Faculty

Chenjuan Ma headshot

Chenjuan Ma

PhD

Assistant Professor

1 212 992 7173

433 First Avenue
New York, NY 10010
United States

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Professional overview

Dr. Chenjuan Ma is a health services researcher, whose program of research focuses on 1) understanding the role of the organization of nursing and its impact on patient care quality and safety as well as patient outcomes and 2) improve quality of care and patient outcomes via re-structure of modifiable organizational nursing factors. As a nurse scientist with extensive training in health services research, Dr. Ma's research utilizes theories and methodologies from different disciplines, including but not limited to sociology, statistics, medicine, and nursing. Dr. Ma also has expertise in large data sets and quantitative methods. Prior to joining the NYU Rory Meyers College of Nursing as an assistant profession (tenure-track), Dr. Ma was a post-doctoral fellow in the National Database of Nursing Quality Indicators (NDNQI) at the University of Kansas.

Education

PhD(2012) - University of Pennsylvania
MSN(2008) - Xi'an Jiaotong University, China
BSN(2005) - Xi'an Jiaotong University, China

Honors and awards

President Gutmann Leadership Award for Travel, University of Pennsylvania (2011)
Rising Star, Sigma Theta Tau International Honor Society of Nursing Xi Chapter (2011)
ThinkSwiss Award, University of Basel, Switzerland (2011)
Outstanding Student Leader, Xi'an Jiaotong University, China (2008)

Specialties

Nursing workforce
Policy
Global
Home care
Research methods

Professional membership

Eastern Nursing Research Society
MidWest Nursing Research Society (2014-2015)
American Nurses Association (2014-2015)
Young Professional Commission, the Advisory Group for The Global Commission on Education Of the Health Professionals for the 21st Century (2010)
AcademyHealth

Publications

Publications

Detecting disparities in medication management among limited English proficient and English proficient home health patients

Miner, S., Squires, A., Ma, C., McDonald, M., & Jones, S. (2019). Home Health Care Management and Practice.

Hospital readmission in persons with dementia: A systematic review

Ma, C., Bao, S., Dull, P., Wu, B., & Yu, F. (2019). International Journal of Geriatric Psychiatry. 10.1002/gps.5140

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.

Inter- and intra-disciplinary collaboration and patient safety outcomes in U.S. acute care hospital units: A cross-sectional study

Ma, C., Park, S. H., & Shang, J. (2018). International Journal of Nursing Studies, 85, 1-6. 10.1016/j.ijnurstu.2018.05.001
Abstract
Background: Collaboration among healthcare providers has been considered a promising strategy for improving care quality and patient outcomes. Despite mounting evidence demonstrating the impact of collaboration on outcomes of healthcare providers, there is little empirical evidence on the relationship between collaboration and patient safety outcomes, particularly at the patient care unit level. Objectives: The purpose of this study is to identify the extent to which interdisciplinary collaboration between nurses and physicians and intradisciplinary collaboration among nurses on patient care units are associated with patient safety outcomes. Methods: This is a cross-sectional study using nurse survey data and patient safety indicators data from U.S. acute care hospital units. Collaboration at the unit level was measured by two 6-item scales: nurse-nurse interaction scale and nurse-physician interaction scale. Patient outcome measures included hospital-acquired pressure ulcers (HAPUs) and patient falls. The unit of analysis was the patient care unit, and the final sample included 900 units of 5 adult unit types in 160 hospitals in the U.S. Multilevel logistic and Poisson regressions were used to estimate the relationship between collaboration and patient outcomes. All models were controlled for hospital and unit characteristics, and clustering of units within hospitals was considered. Results: On average, units had 26 patients with HAPUs per 1000 patients and 3 patient falls per 1000 patient days. Critical care units had the highest HAPU rate (50/1000 patients) and the lowest fall rate (1/1000 patient days). A one-unit increase in the nurse-nurse interaction scale score led to 31% decrease in the odds of having a HAPU (OR, 0.69; 95% CI, 0.56–0.82) and 8% lower patient fall rate (IRR, 0.92; 95% CI, 0.87–0.98) on a nursing unit. A one-unit increase in the nurse-physician interaction scale score was associated with 19% decrease in the odds of having a HAPU (OR, 0.81; 95% CI, 0.68–0.97) and 13% lower fall rates (IRR, 0.87; 95% CI, 0.82–0.93) on a unit. Conclusions: Both nurse-physician collaboration and nurse-nurse collaboration were significantly associated with patient safety outcomes. Findings from this study suggest that improving collaboration among healthcare providers should be considered as an important strategy for promoting patient safety and both interdisciplinary and intradisciplinary collaboration are critical for achieving better patient outcomes.

