- Professional overview
Christine Tassone Kovner, PhD, RN, FAAN, is a highly-respected and widely-published nurse educator and researcher at New York University. Her primary appointment is with Rory Meyers College of Nursing, where she is the Mathy Mezey Professor of Geriatric Nursing and a Senior Faculty Associate at the Hartford Institute for Geriatric Nursing. Additionally, Dr. Kovner is a Professor of Medicine at the NYU School of Medicine. She is an affiliated faculty at NYU College of Global Public Health and is on the Nurse Faculty at the NYU Langone Medical Center.
Dr. Kovner is the Principal Investigator for The TL1 Pre- and Post-Doctoral Program of NYU's Clinical and Translational Science Institute. She maintains an active research program involving studies on quality improvement, RN working conditions, and nursing care cost. Dr. Kovner was 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 - New York UniversityMSN - University of PennsylvaniaBS - Columbia University School of Nursing
- Honors and awards
Treasurer, CGFNS International, Inc. (2016)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 FellowAcademyHealthCouncil for the Advancement of Nursing ScienceSigma Theta Tau
All nurses need to be research nurses.Eckardt, P., Hammer, M. J., Barton-Burke, M., McCabe, M., Kovner, C. T., Behrens, L., … Coller, B. S. (2017). Journal of clinical and translational science 1, (269-270). 10.1017/cts.2017.294
Nurses are critical to the research enterprise. However all nurses are not prepared to participate as members of the research team since education and training in clinical research nursing and nurse-specific Good Clinical Practice are not consistently included in nursing curricula. The lack of nurse education and training in clinical research and Good Clinical Practice leaves research participants vulnerable with a nursing workforce that is not prepared to balance fidelity to protocol and patient quality care and safety.
Enabling a Disaster-Resilient Workforce: Attending to Individual Stress and Collective Trauma.Raveis, V. H., VanDevanter, N., Kovner, C. T., & Gershon, R. (2017). Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing 49, (653-660). 10.1111/jnu.12340
Superstorm Sandy forced the evacuation and extended shutdown of New York University Langone Medical Center. This investigation explored how nurses were impacted by the disasters and how they can best be supported in their nursing responsibilities.
Barriers and facilitators of nurses' use of clinical practice guidelines: An integrative review.Jun, J., Kovner, C. T., & Stimpfel, A. W. (2016). International journal of nursing studies 60, (54-68). 10.1016/j.ijnurstu.2016.03.006
Preventable harm continues to be one of the leading causes of patient death. Each year about 400,000 patients die from sepsis, hospital acquired infections, venous thromboembolism, and pulmonary embolism. However, as shown in the recent reduction in hospital acquired infections, the number of deaths could be reduced if healthcare providers used evidence-based therapies, which are often included in clinical practice guidelines (CPGs).
Estimating and preventing hospital internal turnover of newly licensed nurses: A panel survey.Kovner, C. T., Djukic, M., Fatehi, F. K., Fletcher, J., Jun, J., Brewer, C., & Chacko, T. (2016). International journal of nursing studies 60, (251-62). 10.1016/j.ijnurstu.2016.05.003
Registered nurse job turnover is an ongoing problem in the USA resulting in significant financial costs to both organizations and society. Most research has focused on organizational turnover with few studies about internal or unit-level turnover. Turnover of new nurses in hospitals has particular importance as almost 80% of new nurses work in hospitals and have higher turnover rates when compared to experienced nurses. This paper focuses on new nurses' unit-level turnover rates in hospitals.
Impact of transformational leadership on nurse work outcomes.Brewer, C. S., Kovner, C. T., Djukic, M., Fatehi, F., Greene, W., Chacko, T. P., & Yang, Y. (2016). Journal of advanced nursing 72, (2879-2893). 10.1111/jan.13055
To examine the effect of transformational leadership on early career nurses' intent to stay, job satisfaction and organizational commitment.
A structural equation model of turnover for a longitudinal survey among early career registered nurses.Brewer, C. S., Chao, Y. Y., Colder, C. R., Kovner, C. T., & Chacko, T. P. (2015). International journal of nursing studies 52, (1735-45). 10.1016/j.ijnurstu.2015.06.017
Key predictors of early career nurses' turnover are job satisfaction, organizational commitment, job search, intent to stay, and shock (back injuries) based on the literature review and our previous research. Existing research has often omitted one of these key predictors.
