Faculty

Christine T Kovner headshot

Christine T Kovner

Mathy Mezey Professor of Geriatric Nursing

1 212 998 5312

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

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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.

Education

PhD - New York University
MSN - University of Pennsylvania
BS - 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 Fellow
AcademyHealth
Council for the Advancement of Nursing Science
Sigma Theta Tau

Publications

Publications

Cardiovascular Risk in Middle-Aged and Older Immigrants: Exploring Residency Period and Health Insurance Coverage

Sadarangani, T., Trinh-Shevrin, C., Chyun, D., Yu, G., & Kovner, C. (2019). Journal of Nursing Scholarship. 10.1111/jnu.12465
Abstract
Purpose: It is reported that while immigrants are, initially, healthier than the native-born upon resettlement, this advantage erodes over time. In the United States, uninsured aging immigrants are increasingly experiencing severe complications of cardiovascular disease (CVD). The purpose of this study was to compare overall CVD risk and explore the importance of health insurance coverage on CVD risk relative to other health access barriers, from 2007 to 2012, in recent and long-term immigrants >50 years of age. Methods: This study was based on secondary cross-sectional analysis of the National Health and Nutrition Examination Survey (N = 1,920). The primary outcome, CVD risk category (high or low), was determined using the American College of Cardiology and American Heart Association Pooled Cohort equation. Differences between immigrant groups were examined using independent-samples t tests and chi-square analysis. The association between insurance and CVD risk was explored using a hierarchical block logistic regression model, in which variables were entered in a predetermined order. Changes in pseudo R 2 measured whether health insurance explained variance in cardiac risk beyond other variables. Results: Recent immigrants had lower overall CVD risk than long-term immigrants but were twice as likely to be uninsured and had higher serum glucose and lipid levels. Based on regression models, being uninsured contributed to CVD risk beyond other health access determinants, and CVD risk was pronounced among recent immigrants who were uninsured. Conclusions: Health insurance coverage plays an essential part in a comprehensive approach to mitigating CVD risk for aging immigrants, particularly recent immigrants whose cardiovascular health is susceptible to deterioration. Clinical Relevance: Nurses are tasked with recognizing the unique social and physical vulnerabilities of aging immigrants and accounting for these in care plans. In addition to helping them access healthcare coverage and affordable medication, nurses and clinicians should prioritize low-cost lifestyle interventions that reduce CVD risk, especially diet and exercise programs.

A comparison of scheduling, work hours, overtime, and work preferences across four cohorts of newly licensed Registered Nurses

Stimpfel, A., Fletcher, J., & Kovner, C. (2019). Journal of Advanced Nursing. 10.1111/jan.13972
Abstract
Aims: To conduct a comparative analysis of four cohorts of newly licensed Registered Nurses and their work schedule, daily shift length, weekly work hours, second job, and weekly overtime hours. Nurses also reported their preferences regarding work schedule and daily shift length. Design: We used a retrospective, comparative design analysing four cross-sectional surveys from new nurses first licensed between 2004–2015. Methods: Using state licensure lists, nurses who were first licensed between 1 August 2004 and 31 July 2005 were randomly sampled using a nested design in 23 geographical areas in 13 states and Washington, DC. The same sampling strategy was conducted for subsequent cohorts in January 2009, 2012, and 2016. We sent a mailed survey measuring demographics, education, work attributes, and attitudes to participants with a $5 incentive, following methods by Dillman. Results: There were no statistically significant differences in average weekly work hours (39.4 hrs) or holding more than one job for pay (11.6–14.6% across all cohorts). There were statistically significant differences in overtime across cohorts and shift length by unit type. The preferred shift length was 12 hrs and day shift was the preferred work schedule. Conclusion: New nurses are predominantly scheduled for 12-hrs shifts and nearly half work weekly overtime, trends that have remained relatively stable over the past 10 years. Nurse managers, policy-makers, and researchers should pay attention to new nurses’ schedule and shift preferences and guard against mandatory overtime hours.

