Sean Clarke

Faculty

Sean Clarke Headshot

Sean Clarke

FAAN PhD RN

Ursula Springer Professor in Nursing Leadership

1 212 998 5264

433 First Ave
New York, NY 10010
United States

Sean Clarke, RN, PhD, FAAN, is the executive vice dean and a professor at NYU Rory Meyers College of Nursing. His research focuses on quality and safety issues in acute care hospitals, workforce issues, occupational safety of nurses, and the influences of economic and political factors on healthcare delivery and the nursing profession. He is perhaps best known for research on nurse staffing in hospitals and surveys of nurse working conditions. He has authored or co-authored over 100 peer-reviewed articles and 30 book chapters. Clarke has been a principal investigator on projects supported by the National Institute of Nursing Research, the Centers for Disease Control and Prevention, the Robert Wood Johnson Foundation, and the Ontario Ministry of Health and Long-Term Care and has served as a co-investigator on grants totaling over $10 million over the course of his career. In addition to teaching nursing, health policy, and research at the baccalaureate through doctoral levels, he also supervises PhD and postdoctoral research trainees and maintains a program of research with colleagues from a number of countries. 

Clarke has been a member of a variety of panels and boards related to health research and healthcare quality. He has had extensive involvement in peer review of research articles and grants and served on editorial boards of a number of scientific and professional journals in nursing and health services research. He is a fellow of the American Academy of Nursing and currently holds affiliate faculty appointments at the Université de Montréal and the University of Hong Kong.

Prior to joining the faculty at NYU Meyers, he was a professor and associate dean in the Undergraduate Program at the Connell School of Nursing, Boston College, from 2014–2018. He was also on faculty at the University of Pennsylvania School of Nursing for seven years, held an endowed chair in cardiovascular nursing at the University of Toronto, and was an endowed chair directing a special donor-funded set of projects intended to advance collaboration between the School of Nursing and its affiliated teaching hospitals at McGill University. He also co-directed nursing health services and workforce research groups in Philadelphia and Toronto and has been a consultant to clinicians, leaders, and professional associations on issues related to nursing and patient safety for almost two decades in Canada, the United States, and internationally. 

Clarke completed his basic clinical and research training in nursing at McGill University, in Montreal, Canada, and pursued a nurse practitioner education and a postdoctoral research fellowship at the University of Pennsylvania. He holds BA and BS degrees from the University of Ottawa and Carleton University, in his hometown of Ottawa, Canada.

PhD - McGill University School of Nursing
MS - McGill University School of Nursing
BA - Carleton University
BS - University of Ottawa

Nursing workforce
Adult health
Nursing administration
Health Policy

Creative Teaching Award, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto (2011)
Dean’s Award for Undergraduate Teaching, University of Pennsylvania School of Nursing (2007)
Junior Faculty Research Award, Biobehavioral and Health Sciences Division School of Nursing, University of Pennsylvania (2006)
Fellow, American Academy of Nursing (2006)
Class of 1965 25th Reunion Term Chair, University of Pennsylvania School of Nursing [for enduring contributions to undergraduate education] (2006)
American Academy of Nursing Media Award for coverage of Aiken, Clarke et al., JAMA, October 23/30, 2002 (2003)
Article of the Year, Academy Health [Academy for Health Services Research and Health Policy] for Aiken, Clarke et al., JAMA, October 23/30, 2002 (2003)
American Academy of Nursing Media Award for coverage of Aiken, Clarke, et al. Health Affairs, 2001 (2002)
Induction into Sigma Theta Tau, Xi Chapter (1999)

Making the business case for nursing: Justifying investments in nurse staffing and high-quality practice environments

Clarke, S. P. (2007). Nurse Leader, 5(4), 34-38. 10.1016/j.mnl.2007.05.002
Abstract
Abstract
"Making the business case for nursing" is common shorthand these days for efforts to untangle the inputs and outputs of nursing education and service and provide the data necessary for making responsible decisions about resource allocation. Given the challenges facing American health care, nurse leaders must shape the future of nursing services within their facilities, communicate with nonnurse health care leaders and policymakers about alternatives for securing sufficient nurses and other nursing personnel to meet patient needs, and propose and implement the best strategies and models for ensuring optimal nursing care. They must articulate the consequences of making and not making certain investments as clearly as possible to multiple stakeholders.

