Christine T Kovner

Mathey Mezey Professor of Geriatric Nursing

1 212 998 5312

433 First Avenue
Room 644
New York, NY 10010
United States

Professional overview

Dr. Kovner is a Professor at the College of Nursing at New York University (NYU), a Senior Fellow at the Hartford Institute for Geriatric Nursing at NYU, a Nurse Attending at the NYU Langone Medical Center, and serves on the executive committee of NYU’s Clinical Translational Science Institute. Dr. Kovner maintains an active research program involving studies on quality improvement, RN working conditions and nursing care cost. Dr. Kovner is the principal investigator of a grant from the Robert Wood Johnson Foundation studying the career trajectories of newly licensed registered nurses over the first ten years of their careers.

PhD(1985) - New York University
Honors and awards
Nursing Outlook Excellence in Policy Award. For “State Mandatory Overtime Regulations and Newly Licensed Nurses’ Mandatory and Voluntary Overtime and Total Work Hours.” (2012)
New York University, College of Nursing, Distinguished Alumna Award (2012)
New York University, College of Nursing, Vernice Ferguson Faculty Scholar Award (2010)
“Exploring the Utility of Automated Drug Alerts in Home Healthcare.” Selected for Journal for Healthcare Quality 2007 Golden Pen Award (2007)
New York University, College of Nursing, Health Policy and Legislation Award (2006)
Best of Image (Journal of Nursing Scholarship) Award in Health Policy. For “Nurse Staffing Levels and Adverse Events Following Surgery in U. S. Hospitals” (1999)
New York Counties Registered Nurses Association, Honorary Recognition Award (1999)
Alumni Award for Distinguished Career in Nursing, Columbia University-Presbyterian Hospital Alumni Association (1996)
Foundation of the New York State Nurses Association, Distinguished Nurse Researcher (1994)
New York Counties Registered Nurses Association, Lavinia Dock Distinguished Service Award (1992)
Martha E. Rogers Scholarship Award, Upsilon Chapter, Sigma Theta Tau (1983)
Professional membership
American Academy of Nursing Fellow
Council for the Advancement of Nursing Science
Sigma Theta Tau

A multi-state assessment of employer-sponsored quality improvement education for early-career registered nurses.

Djukic, M., Kovner, C. T., Brewer, C. S., Fatehi, F. K., & Seltzer, J. R. (2013). Journal of continuing education in nursing, 44, 12-9; quiz 20-1, 10.3928/00220124-20121115-68

Increasing participation of registered nurses (RNs) in quality improvement (QI) is a promising strategy to close the health care quality chasm. For RNs to participate effectively in hospital QI, they must have adequate QI knowledge and skills.

Verbal abuse from nurse colleagues and work environment of early career registered nurses.

Budin, W. C., Brewer, C. S., Chao, Y. Y., & Kovner, C. (2013). Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing / Sigma Theta Tau, 45, 308-16, 10.1111/jnu.12033

This study examined relationships between verbal abuse from nurse colleagues and demographic characteristics, work attributes, and work attitudes of early career registered nurses (RNs).

Predictors of actual turnover in a national sample of newly licensed registered nurses employed in hospitals.

Brewer, C. S., Kovner, C. T., Greene, W., Tukov-Shuser, M., & Djukic, M. (2012). Journal of advanced nursing, 68, 521-38, 10.1111/j.1365-2648.2011.05753.x

This paper is a report of a study of factors that affect turnover of newly licensed registered nurses in United States hospitals.

Work environment factors other than staffing associated with nurses' ratings of patient care quality.

Djukic, M., Kovner, C. T., Brewer, C. S., Fatehi, F. K., & Cline, D. D. (2012). The Journal of nursing administration, 42, S17-26, 10.1097/01.NNA.0000420391.95413.88

The impact of registered nurse (RN) staffing on patient care quality has been extensively studied. Identifying additional modifiable work environment factors linked to patient care quality is critical as the projected shortage of approximately 250,000 RNs over the next 15 years will limit institutions' ability to rely on RN staffing alone to ensure high-quality care.