Bachelor's Degree Nurse Graduates Report Better Quality and Safety Educational Preparedness than Associate Degree Graduates

Djukic, M., Stimpfel, A., & Kovner, C. (2018). Joint Commission Journal on Quality and Patient Safety. 10.1016/j.jcjq.2018.08.008
Abstract
Background: Readiness of the nursing workforce in quality and safety competencies is an essential indicator of a health system's ability to deliver high-quality and safe health care. A previous study identified important quality and safety education gaps between associate- and baccalaureate-prepared new nurses who graduated between 2004 and 2005. The purpose of this study was to assess changes in nursing workforce quality and safety education preparedness by examining educational gaps between associate and bachelor's degree graduates in two additional cohorts of new nurses who graduated between 2007–2008 and 2014–2015. Methods: A cross-sectional, comparative design and chi-square tests were used to trend the quality and safety educational preparedness differences between associate and bachelor's degree nurse graduates from 13 states and the District of Columbia licensed in 2007–2008 (N = 324) and 2014–2015 (N = 803). Results: The number of quality and safety educational gaps between bachelor's and associate degree nurse graduates more than doubled over eight years. In the 2007–2008 cohort, RNs with a bachelor's degree reported being significantly better prepared than RNs with an associate degree in 5 of 16 topics. In the 2014–2015 cohort, bachelor's degree RNs reported being significantly better prepared than associate degree RNs in 12 of 16 topics. Conclusion: Improving accreditation and organizational policies requiring baccalaureate education for all nurses could close quality and safety education gaps to safeguard the quality of patient care.

Cardiovascular disease risk among older immigrants in the United States

Sadarangani, T., Chyun, D., Trinh-Shevrin, C., Yu, G., & Kovner, C. (2018). Journal of Cardiovascular Nursing, 33(6), 544-550. 10.1097/JCN.0000000000000498
Abstract
Background: In the United States, 16 million immigrants are 50 years and older, but little is known about their cardiometabolic health and how to best assess their cardiovascular disease (CVD) risk. Aging immigrants may therefore not be benefitting from advances in CVD prevention. Objective: In this study, we estimate and compare CVD risk in a nationally representative sample of aging immigrants using 3 different measures. Methods: This was a cross-sectional analysis using National Health and Nutrition Examination Survey data. Immigrants 50 years and older with no history of CVD were eligible. The Framingham Risk Score (FRS), the American College of Cardiology/American Heart Association Pooled Cohort Risk Equation, and presence of metabolic syndrome (MetS) were used to estimate risk. Bivariate statistics were analyzed using SPSS version 23.0 Complex Survey module to account for National Health and Nutrition Examination Survey unique weighting scheme. Results: The mean age of the sample was 61.3 years; 40% had hypertension, 17% had diabetes, 10% were smokers, and 95% did not meet the recommended physical activity guidelines. Proportions at an elevated CVD risk were as follows: American College of Cardiology/American Heart Association, 42% female and 76% male; FRS, 17.4% female and 76% male; and MetS, 22% female and 24% male. Conclusions: Immigrants had a lower overall risk using MetS and the American College of Cardiology/American Heart Association equation than has been found using these tools in similarly aged samples. The opposite was true for the FRS. The discrepancy between the proportion at risk and those being treated may reflect healthcare access gaps that warrant further investigation. A more holistic approach to risk measurement is needed that accounts for determinants of health that disproportionately affect immigrants, including language and socioeconomic status.

Connecting translational nurse scientists across the nationâ€"the nurse scientist-translational research interest group

Cohn, E. G., McCloskey, D. J., Kovner, C., Schiffman, R., & Mitchell, P. H. (2018). Online Journal of Issues in Nursing, 23(2), 1. 10.3912/OJIN.Vol23No02Man03
Abstract
Translation science is the process of transdisciplinary teams accelerating the discoveries and findings from the laboratory, clinic, and community, and moving them into interventions that improve the health of individuals and populations. These discoveries include new forms of diagnostics, novel therapeutics, and innovative medical and behavioral interventions. The role of nurses in translational science is a natural fit, given the transdisciplinary nature of their work, the evolving role of nursing science, and the high-level of patient and family-centered interaction that nurses have as clinicians and scientists. As Clinical and Translational Science Awards were being developed across the nation, nurses felt the need for a stronger and more united voice. In 2010, nurse leaders in this field started the Nurse Scientist-Translational Interest Research Group (NS-TRIG). The group is now in its eighth year and provides a forum for nurse scientists to connect, communicate and collaborate. The purpose of this article is to describe the formation and background of the NS-TRIG, describe our meeting structure and provide examples of content. We also describe a summary of major accomplishments and work products of the NS-TRIG, and consider lessons learned and future directions of the group.

