Audrey Lyndon

Faculty

Audrey Lyndon Headshot

Audrey Lyndon

PhD RNC FAAN

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

Prof. Lyndon is the Vernice D. Ferguson Professor in Health Equity and Executive Vice Dean at NYU Rory Meyers College of Nursing. Her work focuses on three key areas: maternal health equity, community health engagement, and developing the nursing science and healthcare workforce. 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; researching severe maternal morbidity and maternal mortality; and holistic perinatal wellbeing. Her team has conducted groundbreaking research on the differences in clinicians’ and parents’ perspectives on speaking up about safety concerns, as well as developing an understanding of how women and parents conceptualize safety during childbirth and neonatal intensive care. 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. Lyndon led an interdisciplinary research study funded by the Agency for Healthcare Research and Quality that established hospital-level exclusive breastfeeding rates and cesarean birth rates as nurse-sensitive outcomes. Lyndon’s current work focuses on understanding the experiences of communities that have faced higher rates of severe maternal morbidity and mortality. She and her team seek to gain a deeper understanding of the support needs and research priorities of severe maternal morbidity survivors, and to develop community-driven prevention targets for SMM and maternal health complications. Lyndon’s dedication to developing the nursing science and healthcare workforce includes mentoring and sponsoring clinicians and scientists from underserved communities. Her goals are to develop effective pathway programs for these individuals to pursue careers in nursing, nursing science, and clinical specialties.

 

PhD, University of California
MS, University of California
BA, University of California
Health Services Research
Qualitative Research
Women's health
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
Vernice D. Ferguson Professor in Health Equity, Rory Meyers College of Nursing (2021)
PhD Program Mentor of the Year, University of California, San Francisco School of Nursing (2019)
James P. and Marjorie A. Livingston Chair in Nursing Excellence, University of California, San Francisco (2018)
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)

Providers' perceptions of communication and women's autonomy during childbirth: a mixed methods study in Kenya

Lyndon, A., Afulani, P. A., Buback, L., Kelly, A. M., Kirumbi, L., Cohen, C. R., & Lyndon, A. (2020). In Reproductive health (Vols. 17, Issue 1, p. 85).
Abstract
Abstract
Effective communication and respect for women's autonomy are critical components of person-centered care. Yet, there is limited evidence in low-resource settings on providers' perceptions of the importance and extent of communication and women's autonomy during childbirth. Similarly, few studies have assessed the potential barriers to effective communication and maintenance of women's autonomy during childbirth. We sought to bridge these gaps.

Providers' perceptions of disrespect and abuse during childbirth : A mixed-methods study in Kenya

Afulani, P. A., Kelly, A. M., Buback, L., Asunka, J., Kirumbi, L., & Lyndon, A. (2020). In Health Policy and Planning (Vols. 35, Issues 5, pp. 577-586). 10.1093/heapol/czaa009
Abstract
Abstract
Disrespect and abuse during childbirth are violations of women's human rights and an indicator of poor-quality care. Disrespect and abuse during childbirth are widespread, yet data on providers' perspectives on the topic are limited. We examined providers' perspectives on the frequency and drivers of disrespect and abuse during facility-based childbirth in a rural county in Kenya. We used data from a mixed-methods study in a rural county in Western Kenya with 49 maternity providers (32 clinical and 17 non-clinical) in 2016. Providers were asked structured questions on disrespect and abuse, followed by open-ended questions on why certain behaviours were exhibited (or not). Most providers reported that women were often treated with dignity and respect. However, 53% of providers reported ever observing other providers verbally abuse women and 45% reported doing so themselves. Observation of physical abuse was reported by 37% of providers while 35% reported doing so themselves. Drivers of disrespect and abuse included perceptions of women being difficult, stress and burnout, facility culture and lack of accountability, poor facility infrastructure and lack of medicines and supplies, and provider attitudes. Provider bias, training and women's empowerment influenced how different women were treated. We conclude that disrespect and abuse are driven by difficult situations in a health system coupled with a facilitating sociocultural environment. Providers resorted to disrespect and abuse as a means of gaining compliance when they were stressed and feeling helpless. Interventions to address disrespect and abuse need to tackle the multiplicity of contributing factors. These should include empowering providers to deal with difficult situations, develop positive coping mechanisms for stress and address their biases. We also need to change the culture in facilities and strengthen the health systems to address the system-level stressors.

