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)

Balancing staffing and safety

Clarke, S. P. (2003). Nursing Management, 34(6), 44-48. 10.1097/00006247-200306000-00018
Abstract
Abstract
Several high-profile research studies link nurse staffing and patient safety.

Educational Levels of Hospital Nurses and Surgical Patient Mortality

Aiken, L. H., Clarke, S. P., Cheung, R. B., Sloane, D. M., & Silber, J. H. (2003). JAMA, 290(12), 1617-1623. 10.1001/jama.290.12.1617
Abstract
Abstract
Context: Growing evidence suggests that nurse staffing affects the quality of care in hospitals, but little is known about whether the educational composition of registered nurses (RNs) in hospitals is related to patient outcomes. Objective: To examine whether the proportion of hospital RNs educated at the baccalaureate level or higher is associated with risk-adjusted mortality and failure to rescue (deaths in surgical patients with serious complications). Design, Setting, and Population: Cross-sectional analyses of outcomes data for 232 342 general, orthopedic, and vascular surgery patients discharged from 168 nonfederal adult general Pennsylvania hospitals between April 1, 1998, and November 30, 1999, linked to administrative and survey data providing information on educational composition, staffing, and other characteristics. Main Outcome Measures: Risk-adjusted patient mortality and failure to rescue within 30 days of admission associated with nurse educational level. Results The proportion of hospital RNs holding a bachelor's degree or higher ranged from 0% to 77% across the hospitals. After adjusting for patient characteristics and hospital structural characteristics (size, teaching status, level of technology), as well as for nurse staffing, nurse experience, and whether the patient's surgeon was board certified, a 10% increase in the proportion of nurses holding a bachelor's degree was associated with a 5% decrease in both the likelihood of patients dying within 30 days of admission and the odds of failure to rescue (odds ratio, 0.95; 95% confidence interval, 0.91-0.99 in both cases). Conclusion: In hospitals with higher proportions of nurses educated at the baccalaureate level or higher, surgical patients experienced lower mortality and failure-to-rescue rates.

Failure to rescue.

Clarke, S. P., & Aiken, L. H. (2003). The American Journal of Nursing, 103(1), 42-47. 10.1097/00000446-200301000-00020

Hospital nurse staffing, education, and patient mortality.

Aiken, L. H., Clarke, S. P., Silber, J. H., & Sloane, D. (2003). LDI Issue Brief, 9(2), 1-4.
Abstract
Abstract
A serious shortage of hospital nurses in the U.S., evident in the past decade, is expected to continue and worsen in the next 15 years. Increasingly, the public and the health professions are acknowledging that nurse understaffing represents a serious threat to patient safety in U.S. hospitals. Although anecdotal evidence has linked patient deaths to inadequate nurse staffing, the numbers and kinds of nurses needed for patient safety is unknown. This Issue Brief highlights two studies that clarify the impact of nurse staffing levels on surgical patient outcomes, and examine the effect of nurses' experience and educational level on patient mortality in the 30 days after a surgical admission.

Interview mit Sean Clarke. "In erster Linie eine Frage des Respekts".

Clarke, S. (2003). Krankenpflege. Soins Infirmiers, 96(8), 15.

Nursing Burnout and Patient Safety [3] (multiple letters)

Davis, D., Hand, E. E., Kovner, C., Needleman, J., Aiken, L. H., Clarke, S. P., Sloane, D. M., Sochalski, J., & Silber, J. H. (2003, February 5). In Journal of the American Medical Association (Vols. 289, Issues 5, pp. 549-551). 10.1001/jama.289.5.549-a

Registered Nurse Staffing and Patient and Nurse Outcomes in Hospitals: A Commentary

Clarke, S. P., & Aiken, L. H. (2003). Policy, Politics, & Nursing Practice, 4(2), 104-111. 10.1177/1527154403004002002
Abstract
Abstract
The authors’ research group published a major article in October 2002 showing a strong effect of nurse staffing on both patient outcomes and factors related to nurse turnover in 168 Pennsylvania hospitals. This article reviews major design elements and findings of the study and discusses policy implications of this research. Even though evidence is mounting that hospital staffing is a public health issue, regulation of staffing levels remains controversial. Higher quality staffing data that incorporate information about patients’ needs for nursing care are required for better administrative decision-making and research purposes. That the current nurse shortage is occurring in an era of renewed concerns about safety in hospitals offers unique opportunities for developing public policy to remedy problems with staffing and other long-standing workplace environment issues in hospital nursing.

