Amy Witkoski Stimpfel

Faculty

Amy Witkoski Stimpfel Headshot

Amy Witkoski Stimpfel

Assistant Professor

1 212 992 9387

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

Accepting PhD students

Amy Witkoski Stimpfel's additional information

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

Prior to joining the Meyers faculty, Witkoski Stimpfel completed a post-doctoral fellowship at the University of Pennsylvania in the Center for Health Outcomes and Policy Research.

Witkoski Stimpfel earned a PhD and MS at the University of Pennsylvania and a BSN from Villanova University.

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

Nursing workforce
Health Services Research

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

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

How clinicians manage routinely low supplies of personal protective equipment

Ridge, L. J., Stimpfel, A. W., Dickson, V. V., Klar, R. T., & Squires, A. P. (2021). American Journal of Infection Control, 49(12), 1488-1492. 10.1016/j.ajic.2021.08.012
Abstract
Abstract
Background: Recommended personal protective equipment (PPE) is routinely limited or unavailable in low-income countries, but there is limited research as to how clinicians adapt to that scarcity, despite the implications for patients and workers. Methods: This is a qualitative secondary analysis of case study data collected in Liberia in 2019. Data from the parent study were included in this analysis if it addressed availability and use of PPE in the clinical setting. Conventional content analysis was used on data including: field notes documenting nurse practice, semi-structured interview transcripts, and photographs. Results: Data from the majority of participants (32/37) and all facilities (12/12) in the parent studies were included. Eighty-three percent of facilities reported limited PPE. Five management strategies for coping with limited PPE supplies were observed, reported, or both: rationing PPE, self-purchasing PPE, asking patients to purchase PPE, substituting PPE, and working without PPE. Approaches to rationing PPE included using PPE only for symptomatic patients or not performing physical exams. Substitutions for PPE were based on supply availability. Conclusions: Strategies developed by clinicians to manage low PPE likely have negative consequences for both workers and patients; further research into the topic is important, as is better PPE provision in low-income countries.

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.

Telemedicine and Telehealth in Nursing Homes: An Integrative Review

Groom, L. L., McCarthy, M. M., Stimpfel, A. W., & Brody, A. A. (2021). Journal of the American Medical Directors Association, 22(9), 1784-1801.e7. 10.1016/j.jamda.2021.02.037
Abstract
Abstract
Objectives: Telemedicine and telehealth are increasingly used in nursing homes (NHs). Their use was accelerated further by the COVID-19 pandemic, but their impact on patients and outcomes has not been adequately investigated. These technologies offer promising avenues to detect clinical deterioration early, increasing clinician's ability to treat patients in place. A review of literature was executed to further explore the modalities' ability to maximize access to specialty care, modernize care models, and improve patient outcomes. Design: Whittemore and Knafl's integrative review methodology was used to analyze quantitative and qualitative studies. Setting and Participants: Primary research conducted in NH settings or focused on NH residents was included. Participants included clinicians, NH residents, subacute patients, and families. Methods: PubMed, Web of Science, CINAHL, Embase, PsycNET, and JSTOR were searched, yielding 16 studies exploring telemedicine and telehealth in NH settings between 2014 and 2020. Results: Measurable impacts such as reduced emergency and hospital admissions, financial savings, reduced physical restraints, and improved vital signs were found along with process improvements, such as expedient access to specialists. Clinician, resident, and family perspectives were also discovered to be roundly positive. Studies showed wide methodologic heterogeneity and low generalizability owing to small sample sizes and incomplete study designs. Conclusions and Implications: Preliminary evidence was found to support geriatrician, psychiatric, and palliative care consults through telemedicine. Financial and clinical incentives such as Medicare savings and reduced admissions to hospitals were also supported. NHs are met with increased challenges as a result of the COVID-19 pandemic, which telemedicine and telehealth may help to mitigate. Additional research is needed to explore resident and family opinions of telemedicine and telehealth use in nursing homes, as well as remote monitoring costs and workflow changes incurred with its use.

Variables Associated With Nurse-Reported Quality Improvement Participation

Djukic, M., Fletcher, J., Witkoski Stimpfel, A., & Kovner, C. (2021). Nurse Leader, 19(1), 76-81. 10.1016/j.mnl.2020.06.009
Abstract
Abstract
Lack of staff engagement in quality improvement (QI) is a persistent challenge in improving quality in health care. In this study, we examined variables associated with nurse-reported participation in QI using data from over 500 registered nurses employed in US hospitals. Of the 16 studied variables, based on the adjusted multivariate regression analysis, the following were positively associated (p < 0.05) with nurse-reported participation in QI: working in advanced practice nursing and manager roles versus staff nurse role, working a full-time work schedule versus a part-time work schedule, and reporting higher levels of procedural justice, quantitative workload, and work motivation.

Does unit culture matter? The association between unit culture and the use of evidence-based practice among hospital nurses

Jun, J., Kovner, C. T., Dickson, V. V., Stimpfel, A. W., & Rosenfeld, P. (2020). Applied Nursing Research, 53. 10.1016/j.apnr.2020.151251

Early Career Nurse Reports of Work-Related Substance Use

Stimpfel, A. W., Liang, E., & Goldsamt, L. A. (2020). Journal of Nursing Regulation, 11(1), 29-35. 10.1016/S2155-8256(20)30058-2
Abstract
Abstract
Introduction: Substance use disorder (SUD) is a public health crisis in the United States that occurs across many population segments, including nurses. Aim: The aim of this study was to explore the culture of substance use among nurses in their first 5 years of practice. Methods: Qualitative descriptive design using virtual focus groups in an online platform was used. Data were collected from February to March 2019 with a total of 23 participants. An open-ended focus group guide was used based on the Work, Stress, and Health Model. Results: Three major themes were identified: “See No Evil, Speak No Evil, Hear No Evil”; “It's Somewhere Out There”; and “Caffeine is King and Alcohol is Queen.” Participants reported high caffeine use and moderate alcohol use to cope with shift work and work stress. There was general acceptance of marijuana use in states that legalized it. Participants were reluctance to fully describe illicit substance use on a personal or unit-level basis; however, substance use was identified as a profession-wide problem for nurses. Conclusions: The early career nurses enrolled in this study reported that they relied on caffeine, alcohol, and other substances before, during, and after their workday. These types of substances are readily reported and deemed acceptable by their peers. New nurses could benefit from coping strategies that do not include substance use to manage work stress and professional challenges, such as shift work.

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
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
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
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.