Early career RNs' perceptions of quality care in the hospital setting.

Cline, D. D., Rosenberg, M. C., Kovner, C. T., & Brewer, C. (2011). Qualitative health research, 21, 673-82, 10.1177/1049732310395030

The purpose of this study was to explore early-career registered nurses' perceptions of high-quality nursing care in hospitals. The study findings contribute to ongoing work intended to explore and define what quality nursing care is and how it ultimately impacts patients. The final sample analyzed for this article consisted of 171 narrative responses from hospital-based registered nurses. We used Krippendorff's technique for qualitative content analysis to identify themes. Three themes emerged as integral to high quality nursing care: registered nurse presence, developing relationships, and facilitating the flow of knowledge and information. Development of nursing quality indicators should focus on nursing processes in addition to patient outcomes. Such a focus would better capture the complexity of hospital nursing care.

New nurses' views of quality improvement education.

Kovner, C. T., Brewer, C. S., Yingrengreung, S., & Fairchild, S. (2010). Joint Commission journal on quality and patient safety / Joint Commission Resources, 36, 29-35,

Quality improvement (QI) is a focus of hospital managers and policymakers. The role of registered nurses (RNs) in QI in hospitals is vital because most hospital-based RNs provide direct care to patients. QI skills are necessary to identify gaps between current care and best practice and to design, implement, test, and evaluate changes and are essential for R.N.s to participate effectively in QI. Newly licensed registered nurses' (new nurses') positions as direct caregivers could have an impact on QI if nurses lack sufficient knowledge, concepts, and tools required for QI.

Overlap of registered nurse and physician practice: implications for U.S. health care reform.

Djukic, M., & Kovner, C. T. (2010). Policy, politics & nursing practice, 11, 13-22, 10.1177/1527154410365564

This review offers an analysis of practice overlap between physicians and registered nurses (RNs) who are not advanced practice nurses. Additionally, it spotlights opportunities for expanding traditional professional boundaries to establish novel care delivery models. The examples of RN role expansion offer a beginning for discussion regarding how the health professionals' knowledge and skills can be best used in designing an effective and efficient health care system. Although limited data exist on cost effectiveness and workload implications of the novel care delivery models, policy makers can use the findings of this review to begin to inform U.S. health care reform.

Charting the course for nurses' achievement of higher education levels.

Kovner, C. T., Brewer, C., Katigbak, C., Djukic, M., & Fatehi, F. Journal of professional nursing : official journal of the American Association of Colleges of Nursing, 28, 333-43, 10.1016/j.profnurs.2012.04.021

To improve patient outcomes and meet the challenges of the U.S. health care system, the Institute of Medicine recommends higher educational attainment for the nursing workforce. Characteristics of registered nurses (RNs) who pursue additional education are poorly understood, and this information is critical to planning long-term strategies for U.S. nursing education. To identify factors predicting enrollment and completion of an additional degree among those with an associate or bachelor's as their pre-RN licensure degree, we performed logistic regression analysis on data from an ongoing nationally representative panel study following the career trajectories of newly licensed RNs. For associate degree RNs, predictors of obtaining a bachelor's degree are the following: being Black, living in a rural area, nonnursing work experience, higher positive affectivity, higher work motivation, working in the intensive care unit, and working the day shift. For bachelor's RNs, predictors of completing a master's degree are the following: being Black, nonnursing work experience, holding more than one job, working the day shift, working voluntary overtime, lower intent to stay at current employer, and higher work motivation. Mobilizing the nurse workforce toward higher education requires integrated efforts from policy makers, philanthropists, employers, and educators to mitigate the barriers to continuing education.

Generational differences among newly licensed registered nurses.