Effects of hospital staffing and organizational climate on needlestick injuries to nurses

Clarke, S. P., Sloane, D. M., & Aiken, L. H. (2002). American Journal of Public Health, 92(7), 1115-1119. 10.2105/AJPH.92.7.1115
Abstract
Abstract
Objectives. This study determined the effects of nurse staffing and nursing organization on the likelihood of needlestick injuries in hospital nurses, Methods. We analyzed retrospective data from 732 and prospective data from 960 nurses on needlestick exposures and near misses over different 1-month periods in 1990 and 1991. Staffing levels and survey data about working climate and risk factors for needlestick injuries were collected on 40 units in 20 hospitals. Results. Nurses from units with low staffing and poor organizational climates were generally twice as likely as nurses on well-staffed and better-organized units to report risk factors, needlestick injuries, and near misses. Conclusions. Staffing and organizational climate influence hospital nurses' likelihood of sustaining needlestick injuries. Remedying problems with understaffing, inadequate administrative support, and poor morale could reduce needlestick injuries.

Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction

Aiken, L. H., Clarke, S. P., Sloane, D. M., Sochalski, J., & Silber, J. H. (2002). Journal of the American Medical Association, 288(16), 1987-1993. 10.1001/jama.288.16.1987
Abstract
Abstract
Context The worsening hospital nurse shortage and recent California legislation mandating minimum hospital patient-to-nurse ratios demand an understanding of how nurse staffing levels affect patient outcomes and nurse retention in hospital practice. Objective To determine the association between the patient-to-nurse ratio and patient mortality, failure-to-rescue (deaths following complications) among surgical patients, and factors related to nurse retention. Design, Setting, and Participants Cross-sectional analyses of linked data from 10184 staff nurses surveyed, 232342 general, orthopedic, and vascular surgery patients discharged from the hospital between April 1, 1998, and November 30, 1999, and administrative data from 168 nonfederal adult general hospitals in Pennsylvania. Main Outcome Measures Risk-adjusted patient mortality and failure-to-rescue within 30 days of admission, and nurse-reported job dissatisfaction and job-related burnout. Results After adjusting for patient and hospital characteristics (size, teaching status, and technology), each additional patient per nurse was associated with a 7% (odds ratio [OR], 1.07; 95% confidence interval [CI], 1.03-1.12) increase in the likelihood of dying within 30 days of admission and a 7% (OR, 1.07; 95% CI, 1.02-1.11) increase in the odds of failure-to-rescue. After adjusting for nurse and hospital characteristics, each additional patient per nurse was associated with a 23% (OR, 1.23; 95% CI, 1.13-1.34) increase in the odds of burnout and a 15% (OR, 1.15; 95% CI, 1.07-1.25) increase in the odds of job dissatisfaction. Conclusions In hospitals with high patient-to-nurse ratios, surgical patients experience higher risk-adjusted 30-day mortality and failure-to-rescue rates, and nurses are more likely to experience burnout and job dissatisfaction.

Hospital staffing, organization, and quality of care: Cross-national findings

Aiken, L. H., Clarke, S. P., & Sloane, D. M. (2002). Nursing Outlook, 50(5), 187-194. 10.1067/mno.2002.126696
Abstract
Abstract
OBJECTIVE: To examine the effects of nurse staffing and organizational support for nursing care on nurses' dissatisfaction with their jobs, nurse burnout, and nurse reports of quality of patient care in an international sample of hospitals. DESIGN: Multisite cross-sectional survey SETTING: Adult acute-care hospitals in the U.S. (Pennsylvania), Canada (Ontario and British Columbia), England and Scotland. Study Participants: 10319 nurses working on medical and surgical units in 303 hospitals across the five jurisdictions. INTERVENTIONS: None Main outcome measures: Nurse job dissatisfaction, burnout, and nurse-rated quality of care. RESULTS: Dissatisfaction, burnout and concerns about quality of care were common among hospital nurses in all five sites. Organizational/managerial support for nursing had a pronounced effect on nurse dissatisfaction and burnout, and both organizational support for nursing and nurse staffing were directly, and independently, related to nurse-assessed quality of care. Multivariate results imply that nurse reports of low quality care were three times as likely in hospitals with low staffing and support for nurses as in hospitals with high staffing and support. CONCLUSION: Adequate nurse staffing and organizational/managerial support for nursing are key to improving the quality of patient care, to diminishing nurse job dissatisfaction and burnout and, ultimately, to improving the nurse retention problem in hospital settings.