Sean Clarke
FAAN PhD RN
Ursula Springer Professor in Nursing Leadership
sean.clarke@nyu.edu
1 212 998 5264
Ursula Springer Professor in Nursing Leadership
433 First Ave
New York, NY 10010
United States
Sean Clarke's additional information
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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.
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PhD - McGill University School of NursingMS - McGill University School of NursingBA - Carleton UniversityBS - University of Ottawa
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Nursing workforceAdult healthNursing administrationHealth Policy
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Faculty Honors Awards
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) -
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Publications
Education and role title as predictors of enacted (actual) scope of practice in generalist nurses in a pediatric academic health sciences center
AbstractDéry, J., & Clarke, S. P. (2016). Journal of Nursing Administration, 46(5), 265-269. 10.1097/NNA.0000000000000341AbstractOBJECTIVE: The aim of this study is to document the enacted (actual) scope of practice (SOP) of nurses in pediatric settings in relation to education level and position. BACKGROUND: Baccalaureate-prepared staff nurses routinely carry out only a fraction of the activities essential for quality of care and patient safety they have been educated for. A direct care nurse clinician role exists for nurses with bachelor’s degrees in Quebec, Canada. METHOD: Survey of 301 nurses in a pediatric university hospital in Quebec was conducted. RESULTS: Enacted (actual) SOP for baccalaureate-educated nurses was significantly broader than that of nurses with junior college diplomas and nurse clinicians (baccalaureate-educated) carried out complex activities more frequently. CONCLUSION: The creation of job titling and role descriptions that reflect the upper range of nursing competencies could be an important tool for promoting broadened SOP for baccalaureate nurses.Ensuring positive capstone experiences for students and staff
Smith, A., & Clarke, S. P. (2016). Nursing Management, 47(3), 12-14. 10.1097/01.NUMA.0000480767.08955.61Get your hands dirty! Improving student clinical experiences
Logan, P., & Clarke, S. P. (2016). Nursing Management, 47(5), 10-12. 10.1097/01.NUMA.0000482499.82817.f2Navigating a research-focused doctoral program in nursing
Clarke, S. P. (2016). Nursing Management, 47(1), 19-21. 10.1097/01.NUMA.0000475634.98128.83Optimizing full scope of practice for nurse practitioners in primary care: A proposed conceptual model
AbstractPoghosyan, L., Boyd, D. R., & Clarke, S. P. (2016). Nursing Outlook, 64(2), 146-155. 10.1016/j.outlook.2015.11.015AbstractBackground: Nurse practitioners (NPs), if utilized to their optimal potential, could play a key role in meeting the growing demand for primary care. Purpose: The purpose of this study was to propose a comprehensive model for maximizing NP contributions to primary care which includes the factors affecting NP care and patient outcomes and explains their interrelated impact. Method: We synthesized the results of the published literature to develop a model, which emphasizes NP scope of practice regulations, institutional policies, NP practice environment, and NP workforce outcomes as determinants of NP care and patient outcomes. Discussion: Our model provides a framework to help explain how variations in scope of practice regulations at the state-level and institutional policies within organizations directly and indirectly influence the practice environment of NPs, NP workforce outcomes, and patient care and outcomes. Conclusion: Aligning policy change, organizational innovations, and future research are critical to NP optimal utilization and patient care and outcomes.A protocol to assess the impact of adding nursing support workers to ward staffing
AbstractDuffield, C., Roche, M., Twigg, D., Williams, A., & Clarke, S. (2016). Journal of Advanced Nursing, 72(9), 2218-2225. 10.1111/jan.12965AbstractAim: To assess the impact of adding nursing support workers to ward staffing. Background: Nurses' capacity to provide safe care is compromised by increased workloads and nursing shortages. Use of unregulated workers is an alternative to increasing the number of regulated nurses. The impact of adding nursing support workers on patient, nurse and system outcomes has not been systematically evaluated. Design: A mixed longitudinal and cross-sectional design using administrative data sets and prospective data from a sample of wards. Methods: Payroll data will identify wards on which unregulated staff work. To assess the impact on nursing-sensitive outcomes, retrospective analysis of morbidity and mortality data of all patients admitted to Western Australia hospitals for over 24 hours across 4 years will be undertaken. For the cross-sectional study, a sample of 20 pairs of matched wards will be selected: 10 with unregulated workers added and 10 where they have not. From this sample the impact on patients will be assessed using the Patient Evaluation of Emotional Care during Hospitalisation survey. The impact on nurses will be assessed by a nurse survey used extensively which includes variables such as job satisfaction and intention to leave. The impact on system outcomes will be explored using work sampling of staff activities and the Practice Environment Scale. Interviews will determine nurses' experience of working with nursing support workers. Discussion: The study aims to provide evidence about the impact of adding nursing support workers to ward staffing for patients, staff and the work environment.Rationing of nursing care interventions and its association with nurse-reported outcomes in the neonatal intensive care unit: A cross-sectional survey
