Audrey Lyndon

Faculty

Audrey Lyndon Headshot

Audrey Lyndon

FAAN PhD RNC

Executive Vice Dean
Vernice D. Ferguson Professor in Health Equity

1 212 922 5940

433 First Ave
New York, NY 10010
United States

Accepting PhD students

Dr. Lyndon is the Vernice D. Ferguson Professor in Health Equity and Executive Vice Dean at NYU Rory Meyers College of Nursing. Her equity work is focused in two areas: maternal health equity and diversifying the nursing science and healthcare workforce. Dr. Lyndon’s maternal health work has focused on patient safety and quality in maternity and neonatal care, including improving communication and teamwork among clinicians; identifying parents’ perspectives on safety during labor, birth, and neonatal care; developing nurse-sensitive outcomes for labor and birth; and research on severe maternal morbidity and maternal mortality. Her team has conducted groundbreaking research on differences in clinicians’ and parents’ perspective on speaking up about safety concerns and developing an understanding of how women and parents conceptualize safety during childbirth and neonatal intensive care. Dr. Lyndon co-chaired the development of the CMQCC Obstetric Hemorrhage Toolkit, which became a national and international model for maternal safety bundles and collaborative quality improvement. Dr. Lyndon recently completed a study funded by the Agency for Healthcare Research and Quality examining relationships between nursing care during labor and patient outcomes. She is currently focused on understanding the experiences of Black and Latinx survivors of severe maternal morbidity to better identify their support needs, research priorities, and community-driven prevention targets for severe maternal morbidity. Dr. Lyndon’s work on diversifying the nursing science and healthcare workforce includes mentoring and sponsorship of historically excluded clinicians and scientists and efforts to build effective pathways programs for historically excluded individuals into nursing, nursing science, and clinical specialties.

PhD - University of California, San Francisco
MS - University of California, San Francisco
BA - University of California, Santa Cruz

Women's health
Health Services Research

American Academy of Nursing
American College of Obstetricians and Gynecologists (ACOG), Educational Affiliate
American Nurses Association
Association of Women’s Health Obstetric and Neonatal Nurses
International Family Nursing Association

Reviewer of the Year, Journal of Obstetric, Gynecologic, and Neonatal Nursing (2017)
Irving Harris Visiting Professor, University of Illinois, Chicago College of Nursing (2015)
Distinguished Professional Service Award, Association of Women's Health, Obstetric and Neonatal Nurses (2013)
Fellow, American Academy of Nursing (2012)
Award of Excellence in Research, Association of Women's Health, Obstetric and Neonatal Nurses (2011)

Perinatal safety: From concept to nursing practice

Lyndon, A., & Kennedy, H. P. (2010). Journal of Perinatal and Neonatal Nursing, 24(1), 22-31. 10.1097/JPN.0b013e3181cb9351
Abstract
Abstract
Communication and teamwork problems are leading causes of documented preventable adverse outcomes in perinatal care. An essential component of perinatal safety is the organizational culture in which clinicians work. Clinicians' individual and collective authority to question the plan of care and take action to change the direction of a clinical situation in the patient's best interest can be viewed as their "agency for safety." However, collective agency for safety and commitment to support nurses in their role of advocacy is missing in many perinatal care settings. This article draws from Organizational Accident Theory, High Reliability Theory, and Symbolic Interactionism to describe the nurse's role in maintaining safety during labor and birth in acute care settings and suggests actions for supporting the perinatal nurse at individual, group, and systems levels to achieve maximum safety in perinatal care.

The safest care possible for childbearing women and their infants.

Lyndon, A., Simpson, K. R., & Bakewell-Sachs, S. (2010). The Journal of Perinatal & Neonatal Nursing, 24(1), 1.