Nurse staffing in acute care settings: Research perspectives and practice implications

Clarke, S. P. (2007). Joint Commission Journal on Quality and Patient Safety, 33(11), 30-44. 10.1016/S1553-7250(07)33111-5
Abstract
Abstract
Background: The research literature linking nurse staffing and outcomes has expanded radically at a time of profound changes in human resources and financial management in hospitals and health care systems. Findings: Reviews of more than 100 peer-reviewed studies as of mid-2007 support an association between lower nurse staffing levels and poorer patient outcomes in acute care settings. Research efforts are increasingly aimed at understanding which outcomes are affected and under what circumstances and at evaluating the impact of staffing from an economic point of view. Minimal staffing levels appear to be a necessary but insufficient condition for safety in acute care hospitals. Conclusions and Implications: In the face of a deepening nursing shortage, many facilities are likely to find that various aspects of staffing, such as coverage, licensure levels, and experience, are lower than those historically in place. Advance planning by staff and supervisors and careful monitoring of outcomes are needed to ensure patient safety. Health care managers and executives need to benchmark staffing levels and nursing-sensitive outcomes in their facilities, carefully analyze recruitment and retention issues, and develop short- and long-term strategies for averting and dealing with the shortfalls in numbers and skill mix of nursing personnel that they will likely face increasingly in the coming decades.

Nursing2007® job satisfaction survey

Clarke, S., & Mee, C. (2007). Nursing, 37(3), 7-8. 10.1097/01.NURSE.0000261787.91469.ff

Outcomes of variation in hospital nurse staffing in English hospitals: Cross-sectional analysis of survey data and discharge records

Rafferty, A. M., Clarke, S. P., Coles, J., Ball, J., James, P., McKee, M., & Aiken, L. H. (2007). International Journal of Nursing Studies, 44(2), 175-182. 10.1016/j.ijnurstu.2006.08.003
Abstract
Abstract
Context: Despite growing evidence in the US, little evidence has been available to evaluate whether internationally, hospitals in which nurses care for fewer patients have better outcomes in terms of patient survival and nurse retention. Objectives: To examine the effects of hospital-wide nurse staffing levels (patient-to-nurse ratios) on patient mortality, failure to rescue (mortality risk for patients with complicated stays) and nurse job dissatisfaction, burnout and nurse-rated quality of care. Design and setting: Cross-sectional analysis combining nurse survey data with discharge abstracts. Participants: Nurses (N = 3984) and general, orthopaedic, and vascular surgery patients (N = 118 752) in 30 English acute trusts. Results: Patients and nurses in the quartile of hospitals with the most favourable staffing levels (the lowest patient-to-nurse ratios) had consistently better outcomes than those in hospitals with less favourable staffing. Patients in the hospitals with the highest patient to nurse ratios had 26% higher mortality (95% CI: 12-49%); the nurses in those hospitals were approximately twice as likely to be dissatisfied with their jobs, to show high burnout levels, and to report low or deteriorating quality of care on their wards and hospitals. Conclusions: Nurse staffing levels in NHS hospitals appear to have the same impact on patient outcomes and factors influencing nurse retention as have been found in the USA.

Psychiatric comorbidity and greater hospitalization risk, longer length of stay, and higher hospitalization costs in older adults with heart failure

Sayers, S. L., Hanrahan, N., Kutney, A., Clarke, S. P., Reis, B. F., & Riegel, B. (2007). Journal of the American Geriatrics Society, 55(10), 1585-1591. 10.1111/j.1532-5415.2007.01368.x
Abstract
Abstract
OBJECTIVES: To explore associations between psychiatric comorbidity and rehospitalization risk, length of hospitalization, and costs. DESIGN: Cross-sectional study of 1-year hospital administrative data. SETTING: Claims-based study of older adults hospitalized in the United States. PARTICIPANTS: Twenty-one thousand four hundred twenty-nine patients from a 5% national random sample of U.S. Medicare beneficiaries aged 65 and older, with at least one acute care hospitalization in 1999 with a Diagnostic-Related Group of congestive heart failure. MEASUREMENTS: The number of hospitalizations, mean length of hospital stay, and total hospitalization costs in calendar year 1999. RESULTS: Overall, 15.8% of patients hospitalized for heart failure (HF) had a coded psychiatric comorbidity; the most commonly coded comorbid psychiatric disorder was depression (8.5% of the sample). Most forms of psychiatric comorbidity were associated with greater inpatient utilization, including risk of additional hospitalizations, days of stay, and hospitalization charges. Additional hospitalization costs associated with psychiatric comorbidity ranged up to $7,763, and additional days length of stay ranged up to 1.4 days. CONCLUSION: Psychiatric comorbidity appears in a significant minority of patients hospitalized for HF and may affect their clinical and economic outcomes. The associations between psychiatric comorbidity and use of inpatient care are likely to be an underestimate, because psychiatric illness is known to be underdetected in older adults and in hospitalized medical patients.