Scheduling and shift work characteristics associated with risk for occupational injury in newly licensed registered nurses: An observational study.Stimpfel, A. W., Brewer, C. S., & Kovner, C. T. (2015). International journal of nursing studies 52, (1686-93). 10.1016/j.ijnurstu.2015.06.011
Registered nurses across the globe bear a heavy injury burden. Every shift, nurses are exposed to a variety of hazards that can jeopardize their health, which negatively impacts their ability to provide high-quality patient care. Previous research suggests that inexperienced, or newly licensed nurses, may have an increased risk for certain occupational injuries. However, the current knowledge base is insufficient to fully understand how work hours influence newly licensed nurses' occupational injury, given the significant variation in hospital organization and work characteristics.
Challenges of nurses' deployment to other New York City hospitals in the aftermath of Hurricane Sandy.VanDevanter, N., Kovner, C. T., Raveis, V. H., McCollum, M., & Keller, R. (2014). Journal of urban health : bulletin of the New York Academy of Medicine 91, (603-14). 10.1007/s11524-014-9889-0
On October 29, 2012, a 12-ft storm surge generated by Hurricane Sandy necessitated evacuation and temporary closure of three New York City hospitals including NYU Langone Medical Center (NYULMC). NYULMC nurses participated in the evacuation, and 71 % were subsequently deployed to area hospitals to address patient surge for periods from a few days up to 2 months when NYULMC reopened. This mixed methods study explored nurses' experience in the immediate disaster and the subsequent deployment. More than 50 % of deployed nurse participants reported the experience to be extremely or very stressful. Deployed nurses encountered practice challenges related to working in an unfamiliar environment, limited orientation, legal concerns about clinical assignments. They experienced psychosocial challenges associated with the intense experience of the evacuation, uncertainty about future employment, and the increased demands of managing the deployment. Findings provide data to inform national and regional policies to support nurses in future deployments.
Exploring direct and indirect influences of physical work environment on job satisfaction for early-career registered nurses employed in hospitals.Djukic, M., Kovner, C. T., Brewer, C. S., Fatehi, F., & Greene, W. H. (2014). Research in nursing & health 37, (312-25). 10.1002/nur.21606
We explored direct and indirect influences of physical work environment on job satisfaction in a nationally representative sample of 1,141 early-career registered nurses. In the fully specified model, physical work environment had a non-significant direct effect on job satisfaction. The path analysis used to test multiple indirect effects showed that physical work environment had a positive indirect effect (p < .05) on job satisfaction through ten variables: negative affectivity, variety, workgroup cohesion, nurse-physician relations, quantitative workload, organizational constraints, distributive justice, promotional opportunity, local and non-local job opportunities. The findings make important contributions to the understanding of the relationship between physical work environment and job satisfaction. The results can inform health care leaders' insight about how physical work environment influences nurses' job satisfaction.
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 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 Wiley-Blackwell.
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.
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.
Determinants of job satisfaction for novice nurse managers employed in hospitals.Djukic, M., Jun, J., Kovner, C., Brewer, C., & Fletcher, J. Health care management review 42, (172-183). 10.1097/HMR.0000000000000102
Numbering close to 300,000 nurse managers represent the largest segment of the health care management workforce. Their effectiveness is, in part, influenced by their job satisfaction.
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.
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.
What does nurse turnover rate mean and what is the rate?Kovner, C. T., Brewer, C. S., Fatehi, F., & Jun, J. Policy, politics & nursing practice 15, (64-71). 10.1177/1527154414547953
Registered nurse turnover is an important indicator of the nurse job market. Despite its wide use as a measure for health-care system analysis, there is a lack of consistency in the definition of turnover. Some definitions include any nurse leaving an organization; others may include involuntary and voluntary leaving. These inconsistent definitions also result in various turnover rates. The RN Work Project is a 10-year panel study of new nurses. Data were collected from the new nurses, rather than from a specific organization. About 17.5% of new nurses leave their first job within 1 year of starting their jobs. Consistent and accurate measurement of turnover is an important step in addressing organizational work environments and policies about the nursing workforce.