Skilful anticipation: Maternity nurses' perspectives on maintaining safety

Lyndon, A. (2010). Quality and Safety in Health Care, 19(5). 10.1136/qshc.2007.024547
Abstract
Abstract
Objective To describe maternity nurses' perspectives on how they contribute to safety during labour and birth at two urban academic medical centres in the United States. Design Grounded theory: data were collected using semistructured, open-ended interviews and participant observations with registered nurses (RNs) in two inpatient maternity settings. Data were analysed simultaneously using constant comparison, and dimensional and situational analysis. Participants Purposive sample of 12 RNs working in the two maternity units. Findings Safety was broadly conceptualised by RNs as protecting the physical, psychological and emotional wellbeing of a woman and her family. During labour and birth, safety was maintained by RNs through "skilful anticipation" of situational potential. This required integration of medical and technical knowledge and skill with intimate knowledge of the woman and the operational context of care to achieve accurate situation awareness and appropriate future planning. Conditions and processes promoting skilful anticipation included being prepared, knowing, and envisioning the whole picture. Conclusions In the two settings, maternity RNs made active contributions to safe birth in the context of constrained resources through preparing the environment, anticipating potential problems and trapping errors before they reached the patient. The contributions of maternity nurses to team situation awareness and to creating safety need to be appreciated and administratively supported. Continued research with RNs may reveal previously unrecognised opportunities for safety improvements.

Clinical disagreements during labor and birth: How does real life compare to best practice?

Simpson, K. R., & Lyndon, A. (2009). MCN The American Journal of Maternal Child Nursing, 34(1), 31-39. 10.1097/01.NMC.0000343863.72237.2b
Abstract
Abstract
Purpose: To describe how nurses would respond in common clinical situations involving disagreement with physician colleagues during labor and birth. Study Design and Methods: An electronic survey, consisting of five clinical disagreement case scenarios along with two open-ended questions regarding how to promote effective interdisciplinary communication and collaboration, was administered via a secure Web site. Seven hundred four obstetric nurses in a mid-size metropolitan area were invited to participate via mail. One hundred thirty-three nurses responded. Data were analyzed using descriptive statistics and thematic analysis of open-ended text responses. Results: Respondents were primarily aged ≥40, experienced in labor nursing, and held a BSN; 35% were members of the Association of Women's Health, Obstetric and Neonatal Nurses, 35% were certified in electronic fetal monitoring, and 33% were certified in inpatient obstetrics. In all five scenarios, most nurses were aware of current evidence and published standards of care (range 52%-86%). However, there was a wide discrepancy between current evidence/standards and what nurses indicated would occur in actual clinical practice. Clinical Implications: In this well-educated and knowledgeable sample of experienced labor nurses, reports of what would occur in clinical practice did not match current evidence or standards of care. Adequate nursing knowledge may not be an accurate predictor of appropriate clinical practice. Confidence in administrative support appears to be one of the key factors in empowering nurses to pursue resolution of disagreements in patients' best interests, whereas medical hierarchy, fear, and intimidation are significant barriers.

Fetal Heart Monitoring Principles and Practices

Lyndon, A., & Ali, L. (Eds.). (2009). (4th eds., 1–). Association of Women’s Health, Obstetric, & Neonatal Nurses/Kendall Hunt.

Interpretation of Fetal Heart Monitoring

Lyndon, A., O’Brien-Abel, N., & Simpson, K. (2009). In A. Lyndon & L. Ali (Eds.), Fetal Heart Monitoring Principles and Practices (4th eds., 1–). Association of Women’s Health, Obstetric, & Neonatal Nurses/Kendall Hunt.

