Hilderband and Grindle's (1996) “Dimensions of Capacity” model. Results: Analysis showed primary themes for conceptualization of capacity building of nurses by practitioners included: human resources for health, particularly pre- and post- nursing licensure training, and human (nursing) resource retention. Other themes included: management, health expenditure, and physical resources. There are several commonly used metrics for human resources for health, and a few for health expenditures, but none for management or physical resources. Overlapping themes of operationalization include: number of healthcare workers, post-licensure training, and physical resources. The Hilderband and Grindle (1996) model was a strong fit with how capacity is defined by practitioners working on nursing workforce issues in sub-Saharan Africa. If overall significant differences between conceptualization and operationalization emerged, as the reader I want to know what these differences were. Conclusions: This review indicates there is significant informal consensus on the definition of “capacity” and that the Hilderbrand and Grindle (1996) framework is a good representation of that consensus. This framework could be utilized by capacity building practitioners and researchers as those groups plan, execute, and evaluate nursing capacity building programming.

Beliefs and perceptions of mentorship among nursing faculty and traditional and accelerated undergraduate nursing students

Dunn-Navarra, A.-M., Stimpfel, A., Rodriguez, K., Lim, F., Nelson, N., & Slater, L. (2017). Nurse Education Today, 61, 20-24. 10.1016/j.nedt.2017.10.009
Abstract
Background In order to meet the demands of a dynamic and complex health care landscape, nursing education must develop and implement programming to produce a highly educated nursing workforce. Interprofessional honors education in nursing with targeted mentorship is one such model. Purpose To describe undergraduate nursing student and faculty perceptions and beliefs of mentorship in the context of interprofessional honors education, and compare and contrast the perceptions and beliefs about mentorship in interprofessional honors education between undergraduate nursing students and faculty. Methods The study used a cross-sectional, descriptive design. Data were collected at an urban university in the northeast US, using a researcher-developed electronic survey. The sample included 24 full-time nursing faculty, and 142 undergraduate nursing students. Results Perceptions and beliefs regarding mentorship in the context of interprofessional honors education were similar for faculty and students, with both ranking mentorship among the most important components of a successful honors program. Conclusions Honors education with a dedicated mentorship component may be implemented to improve the undergraduate education experience, facilitate advanced degree attainment, and develop future nursing leaders.

Common predictors of nurse-reported quality of care and patient safety

Stimpfel, A., Djukic, M., Brewer, C. S., & Kovner, C. (2017). Health Care Management Review. 10.1097/HMR.0000000000000155
Abstract
BACKGROUND:: In the era of the Patient Protection and Affordable Care Act, quality of care and patient safety in health care have never been more visible to patients or providers. Registered nurses (nurses) are key players not only in providing direct patient care but also in evaluating the quality and safety of care provided to patients and families. PURPOSE:: We had the opportunity to study a unique cohort of nurses to understand more about the common predictors of nurse-reported quality of care and patient safety across acute care settings. APPROACH:: We analyzed cross-sectional survey data that were collected in 2015 from 731 nurses, as part of a national 10-year panel study of nurses. Variables selected for inclusion in regression analyses were chosen based on the Systems Engineering Initiative for Patient Safety model, which is composed of work system or structure, process, and outcomes. RESULTS:: Our findings indicate that factors from three components of the Systems Engineering Initiative for Patient Safety model–Work System (person, environment, and organization) are predictive of quality of care and patient safety as reported by nurses. The main results from our multiple linear and logistic regression models suggest that significant predictors common to both quality and safety were job satisfaction and organizational constraints. In addition, unit type and procedural justice were associated with patient safety, whereas better nurse-physician relations were associated with quality of care. CONCLUSION:: Increasing nurses’ job satisfaction and reducing organizational constraints may be areas to focus on to improve quality of care and patient safety. PRACTICAL IMPLICATIONS:: Our results provide direction for hospitals and nurse managers as to how to allocate finite resources to achieve improvements in quality of care and patient safety alike.

Barriers and facilitators of nurses' use of clinical practice guidelines: An integrative review

Jun, J., Kovner, C., & Stimpfel, A. (2016). International Journal of Nursing Studies, 60, 54-68. 10.1016/j.ijnurstu.2016.03.006
Abstract
Background: Preventable harm continues to be one of the leading causes of patient death. Each year about 400,000 patients die from sepsis, hospital acquired infections, venous thromboembolism, and pulmonary embolism. However, as shown in the recent reduction in hospital acquired infections, the number of deaths could be reduced if healthcare providers used evidence-based therapies, which are often included in clinical practice guidelines (CPGs). Purpose: The purpose of this integrative review is to appraise and synthesize the current literature on barriers to and facilitators in the use of clinical practice guidelines (CPGs) by registered nurses. Design: Whittemore and Knafl integrative review methodology was used. Primary quantitative and qualitative studies about the nurses' use of CPGs and published in peer-reviewed journals between January 2000 and August 2015 were included. Methods: The Critical Skills Appraisal Program (CASP) was used to critically appraise the quality of sixteen selected quantitative and qualitative studies. Results: Internal factors were attitudes, perceptions, and knowledge whereas format and usability of CPGs, resources, leadership, and organizational culture were external factors influencing CPG use. Conclusion: Given each barrier and facilitator, interventions and policies can be designed to increase nurses' use of CPGs to deliver more evidence based therapy. In order to improve the use of CPGs and to ensure high quality care for all patients, nurses must actively participate in development, implementation, and maintenance of CPGs.

Changes in patient and nurse outcomes associated with magnet hospital recognition

Kutney-Lee, A., Stimpfel, A. W., Sloane, D. M., Cimiotti, J. P., Quinn, L. W., & Aiken, L. H. (2015). Medical Care, 53(6), 550-557. 10.1097/MLR.0000000000000355
Abstract
Background: Research has documented an association between Magnet hospitals and better outcomes for nurses and patients. However, little longitudinal evidence exists to support a causal link between Magnet recognition and outcomes. Objective: To compare changes over time in surgical patient outcomes, nurse-reported quality, and nurse outcomes in a sample of hospitals that attained Magnet recognition between 1999 and 2007 with hospitals that remained non-Magnet. Research Design: Retrospective, 2-stage panel design using 4 secondary data sources. Subjects: One hundred thirty-six Pennsylvania hospitals (11 emerging Magnets and 125 non-Magnets). Measures: American Nurses Credentialing Center Magnet recognition; risk-adjusted rates of surgical 30-day mortality and failure-to-rescue, nurse-reported quality measures, and nurse outcomes; the Practice Environment Scale of the Nursing Work Index. Methods: Fixed-effects difference models were used to compare changes in outcomes between emerging Magnet hospitals and hospitals that remained non-Magnet. Results: Emerging Magnet hospitals demonstrated markedly greater improvements in their work environments than other hospitals. On average, the changes in 30-day surgical mortality and failure-to-rescue rates over the study period were more pronounced in emerging Magnet hospitals than in non-Magnet hospitals, by 2.4 fewer deaths per 1000 patients (P<0.01) and 6.1 fewer deaths per 1000 patients (P=0.02), respectively. Similar differences in the changes for emerging Magnet hospitals and non-Magnet hospitals were observed in nurse-reported quality of care and nurse outcomes. Conclusions: In general, Magnet recognition is associated with significant improvements over time in the quality of the work environment, and in patient and nurse outcomes that exceed those of non-Magnet hospitals.