Challenges and Resources for Nurses Participating in a Hurricane Sandy Hospital Evacuation

Van Devanter, N., Raveis, V., Kovner, C., McCollum, M., & Keller, R. (2017). Journal of Nursing Scholarship, 49(6), 635-643. 10.1111/jnu.12329
Abstract
Purpose: Weather-related disasters have increased dramatically in recent years. In 2012, severe flooding as a result of Hurricane Sandy necessitated the mid-storm patient evacuation of New York University Langone Medical Center. The purpose of this study was to explore, from the nurses’ perspective, what the challenges and resources were to carrying out their responsibilities, and what the implications are for nursing education and preparation for disaster. Design: This mixed-methods study included qualitative interviews with a purposive sample of nurses and an online survey of nurses who participated in the evacuation. Methods: The interviews explored prior disaster experience and training, communication, personal experience during the evacuation, and lessons learned. The cross-sectional survey assessed social demographic factors, nursing education and experience, as well as potential challenges and resources in carrying out their disaster roles. Findings: Qualitative interviews provided important contextual information about the specific challenges nurses experienced and their ability to respond effectively. Survey data identified important resources that helped nurses to carry out their roles, including support from coworkers, providing support to others, personal resourcefulness, and leadership. Nurses experienced considerable challenges in responding to this disaster due to limited prior disaster experience, training, and education, but drew on their personal resourcefulness, support from colleagues, and leadership to adapt to those challenges. Conclusions: Disaster preparedness education in schools of nursing and practice settings should include more hands-on disaster preparation exercises, more “low-tech” options to address power loss, and specific policies on nurses’ disaster roles. Clinical Relevance: Nurses play a critical role in responding to disasters. Learning from their disaster experience can inform approaches to nursing education and preparation.

Common predictors of nurse-reported quality of care and patient safety

Stimpfel, A., Djukic, M., Brewer, C. S., & Kovner, C. (2017). Health Care Management Review. 10.1097/HMR.0000000000000155
Abstract
BACKGROUND:: In the era of the Patient Protection and Affordable Care Act, quality of care and patient safety in health care have never been more visible to patients or providers. Registered nurses (nurses) are key players not only in providing direct patient care but also in evaluating the quality and safety of care provided to patients and families. PURPOSE:: We had the opportunity to study a unique cohort of nurses to understand more about the common predictors of nurse-reported quality of care and patient safety across acute care settings. APPROACH:: We analyzed cross-sectional survey data that were collected in 2015 from 731 nurses, as part of a national 10-year panel study of nurses. Variables selected for inclusion in regression analyses were chosen based on the Systems Engineering Initiative for Patient Safety model, which is composed of work system or structure, process, and outcomes. RESULTS:: Our findings indicate that factors from three components of the Systems Engineering Initiative for Patient Safety model–Work System (person, environment, and organization) are predictive of quality of care and patient safety as reported by nurses. The main results from our multiple linear and logistic regression models suggest that significant predictors common to both quality and safety were job satisfaction and organizational constraints. In addition, unit type and procedural justice were associated with patient safety, whereas better nurse-physician relations were associated with quality of care. CONCLUSION:: Increasing nurses’ job satisfaction and reducing organizational constraints may be areas to focus on to improve quality of care and patient safety. PRACTICAL IMPLICATIONS:: Our results provide direction for hospitals and nurse managers as to how to allocate finite resources to achieve improvements in quality of care and patient safety alike.