Keepnews, D. M., Brewer, C. S., Kovner, C. T., & Shin, J. H. Nursing outlook, 58, 155-63, 10.1016/j.outlook.2009.11.001

Responses of 2369 newly licensed registered nurses from 3 generational cohorts-Baby Boomers, Generation X, and Generation Y-were studied to identify differences in their characteristics, work-related experiences, and attitudes. These responses revealed significant differences among generations in: job satisfaction, organizational commitment, work motivation, work-to-family conflict, family-to-work conflict, distributive justice, promotional opportunities, supervisory support, mentor support, procedural justice, and perceptions of local job opportunities. Health organizations and their leaders need to anticipate intergenerational differences among newly licensed nurses and should provide for supportive working environments that recognize those differences. Orientation and residency programs for newly licensed nurses should be tailored to the varying needs of different generations. Future research should focus on evaluating the effectiveness of orientation and residency programs with regard to different generations so that these programs can be tailored to meet the varying needs of newly licensed nurses at the start of their careers.

Nosocomial infection in an intensive care unit in a Brazilian university hospital.

de Oliveira, A. C., Kovner, C. T., & da Silva, R. S. Revista latino-americana de enfermagem, 18, 233-9,

This prospective study aimed to determine the nosocomial infection (NI) incidence in an Intensive Care Unit (ICU), its association with clinical characteristics and occurrence sites. It was carried out among 1.886 patients admitted in an ICU of a University Hospital, from August 2005 to January 2008. Data analysis was done using Fishers test and Relative Risk (RR). There were 383 NIs (20.3%). The infections were in the urinary tract (n=144; 37.6%), pneumonia (n=98; 25.6%), sepsis (n=58; 15.1%), surgical site (n=54; 14.1%) and others (n=29; 7.7%). Hospitalization average was 19.3 days for patients with NI and 20.2 days for those with colonization by resistant microorganisms. The mortality was 39.5% among patients with NI (RR: 4.4; 3.4-5.6). The NI was associated with patients originated from other units of the institution/emergency unit, more than 4 days of hospitalization, community infection, colonized by resistant microorganisms, using invasive procedures and deaths resulting from NI.

Positive work environments of early-career registered nurses and the correlation with physician verbal abuse.

Brewer, C. S., Kovner, C. T., Obeidat, R. F., & Budin, W. C. Nursing outlook, 61, 408-16, 10.1016/j.outlook.2013.01.004

Verbal abuse in the workplace is experienced by registered nurses (RNs) worldwide; physicians are one of the main sources of verbal abuse.

State mandatory overtime regulations and newly licensed nurses' mandatory and voluntary overtime and total work hours.

Bae, S. H., Brewer, C. S., & Kovner, C. T. Nursing outlook, 60, 60-71, 10.1016/j.outlook.2011.06.006

Nurse overtime has been used to handle normal variations in patient census and to control chronic understaffing. By 2010, 16 states had regulations to limit nurse overtime. We examined mandatory overtime regulations and their association with mandatory and voluntary overtime and total hours worked by newly licensed registered nurses (NLRNs). For this secondary data analysis, we used a panel survey of NLRNs; the final dataset consisted of 1,706 NLRNs. Nurses working in states that instituted overtime regulations after 2003 or in states that restricted any type of mandatory overtime had a lower probability of experiencing mandatory overtime than those nurses working in states without regulations. Nurses who worked in states with mandatory overtime regulations reported fewer total hours worked per week. The findings of this study provided insight into how mandatory overtime regulations were related to nurse mandatory and voluntary overtime and the total number of hours worked. Future research should investigate institutions' compliance with regulations and the impact of regulations on nurse and patient outcomes.

The sustainability budgeting model: multiplemode flexible budgeting using sustainability as the synthesizing criterion.

Kovner, C. T., & Lusk, E. J. Nursing economic$, 28, 377-85,

The Sustainability Budgeting Model (SBM) is presented in the context of a department of nursing of a major hospital. If successfully incorporated in the department of nursing, the SBM can easily be moved into the larger hospital context. The SBM was designed recognizing the three necessary components underlying all budgeting models. The SBM incorporates the inherent variability of the resource inflows and outflows and in that sense is robust; it is recommended these resource flows be calibrated for the various time horizons using the standard Present Value model so as to provide comparability across projects. Most importantly, the SBM focuses on financial sustainability considering all the relevant costs--variable and fixed--and so speaks to long-term coordinated planning and continuation of desired patient services.