AbstractRochefort, C. M., Rathwell, B. A., & Clarke, S. P. (2016). BMC Nursing, 15(1). 10.1186/s12912-016-0169-zAbstractBackground: Evidence internationally suggests that staffing constraints and non-supportive work environments result in the rationing of nursing interventions (that is, limiting or omitting interventions for particular patients), which in turn may influence patient outcomes. In the neonatal intensive care unit (NICU), preliminary studies have found that discharge preparation and infant comfort care are among the most frequently rationed nursing interventions. However, it is unknown if the rationing of discharge preparation is related to lower perceptions of parent and infant readiness for NICU discharge, and if reports of increased rationing of infant comfort care are related to lower levels of perceived neonatal pain control. The purpose of this study was to assess these relationships. Methods: In late 2014, a cross-sectional survey was mailed to 285 Registered Nurses (RNs) working in one of 7 NICUs in the province of Quebec (Canada). The survey contained validated measures of care rationing, parent and infant readiness for discharge, and pain control, as well as items measuring RNs' characteristics. Multivariate regression was used to examine the association between care rationing, readiness for discharge and pain control, while adjusting for RNs' characteristics and clustering within NICUs. Results: Overall, 125 RNs completed the survey; a 44.0 % response rate. Among the respondents, 28.0 and 40.0 % reported rationing discharge preparation and infant comfort care "often" or "very often", respectively. Additionally, 15.2 % of respondents felt parents and infants were underprepared for NICU discharge, and 54.4 % felt that pain was not well managed on their unit. In multivariate analyses, the rationing of discharge preparation was negatively related to RNs' perceptions of parent and infant readiness for discharge, while reports of rationing of parental support and teaching and infant comfort care were associated with less favourable perceptions of neonatal pain control. Conclusions: The rationing of nursing interventions appears to influence parent and infant readiness for discharge, as well as pain control in NICUs. Future investigations, in neonatal nursing care as well as in other nursing specialties, should address objectively measured patient outcomes (such as objective pain assessments and post-discharge outcomes assessed through administrative data).Risk Factors and Best Practices for the Prevention of Post-Cardiac Surgery Surgical Site Infections in a Tertiary Care Centre
AbstractLogan, S., Quinn, D., Brault, D., Vandal, V., Pare, B., & Clarke, S. (2016). Canadian Journal of Cardiovascular Nursing = Journal Canadien En Soins Infirmiers Cardio-Vasculaires, 26(4), 19-26.AbstractBACKGROUND: Post-cardiac surgery surgical site infections (SSIs) pose devastating consequences in terms of morbidity and mortality to patients.OBJECTIVE: To examine current risk factors and best practice perioperative care for prevention of SSI following cardiac surgery through the lens of the demographic/clinical characteristics of patients who developed post-cardiac surgery SSIs at a major tertiary care institution, and to identify where documentation is lacking and could be improved to better serve clinical practice.METHODS: A literature review on post-cardiac surgery SSI prevention and risk factors was performed. These risk factors were examined through a retrospective chart review of the population of patients who developed SSIs during the study period.RESULTS: The study population was characterized by a high prevalence of riskfactors including age, diabetes, obesity, operative time, blood glucose control, surgical re-exploration, blood transfusions, and emergency context, as well as differences from best practice guidelines such as preoperative showering. Compared to other populations in the literature, several ofthese risk factors were more prevalent at the study site than in the other comparable populations.CONCLUSION: The patient population had a relatively high prevalence of riskfactors, and the care received by these patients varied in some ways from best practices. Using best practice guidelines, known risk factors, and the data specific to the institution can provide insightsfor analysis and practice improvement efforts in the form of identifying at-risk patients, improving adherence to best practice guidelines, targeting areas to focus care efforts, and improving clincal documentation.Factors that impact on the use of mechanical ventilation weaning protocols in critically ill adults and children: A qualitative evidence-synthesis
AbstractJordan, J., Rose, L., Dainty, K. N., Noyes, J., Clarke, S., & Blackwood, B. (2015). Cochrane Database of Systematic Reviews, 2015(7). 10.1002/14651858.CD009851.pub2AbstractThis is the protocol for a review and there is no abstract. The objectives are as follows: To enhance and extend the recent Cochrane effectiveness review of protocolized weaning (Blackwood 2010) by synthesizing evidence from qualitative research to identify contextual factors that impact on the use of ventilator weaning protocols for critically ill adults and children. The research questions we will address are as follows. 1. Which contextual factors may have contributed to the heterogeneity in effect sizes of the randomized controlled trials included in the Blackwood (2010) review on protocolized weaning? (enhancing the review). 2. Which contextual factors (facilitators and barriers) may have an impact on the effective use of protocols for weaning critically ill adults and children from mechanical ventilation? (extending the review).Influences on and Outcomes of Enacted Scope of Nursing Practice: A New Model
AbstractDéry, J., D’Amour, D., Blais, R., & Clarke, S. P. (2015). Advances in Nursing Science, 38(2), 136-143. 10.1097/ANS.0000000000000071AbstractEnacted scope of practice is a major issue for nursing administrators, given the potentially negative effect on accessibility, continuity, safety and quality of care, job satisfaction, and organizational costs of nurses working at reduced scope. Optimal deployment of nurses to a fuller enacted scope of nursing practice holds much promise for addressing all of these larger challenges. In this sense, new model of the Enacted Scope of Nursing Practice presented in this article provides a number of directions for interventions that could improve health system functioning.