Practice Environment Characteristics Associated With Missed Nursing Care

Park, S. H., Hanchett, M., & Ma, C. (2018). Journal of Nursing Scholarship. 10.1111/jnu.12434
Abstract
Purpose: To examine which characteristics of the practice environment were associated with missed nursing care in U.S. acute care hospital units. Design: A descriptive, correlational study used secondary analysis of the 2015 National Database of Nursing Quality Indicators® Registered Nurse (RN) Survey data. Subscales of the Practice Environment Scale of the Nursing Work Index were used to measure practice environment characteristics. The sample included 1,583 units in 371 hospitals, containing survey responses from 31,650 RNs. Methods: Multilevel logistic regression was performed to estimate the effects of the practice environment characteristics on missed care, controlling for hospital and unit characteristics. Results: About 84.1% of unit RNs reported missing at least one of the 15 necessary care activities. Good environment units had 63.3% significantly lower odds of having RNs miss care activities than poor environment units. Units had 81.5% lower odds of having RNs miss any necessary activities with 1 point increase of the staffing and resource adequacy score; 21.9% lower odds for 1 point increase in the nurse–physician relations score; and approximately 2.1 times higher odds with 1 point increase in the nurse participation in hospital affairs score. Conclusions: Good environments were significantly associated with lower levels of missed care. The impact on missed care differed by the characteristics of the practice environment. Clinical Relevance: Hospital and nursing administrators should maintain good practice environments for nurses to reduce missed care activities and thus potentially improve patient outcomes. Specifically, their efforts should be targeted on improving staffing and resource adequacy and nurse–physician relations and on reducing workloads on hospital affairs.

Recent Trends in Baccalaureate-Prepared Registered Nurses in U.S. Acute Care Hospital Units, 2004–2013: A Longitudinal Study

Ma, C., Garrard, L., & He, J. (2018). Journal of Nursing Scholarship, 50(1), 83-91. 10.1111/jnu.12347
Abstract
Purpose: To examine the trends in baccalaureate (bachelor of science in nursing)–prepared registered nurses (BSN RNs) in U.S. acute care hospital units and to project the growth in the number of BSN RNs by 2020. Design: This is a longitudinal study using the Registered Nurse Education Indicators data (2004–2013) from the National Database of Nursing Quality Indicators. Methods: The level of BSN RNs in each unit was operationalized as the proportion of nurses holding a baccalaureate degree or higher among all the nurses in a unit. Our sample included 12,194 unit-years from 2,126 units of six cohorts in 377 U.S. acute care hospitals. A hierarchical linear regression model was used to examine the trends in BSN RNs and to project future growth in the number of BSN RNs when controlling for hospital and unit characteristics and considering repeated measures in units over time and clustering of units within hospitals. Results: The proportion of BSN RNs in U.S. acute care hospital units increased from 44% in 2004 to 57% in 2013 (a 30% increase); when combining all cohorts, this rate increased from 44% in 2009 to 51% in 2013. On average, the proportion of BSN RNs in a unit increased by 1.3% annually before 2010 and by 1.9% each year from 2010 on. The percentage of units having at least 80% of their nurses with a baccalaureate degree or higher increased from 3% in 2009 to 7% in 2013. Based on the current trends, 64% of the nurses working in a hospital unit will have a baccalaureate degree by 2020, and 22% of the units will reach the 80% goal by 2020. Conclusions: There was a significant increase in the proportion of BSN RNs in U.S. acute care hospital units over the past decade, particularly after 2010. However, given the current trends, it is unlikely that the goal of 80% nurses with a baccalaureate degree will be achieved by 2020. Clinical Relevance: The U.S. nursing workforce is under educational transformation in order to meet the increasing healthcare needs. To help accelerate this transformation, further advocacy, commitment, and investment are needed from all healthcare stakeholders (e.g., policymakers, executives and managers of healthcare facilities, nursing schools, etc.).