Diversity and education of the nursing workforce 2006-2016

Kovner, C., Djukic, M., Jun, J., Fletcher, J., Fatehi, F. K., & Brewer, C. S. (2017). Nursing Outlook. 10.1016/j.outlook.2017.09.002
Abstract
Background: The Institute of Medicine (IOM) report, The Future of Nursing, included recommendations to increase nurse diversity, the percent of nurses obtaining a bachelor's degree, and inter-professional education. Purpose: The purpose of this paper is to report the progress toward achievement of these recommendations. Methods: We used a longitudinal, multi-state data from four cohorts of nurses newly licensed in 2004 to 2005, 2007 to 2008, 2010 to 2011, and 2014 to 2015 to examine and compare the trends. Discussion: The percentage of males who became licensed increased, from 8.8% in 2004 to 2005 cohort to 13.6% in the 2014 to 2015 cohort. The percentage of white-non-Hispanic nurses who were licensed decreased from 78.9% in 2007 to 2008 to 73.8% in 2014 to 2015. These differences primarily reflect an increase in white-Hispanic nurses. More nurses are obtaining a bachelor's degree as their first professional degree, from 36.6% in 2004 to 2005 cohort to 48.5% in 2014 to 2015 cohort. About 40% of the 2014 to 2015 cohort reported that they learned to work in inter-professional teams. Collegial nurse-physician relations had an upward positive trajectory over time increasing almost 7%. Conclusion: The diversity and education of new nurses have increased, but are short of meeting the IOM recommendations.

Enabling a Disaster-Resilient Workforce: Attending to Individual Stress and Collective Trauma

Raveis, V., Van Devanter, N., Kovner, C., & Gershon, R. (2017). Journal of Nursing Scholarship, 49(6), 653-660. 10.1111/jnu.12340
Abstract
Purpose: 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. Design: Sequential mixed methods were used to explore the psychosocial issues nurses experienced throughout the course of this natural disaster and its lingering aftermath. Methods: In-depth interviews were conducted from April to June 2013 with a subsample of nurses who participated in the evacuation deployment (n = 16). An anonymous, Internet-based cross-sectional survey sent to all registered nurses employed at the hospital at the time of the storm explored storm impact and recovery. Between July and September 2013, 528 surveys were completed. Findings: The qualitative data revealed challenges in balancing professional obligations and personal concerns. Accounts described dealing in the immediate recovery period with unexpected job changes and resultant work uncertainty. The storm's lingering aftermath did not signify restoration of their predisaster lifestyle for some, but necessitated coping with this massive storm's long-lasting impact on their personal lives and communal loss. Conclusions: Nurses working under the rapidly changing, uncontrolled, and potentially dangerous circumstances of a weather-related disaster are also experiencing concerns about their families’ welfare and worries about personal loss. These multiple issues increase the psychosocial toll on nurses during a disaster response and impending recovery. Clinical Relevance: Awareness of concerns and competing demands nurses experience in a disaster and aftermath can inform education and services to enable nurses to perform their critical functions while minimizing risk to patients and themselves.

Nurses Improve Their Communities’ Health Where They Live, Learn, Work, and Play

McCollum, M., Kovner, C., Ojemeni, M. T., Brewer, C., & Cohen, S. (2017). Policy, Politics, and Nursing Practice, 18(1), 7-16. 10.1177/1527154417698142
Abstract
Nurses are often recognized for their volunteer efforts following disasters and international humanitarian crises. However, little attention is paid to the activities of nurses who promote a culture of health in their communities through local volunteer work. In this article, we describe nurses’ perceptions of how they promote health in their communities through formal and informal volunteer work. Using 315 written responses to an open-ended question included in a 2016 survey of the career patterns of nurses in the U.S., we utilized conventional content analysis methods to code and thematically synthesize responses. Two broad categories of nurse involvement in volunteer activities arose from the participants’ responses to the open-ended question, “Please tell us what you have done in the past year to improve the health of your community”: 17% identified job-related activities, and 74% identified non-job-related activities. 9% of respondents indicated they do not participate in volunteer work. Job-related activities included patient education, educating colleagues, and “other” job-related activities. Non-job-related activities included health-related community volunteering, volunteering related to a specific population or disease, family-related volunteering, church activities, health fairs, raising or donating money, and travelling abroad for volunteer work. Nurses are committed to promoting a culture of health in their communities both at work and in their daily lives. Leveraging nurses’ interest in volunteer work could improve the way nurses engage with their communities, expand the role of nurses as public health professionals, and foster the social desirability of healthful living.