Providers' perceptions of disrespect and abuse during childbirth: a mixed-methods study in Kenya

Lyndon, A., Afulani, P. A., Kelly, A. M., Buback, L., Asunka, J., Kirumbi, L., & Lyndon, A. (2020). In Health policy and planning (Vols. 35, Issues 5, pp. 577-586).
Abstract
Abstract
Disrespect and abuse during childbirth are violations of women's human rights and an indicator of poor-quality care. Disrespect and abuse during childbirth are widespread, yet data on providers' perspectives on the topic are limited. We examined providers' perspectives on the frequency and drivers of disrespect and abuse during facility-based childbirth in a rural county in Kenya. We used data from a mixed-methods study in a rural county in Western Kenya with 49 maternity providers (32 clinical and 17 non-clinical) in 2016. Providers were asked structured questions on disrespect and abuse, followed by open-ended questions on why certain behaviours were exhibited (or not). Most providers reported that women were often treated with dignity and respect. However, 53% of providers reported ever observing other providers verbally abuse women and 45% reported doing so themselves. Observation of physical abuse was reported by 37% of providers while 35% reported doing so themselves. Drivers of disrespect and abuse included perceptions of women being difficult, stress and burnout, facility culture and lack of accountability, poor facility infrastructure and lack of medicines and supplies, and provider attitudes. Provider bias, training and women's empowerment influenced how different women were treated. We conclude that disrespect and abuse are driven by difficult situations in a health system coupled with a facilitating sociocultural environment. Providers resorted to disrespect and abuse as a means of gaining compliance when they were stressed and feeling helpless. Interventions to address disrespect and abuse need to tackle the multiplicity of contributing factors. These should include empowering providers to deal with difficult situations, develop positive coping mechanisms for stress and address their biases. We also need to change the culture in facilities and strengthen the health systems to address the system-level stressors.

Reflecting on Equity in Perinatal Care during a Pandemic

Niles, P. M., Asiodu, I. V., Crear-Perry, J., Julian, Z., Lyndon, A., McLemore, M. R., Planey, A. M., Scott, K. A., & Vedam, S. (2020). In Health Equity (Vols. 4, Issue 1, pp. 330-333). 10.1089/heq.2020.0022
Abstract
Abstract
Growing discourse around maternity care during the pandemic offers an opportunity to reflect on how this crisis has amplified inequities in health care. We argue that policies upholding the rights of birthing people, and policies decreasing the risk of COVID-19 transmission are not mutually exclusive. The explicit lack of standardization of evidence-based maternity care, whether expressed in clinical protocols or institutional policy, has disproportionately impacted marginalized communities. If these factors remain unexamined, then it would seem that equity is not the priority, but retaining power and control is. We advocate for a comprehensive understanding of how this pandemic has revealed our deepest failures.

Reflecting on Equity in Perinatal Care During a Pandemic

Lyndon, A., Niles, P. M., Asiodu, I. V., Crear-Perry, J., Julian, Z., Lyndon, A., McLemore, M. R., Planey, A. M., Scott, K. A., & Vedam, S. (2020). In Health equity (Vols. 4, Issue 1, pp. 330-333).
Abstract
Abstract
Growing discourse around maternity care during the pandemic offers an opportunity to reflect on how this crisis has amplified inequities in health care. We argue that policies upholding the rights of birthing people, and policies decreasing the risk of COVID-19 transmission are not mutually exclusive. The explicit lack of standardization of evidence-based maternity care, whether expressed in clinical protocols or institutional policy, has disproportionately impacted marginalized communities. If these factors remain unexamined, then it would seem that equity is not the priority, but retaining power and control is. We advocate for a comprehensive understanding of how this pandemic has revealed our deepest failures.

Adaptation of the MISSCARE Survey to the Maternity Care Setting

Lyndon, A., Simpson, K. R., Lyndon, A., Spetz, J., Gay, C. L., & Landstrom, G. L. (2019). In Journal of obstetric, gynecologic, and neonatal nursing : JOGNN (Vols. 48, Issues 4, pp. 456-467).
Abstract
Abstract
Missed nursing care is an important measure of nursing care quality that is sensitive to nurse staffing and is associated with patient outcomes in medical-surgical and pediatric inpatient settings. Missed nursing care during labor and birth has not been studied, yet childbirth represents the most common reason for hospitalization in the United States. The Missed Nursing Care (MISSCARE) Survey, a measure of medical-surgical nursing quality with substantial evidence for validity and reliability, was adapted to maternity nursing care using data from focus groups of labor nurses, physicians, and new mothers and an online survey of labor nurses. Content validity was evaluated via participant feedback, and exploratory factor analysis was performed to identify the factor structure of the instrument. The modified version, the Perinatal Missed Care Survey, appears to be a feasible and promising instrument with which to evaluate missed nursing care of women during labor and birth in hospitals.

