Faculty

Amy Stimpfel headshot

Amy Witkoski Stimpfel

Assistant Professor

1 212 992 9387

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

Accepting PhD students

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Professional overview

Amy Witkoski Stimpfel is the deputy director of the NIOSH-funded T-42 doctoral training program in occupational and environmental health nursing and an assistant professor at NYU Rory Meyers College of Nursing. Her research explores how to optimize nurses' work environment to improve nurse well-being, such as burnout and clinical outcomes, occupational health and safety, sleep-chronobiology, and nursing. Her research has been funded by the National Council of State Boards of Nursing, the American Nurses Foundation, and others, and has been published in leading health policy and nursing journals, such as Health Affairs, Health Services Research, and The International Journal of Nursing Studies. 

Witkoski Stimpfel earned her PhD and MS at the University of Pennsylvania and BSN from Villanova University. She completed a post-doctoral fellowship at the University of Pennsylvania in the Center for Health Outcomes and Policy Research. 

Education

PhD - University of Pennsylvania (2011)
MS - University of Pennsylvania (2009)
BSN - Villanova University (Cum Laude, 2006)

Specialties

Nursing workforce

Professional membership

AcademyHealth
American Association of Occupational Health Nurses
American Nurses Association
Eastern Nursing Research Society
Sigma Theta Tau International
Sleep Research Society

Honors and awards

Faculty Honors Awards

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

Publications

Publications

Organization of Work Factors Associated with Work Ability among Aging Nurses

Stimpfel, A. W., Arabadjian, M., Liang, E., Sheikhzadeh, A., Weiner, S. S., & Dickson, V. V. (2020). Western Journal of Nursing Research, 42(6), 397-404. 10.1177/0193945919866218
Abstract
The United States (U.S.) workforce is aging. There is a paucity of literature exploring aging nurses’ work ability. This study explored the work-related barriers and facilitators influencing work ability in older nurses. We conducted a qualitative descriptive study of aging nurses working in direct patient care (N = 17). Participants completed phone or in-person semi-structured interviews. We used a content analysis approach to analyzing the data. The overarching theme influencing the work ability of aging nurses was intrinsically motivated. This was tied to the desire to remain connected with patients at bedside. We identified factors at the individual, unit-based work level and the organizational level associated with work ability. Individual factors that were protective included teamwork, and feeling healthy and capable of doing their job. Unit-based level work factors included having a schedule that accommodated work-life balance, and one’s chronotype promoted work ability. Organizational factors included management that valued worker’s voice supported work ability.

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

Djukic, M., Stimpfel, A. W., & Kovner, C. (2019). Joint Commission Journal on Quality and Patient Safety, 45(3), 180-186. 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.

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

Stimpfel, A. W., Djukic, M., Brewer, C. S., & Kovner, C. T. (2019). Health Care Management Review, 44(1), 57-66. 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.

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

Stimpfel, A. W., & Gilmartin, M. J. (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.

Home health care services to persons with dementia and language preference

Ma, C., Herrmann, L., Miner, S., Stimpfel, A. W., & Squires, A. (2019). Geriatric Nursing. 10.1016/j.gerinurse.2019.08.016
Abstract
Despite the rapid increase in the number of persons with dementia (PWD) receiving home health care (HHC), little is known of HHC services patterns to PWD of varied backgrounds, including language preference other than English. Analyzing data of 12,043 PWD from an urban home health agency, we found on average PWD received 2.48 skilled visits or 1.88-hour skilled care and 5.81 aide visits or 24.13-hour aide care weekly. Approximately 63% of the skilled visits were from nurses. More non-English preferred PWD received aide visits, compared to English preferred PWD (44% vs. 36%). The type and intensity of HHC services were associated with language preference; when stratified by insurance, non-English preference was still significantly associated with more HHC aide care. Our study indicated that HHC services (both type and amount) varied by language preference and insurance type as an indicator of access disparities was a significant contributor to the observed differences.