Racial segregation and differential outcomes in hospital care

Clarke, S. P., Davis, B. L., & Nailon, R. E. (2007). Western Journal of Nursing Research, 29(6), 739-757. 10.1177/0193945907303167
Abstract
Abstract
This exploratory study of patients in Pennsylvania (PA) and Virginia (VA) hospitals in 1998-1999 measures the segregation of care for Black patients receiving inpatient care for specific medical and surgical conditions. It also examined inpatient mortality risk for Black patients and the impact of treatment in heavily segregated hospitals on mortality for Blacks and non-Blacks. Segregation of hospital care was found across both states but was more pronounced in PA. Blacks did not experience higher mortality rates than non-Blacks either before or after controls for clinical risk factors in either state and for certain admission types had lower mortality. Both Black and non-Black surgical, heart failure, and lung disease patients treated in VA hospitals with more Black patients had poorer outcomes. Future research should examine how access, patient choice, hospital organization, processes of care, and factors related to nursing care might influence hospital outcomes for patients from different racial backgrounds.

Rapid‐fire strategies for regulatory readiness

Carrick, L., Cutts, G. H., Chodoff, S., & Clarke, S. (2007). Nursing Management, 38(11), 28-33. 10.1097/01.NUMA.0000299210.70758.a7

Registered nurse staffing and patient outcomes in acute care looking back, pushing forward

Clarke, S. P. (2007). Medical Care, 45(12), 1126-1128. 10.1097/MLR.0b013e31815ccaaf

A salute to our reviewers: Partners in the scientific endeavour

Gottlieb, L. N., & Clarke, S. P. (2007). Canadian Journal of Nursing Research, 39(4), 5-9.

Sharp-device injuries to hospital staff nurses in 4 countries

Clarke, S. P., Schubert, M., & Körner, T. (2007). Infection Control and Hospital Epidemiology, 28(4), 473-478. 10.1086/513445
Abstract
Abstract
OBJECTIVE. To compare sharp-device injury rates among hospital staff nurses in 4 Western countries. DESIGN. Cross-sectional survey. SETTING. Acute-care hospital nurses in the United States (Pennsylvania), Canada (Alberta, British Columbia, and Ontario), the United Kingdom (England and Scotland), and Germany. PARTICIPANTS. A total of 34,318 acute-care hospital staff nurses in 1998-1999. RESULTS. Survey-based rates of retrospectively-reported needlestick injuries in the previous year for medical-surgical unit nurses ranged from 146 injuries per 1,000 full-time equivalent positions (FTEs) in the US sample to 488 injuries per 1,000 FTEs in Germany. In the United States and Canada, very high rates of sharp-device injury among nurses working in the operating room and/or perioperative care were observed (255 and 569 injuries per 1,000 FTEs per year, respectively). Reported use of safety-engineered sharp devices was considerably lower in Germany and Canada than it was in the United States. Some variation in injury rates was seen across nursing specialties among North American nurses, mostly in line with the frequency of risky procedures in the nurses' work. CONCLUSIONS. Studies conducted in the United States over the past 15 years suggest that the rates of sharp-device injuries to front-line nurses have fallen over the past decade, probably at least in part because of increased awareness and adoption of safer technologies, suggesting that regulatory strategies have improved nurse safety. The much higher injury rate in Germany may be due to slow adoption of safety devices. Wider diffusion of safer technologies, as well as introduction and stronger enforcement of occupational safety and health regulations, are likely to decrease sharp-device injury rates in various countries even further.