Adaptation of the MISSCARE Survey to the Maternity Care Setting

Simpson, K. R., Lyndon, A., Spetz, J., Gay, C. L., & Landstrom, G. L. (2019). In JOGNN - Journal of Obstetric, Gynecologic, and Neonatal Nursing (Vols. 48, Issues 4, pp. 456-467). 10.1016/j.jogn.2019.05.005
Abstract
Abstract
Missed nursing care is an important measure of nursing care quality that is sensitive to nurse staffing and is associated with patient outcomes in medical-surgical and pediatric inpatient settings. Missed nursing care during labor and birth has not been studied, yet childbirth represents the most common reason for hospitalization in the United States. The Missed Nursing Care (MISSCARE) Survey, a measure of medical-surgical nursing quality with substantial evidence for validity and reliability, was adapted to maternity nursing care using data from focus groups of labor nurses, physicians, and new mothers and an online survey of labor nurses. Content validity was evaluated via participant feedback, and exploratory factor analysis was performed to identify the factor structure of the instrument. The modified version, the Perinatal Missed Care Survey, appears to be a feasible and promising instrument with which to evaluate missed nursing care of women during labor and birth in hospitals.

Adherence to the AWHONN Staffing Guidelines as Perceived by Labor Nurses

Lyndon, A., Simpson, K. R., Lyndon, A., Spetz, J., Gay, C. L., & Landstrom, G. L. (2019). In Nursing for women’s health (Vols. 23, Issues 3, pp. 217-223).
Abstract
Abstract
To evaluate the degree to which registered nurses perceive their labor and delivery units to be adhering to Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) staffing guidelines.

Adherence to the AWHONN Staffing Guidelines as Perceived by Labor Nurses

Simpson, K. R., Lyndon, A., Spetz, J., Gay, C. L., & Landstrom, G. L. (2019). In Nursing for Women's Health (Vols. 23, Issues 3, pp. 217-223). 10.1016/j.nwh.2019.03.003
Abstract
Abstract
Objective: To evaluate the degree to which registered nurses perceive their labor and delivery units to be adhering to Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) staffing guidelines. Design: Prospective, cross-sectional study via an online survey of labor nurses recruited from hospitals in three states. Setting/Local Problem: In late 2016 and early 2017, labor nurses in selected hospitals in California, Michigan, and New Jersey were contacted via e-mail invitation to participate in a study about nursing care during labor and birth. Nurse leaders in each hospital facilitated the invitations. Participants: A total of 615 labor nurses from 67 hospitals. Intervention/Measurements: Descriptive statistics and linear regression models were used for data analysis. Results: Most nurses reported that the AWHONN nurse staffing guidelines were frequently or always followed in all aspects of care surveyed. Hospitals with annual birth volumes of 500 to 999 range were significantly more likely than hospitals with 2,500 or more annual births to be perceived as compliant with AWHONN staffing guidelines. Conclusion: When the AWHONN staffing guidelines were first published in 2010, there was concern among some nurse leaders that they would not be adopted into clinical practice, yet nurses in our sample overwhelmingly perceived their hospitals to be guideline compliant. There remains much more work to be done to determine nurse-sensitive outcomes for maternity care and to ensure that all women in labor in the United States are cared for by nurses who are not overburdened or distracted by being assigned more women than can be safely handled. In our survey of 615 labor nurses, most reported that the AWHONN nurse staffing guidelines were frequently or always followed in all aspects of care surveyed.

The electronic health record's impact on nurses' cognitive work: An integrative review

Lyndon, A., Wisner, K., Lyndon, A., & Chesla, C. A. (2019). In International journal of nursing studies (Vols. 94, pp. 74-84).
Abstract
Abstract
Technology use can impact human performance and cognitive function, but few studies have sought to understand the electronic health record's impact on these dimensions of nurses' work.