How language barriers influence provider workload for home health care professionals: A secondary analysis of interview data

Squires, A., Miner, S., Liang, E., Lor, M., Ma, C., & Witkoski Stimpfel, A. (2019). International Journal of Nursing Studies, 99. 10.1016/j.ijnurstu.2019.103394
Abstract
BackgroundIncreasingly, patients with limited English proficiency are accessing home health care services in the United States. Few studies have examined how language barriers influence provider role implementation or workload in the home health care setting.ObjectivesTo explore home health care professionals’ perspectives about how workload changes from managing language barriers influence quality and safety in home health care.DesignA qualitative secondary data analysis using a summative content analysis approach was used to analyze existing semi-structured interview data.SettingA large urban home health care agency located on the East Coast of the United States.ParticipantsThirty five home health care providers [31 registered nurses, 3 physical therapists, 1 occupational therapist].ResultsA total of 142 discrete incidents emerged from the analysis. Overall, home health care providers experienced distinct shifts in how they implemented their roles that added to their workload and time spent with Limited English Proficiency patients and family members. Providers were concerned about interpretation accuracy and perceived it as potentially posing risks to patient safety. Changes in work patterns, therefore, sought to maximize patient safety.ConclusionsHome health care providers decision-making about how they adapt practice when faced with a language barrier is a sequence of actions based on awareness of the patient’s language preference and if they spoke another language. Subsequent choices showed proactive behaviors to manage increased workload shaped by their perceived risk of the threats posed by the quality of interpreter services. Future research should develop quantitative models examining differences in workload when caring for limited English proficiency versus English speaking patients as well as the relationship between visit length and patient outcomes to determine optimal quality models.

The Interdisciplinary Research Group on Nursing Issues: Advancing Health Services Research, Policy, Regulation, and Practice

Squires, A., Germack, H., Muench, U., Stolldorf, D., Witkoski-Stimpfel, A., Yakusheva, O., Brom, H., Harrison, J., Patel, E., Riman, K., & Martsolf, G. (2019). Journal of Nursing Regulation, 10(2), 55-59. 10.1016/S2155-8256(19)30116-4

Nurses' sleep, work hours, and patient care quality, and safety

Stimpfel, A. W., Fatehi, F., & Kovner, C. (2019). Sleep Health. 10.1016/j.sleh.2019.11.001
Abstract
OBJECTIVES: To describe sleep duration and work characteristics among registered nurses ("nurses") across health care settings and unit types and determine the association between sleep duration and quality of care and patient safety.DESIGN: We used an observational, retrospective design. Survey data were collected from two cohorts of nurses in 2015 and 2016.SETTING: Health care and community settings across the United States, primarily acute care hospitals.PARTICIPANTS: Nurses working in a staff or general duty position (N=1,568).MEASUREMENTS: The independent variable was nurses' sleep duration before work and nonwork days. The two dependent variables were nurse reported quality of care (single item rating) and overall patient safety, measured by the Agency for Healthcare Research and Quality (AHRQ) Hospital Survey on Patient Safety Culture.RESULTS: Nurses reported an average of 414 minutes, or just less than 7 hours, of sleep before a work day and 497 minutes, or just over 8 hours, before a nonwork day. Short sleep duration was statistically significantly associated with lower ratings of quality of care (p=.002) and patient safety (p=.000).CONCLUSIONS: Nurses are sleeping, on average, less than recommended amounts before work, which may be impacting their health and performance on the job. Health care managers may consider interventions to support nurses' sleep to improve patient care. Further research is warranted.

The Occupational Health of Nurses in the Economic Community of West African States: A Review of the Literature

Ridge, L. J., Dickson, V. V., & Stimpfel, A. W. (2019). Workplace Health and Safety, 67(11), 554-564. 10.1177/2165079919859383
Abstract
Nurses provide the majority of health care in sub-Saharan Africa, which has high rates of Hepatitis B Virus (HBV) and human immunodeficiency virus (HIV). This systematic review used PRISMA methodology to synthesize the literature published between January 2008 and December 2018 examining the occupational health of nurses practicing in the Economic Community of West African States (ECOWAS). The United States’ National Institute for Occupational Safety and Health’s Hierarchy of Controls is used to frame the findings. This research was mostly conducted in Nigeria and Ghana and focused on administrative controls. Nurses practicing in ECOWAS are at high risk of acquiring a bloodborne illness due to inadequate engineering and administrative controls, as well as limited access to personal protective equipment (PPE). These findings indicate interventions to improve these controls would likely lower the occupational risks faced by nurses practicing in ECOWAS. Research in more countries in ECOWAS would likely find differences in occupational health practices in Nigeria and Ghana, which are relatively wealthy, and other countries in the region. This literature showed nurses practicing in ECOWAS did not have adequate protection from biological hazards. Regional health groups, such as the West African Health Organization, should commit to improving occupational health practice. Needle recapping and double gloving must be discontinued, and PPE must be made more widely available in ECOWAS. Occupational health professionals in the region should advocate for better distribution of PPE and consider offering trainings on these behaviors.

比较四组队列新注册护士的日程安排、工作时间、加班和工作偏好

Stimpfel, A. W., Fletcher, J., & Kovner, C. T. (2019). Journal of Advanced Nursing, 75(9), 1902-1910. 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.