Social and environmental conditions creating fluctuating agency for safety in two urban academic birth centers

Lyndon, A. (2008). JOGNN - Journal of Obstetric, Gynecologic, and Neonatal Nursing, 37(1), 13-23. 10.1111/j.1552-6909.2007.00204.x
Abstract
Abstract
Objective: To identify processes affecting agency for safety among perinatal nurses, physicians, and certified nurse-midwives. Design: Grounded theory, as informed by Strauss and Schatzman. Setting: Two academic perinatal units in the western United States. Participants: Purposive sample of 12 registered nurses, 5 physicians, and 2 certified nurse-midwives. Findings: Agency for safety (the willingness to take a stand on an issue of concern) fluctuated for all types of providers depending on situational context and was strongly influenced by interpersonal relationships. While physicians and certified nurse-midwives believed that they valued nurses' contributions to care, their units had deeply embedded hierarchies. Nurses were structurally excluded from important sources of information exchange and from contributing to the plan of care. Nurses'confidence was a key driver for asserting their concerns. Confidence was undermined in novel or ambiguous situations and by poor interpersonal relationships, resulting in a process of redefining the situation as a problem of self. Conclusions: Women and babies should not be dependent on the interpersonal relationships of providers for their safety. Clinicians should be aware of the complex social pressures that can affect clinical decision making. Continued research is needed to fully articulate facilitators and barriers to perinatal safety.

Tensions and teamwork in nursing and midwifery relationships

Kennedy, H. P., & Lyndon, A. (2008). JOGNN - Journal of Obstetric, Gynecologic, and Neonatal Nursing, 37(4), 426-435. 10.1111/j.1552-6909.2008.00256.x
Abstract
Abstract
Objective: To explore the practice of midwifery within a busy urban tertiary hospital birth setting and to present findings on the relationships between nurses and midwives in providing maternity care. Design/Method: A focused ethnography on midwifery practice conducted over 2 years (2004-2006) in a teaching hospital serving a primarily Medicaid-eligible population in Northern California. Data were collected through participant observations and in-depth interviews with midwives (N = 11) and nurses (N = 14). Practices and relationships among the midwives and nurses were examined in an ethnographic framework through thematic analysis. Findings: Two themes described the nature of nursing-midwifery relationships: tension and teamwork. Tension existed in philosophic approaches to care, definitions of safe practice, communication, and respect. Teamwork existed when the midwives and nurses worked in partnership with the woman to develop a plan of care. Changes were brought about to improve the midwife-nurse relationship during the conduct of the study. Conclusions: Midwives and nurses experienced day-to-day challenges in providing optimal care for childbearing women. The power of effective teamwork was profound, as was the tension when communication broke down. Failure to include nurses resulted in impaired translation of evidence into practice. All stakeholders in birth practices and policy development must be involved in future research in order to develop effective maternity care models.

Communication and teamwork in patient care: how much can we learn from aviation?

Lyndon, A. (2006). Journal of Obstetric, Gynecologic, and Neonatal Nursing : JOGNN NAACOG, 35(4), 538-546. 10.1111/j.1552-6909.2006.00074.x
Abstract
Abstract
OBJECTIVE: To identify evidence on the role of assertiveness and teamwork and the application of aviation industry techniques to improve patient safety for inpatient obstetric care. DATA SOURCES: Studies limited to research with humans in English language retrieved from CINAHL, PubMed, Social Science Abstracts, and Social Sciences Citation Index, and references from reviewed articles. STUDY SELECTION: A total of 13 studies were reviewed, including 5 studies of teamwork, communication, and safety attitudes in aviation; 2 studies comparing these factors in aviation and health care; and 6 studies of assertive behavior and decision making by nurses. Studies lacking methodological rigor or focusing on medication errors and deviant behavior were excluded. DATA SYNTHESIS: Pilot attitudes regarding interpersonal interaction on the flight deck predicted effective performance and were amenable to behavior-based training to improve team performance. Nursing knowledge was inconsistently accessed in decision making. Findings regarding nurse assertiveness were mixed. CONCLUSIONS: Adaptation of training concepts and safety methods from other fields will have limited impact on perinatal safety without an examination of the contextual experiences of nurses and other health care providers in working to prevent patient harm.

Journal of Perinatal & Neonatal Nursing: From the editors

Lyndon, A., Arafeh, J. M., & Bakewell-Sachs, S. (2006). Journal of Perinatal and Neonatal Nursing, 20(4), 277-278. 10.1097/00005237-200610000-00001