Hospital Magnet Status, Unit Work Environment, and Pressure Ulcers

Ma, C., & Park, S. H. (2015). Journal of Nursing Scholarship, 47(6), 565-573. 10.1111/jnu.12173
Abstract
Purpose: To identify how organizational nursing factors at different structural levels (i.e., unit-level work environment and hospital Magnet status) are associated with hospital-acquired pressure ulcers (HAPUs) in U.S. acute care hospitals. Design: A cross-sectional observational study used data from the National Database of Nursing Quality Indicators®. Responses from 33,845 registered nurses (RNs) were used to measure unit work environments. The unit of analysis was the nursing unit, and there were 1,381 units in 373 hospitals in the United States. Methods: Unit work environment was measured by the Practice Environment Scale of Nurse Working Index (PES-NWI). Multilevel logistic regressions were used to estimate the effects of unit work environment and hospital Magnet status on HAPUs. All models were controlled for hospital and unit characteristics when considering clustering of units within hospitals. Results: Magnet hospital units had 21% lower odds of having an HAPU than non-Magnet hospital units (95% confidence interval [CI], 0.64-0.98). With one unit increase of the PES-NWI score, units had 29% lower odds of having an HAPU (95% CI, 0.55-0.91). When including both hospital Magnet status and unit work environment in the model, hospital Magnet status no longer had a significant effect on HAPUs (odds ratio [OR] = 0.82; 95% CI, 0.66-1.02), whereas the significant effect of unit work environment persisted (OR = 0.73; 95% CI, 0.56-0.93). Conclusions: Both hospital and unit environments were significantly associated with HAPUs, and the unit-level work environment can be more influential in reducing HAPUs. Clinical Relevance: Investment in the nurse work environments at both the hospital level and unit level has the potential to reduce HAPUs; and additional to hospital-level initiatives (e.g., Magnet recognition program), efforts targeting on-unit work environments deserve more attention.

Nurse work environment and quality of care by unit types: A cross-sectional study

Ma, C., Olds, D. M., & Dunton, N. E. (2015). International Journal of Nursing Studies, 52(10), 1565-1572. 10.1016/j.ijnurstu.2015.05.011
Abstract
BACKGROUND: Nursing unit is the micro-organization in the hospital health care system in which integrated patient care is provided. Nursing units of different types serve patients with distinct care goals, clinical tasks, and social structures and norms. However, empirical evidence is sparse on unit type differences in quality of care and its relation with nurse work environment. Nurse work environment has been found as an important nursing factor predicting nurse and patient outcomes.OBJECTIVES: To examine the unit type differences in nurse-reported quality of care, and to identify the association between unit work environment and quality of care by unit types.METHODS: This is a cross-sectional study using nurse survey data (2012) from US hospitals nationwide. The nurse survey collected data on quality of care, nurse work environment, and other work related information from staff nurses working in units of various types. Unit types were systematically classified across hospitals. The unit of analysis was the nursing unit, and the final sample included 7677 units of 14 unit types from 577 hospitals in 49 states in the US. Multilevel regressions were used to assess the relationship between nurse work environment and quality of care across and by unit types.RESULTS: On average, units had 58% of the nurses reporting excellent quality of care and 40% of the nurses reporting improved quality of care over the past year. Unit quality of care varied by unit types, from 43% of the nurses in adult medical units to 73% of the nurses in interventional units rating overall quality of care on unit as excellent, and from 35% of the nurses in adult critical care units to 44% of the nurses in adult medical units and medical-surgical combined units reporting improved quality of care. Estimates from regressions indicated that better unit work environments were associated with higher quality of care when controlling various hospital and unit covariates; and this association persisted among units of different types.CONCLUSIONS: Unit type differences exist in the overall quality of care as well as achievement in improving quality of care. The low rates of nurses reporting improvement in the quality of nursing care to patients suggest that further interventions focusing at the unit-level are needed for achieving high care quality. Findings from our study also suggest that improving nurse work environments can be an effective strategy to improve quality of care.

"Can nurse work environment influence readmission risk?" A systematic review

Ma, C., Shang, J., & Stone, P. (2014). Nursing: Research & Reviews, 4, 91-101.

The study of AIDS-related knowledge attitude and behaviors in resource-limited rural residents of Shaanxi Province

Li, X., Ma, C., Lu, A., & Guo, X. (2010). Chinese Journal of Nursing, 45(5), 389-393.