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 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)

Factors that impact on the use of mechanical ventilation weaning protocols in critically ill adults and children: A qualitative evidence-synthesis

Jordan, J., Rose, L., Dainty, K. N., Noyes, J., Clarke, S., & Blackwood, B. (2015). Cochrane Database of Systematic Reviews, 2015(7). 10.1002/14651858.CD009851.pub2
Abstract
Abstract
This 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

Déry, J., D’Amour, D., Blais, R., & Clarke, S. P. (2015). Advances in Nursing Science, 38(2), 136-143. 10.1097/ANS.0000000000000071
Abstract
Abstract
Enacted 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.

Pain and anxiety in rural acute coronary syndrome patients awaiting diagnostic cardiac catheterization

O’Keefe-McCarthy, S., McGillion, M., Clarke, S. P., & McFetridge-Durdle, J. (2015). Journal of Cardiovascular Nursing, 30(6), 546-557. 10.1097/JCN.0000000000000203
Abstract
Abstract
Context: In rural areas of Canada, people with acute coronary syndromes (ACS) can wait up to 32 hours for transfer for diagnostic cardiac catheterization (CATH). While awaiting CATH, it is critical that pain and anxiety management be optimal to preserve myocardial muscle and minimize the risk of further deterioration. Objectives: The aim of this study was to examine the relationship between clinical management, cardiac pain intensity, and state anxiety for rural ACS patients awaiting diagnostic CATH. Methods: In a prospective, descriptive-correlational repeated-measures design involving 121 ACS rural patients, we examined the associations of analgesic and nitroglycerin administration with cardiac pain intensity (numeric rating scale) and state anxiety (Spielberger State Anxiety Inventory) and also nurses' pain knowledge and attitudes (Toronto Pain Management InventoryYACS Version and Knowledge and Attitudes Survey Regarding Pain) using linear mixed models. Results: The mean age of patients was 67.6 T 13, 50% were men, and 60% had unstable angina and the remainder had non-ST-elevated myocardial infarction. During follow-up, cardiac pain intensity scores remained in the mild range from 1.1 T 2.2 to 2.4 T 2.7. State anxiety ranged from 44.0 T 7.2 to 46.2 T 6.6. Cumulative analgesic dose was associated with a reduction in cardiac pain by 1.0 points (numeric rating scale, 0Y10) (t108 = j2.5; SE, j0.25; confidence interval, j0.45 to j0.06; P = .013). Analgesic administration was not associated with state anxiety. Over the course of follow-up, ACS patients reported consistently high anxiety scores. Conclusions: Whereas cardiac pain declines in most patients in the early hours after admission, many patients experience a persistent anxious state up to 8 hours later, which suggest that development and testing of protocols for anxiety reduction may be needed. More urgently, the development and examination of a treatment intervention, early on in the ACS trajectory, are warranted that targets pain and anxiety for those for whom immediate angioplasty is not possible and who continue to experience cardiac pain and persistent high levels of anxiety. Moreover, a larger prognostic study is required to determine whether high levels of anxiety in rural ACS patients are predictive of major adverse cardiac events.

Patient safety research

Clarke, S. P., & Schubert, M. (2015). In Routledge International Handbook of Advanced Quantitative Methods in Nursing Research: Methodological challenges (1–, pp. 381-396). Taylor and Francis Inc.

Patients in the radiology department may be at an increased risk of developing critical instability

Ott, L. K., Pinsky, M. R., Hoffman, L. A., Clarke, S. P., Clark, S., Ren, D., & Hravnak, M. (2015). Journal of Radiology Nursing, 34(1), 29-34. 10.1016/j.jradnu.2014.11.003
Abstract
Abstract
The purpose of this study was to calculate the event rate for inpatients in the radiology department (RD) developing instability leading to calls for medical emergency team (MET) assistance (MET-RD) compared with general ward (MET-W) patients. A retrospective comparison was done of MET-RD and MET-W calls in 2009 in a US tertiary hospital with a well-established MET system. MET-RD and MET-W event rates represented as MET calls/hr/1,000 admissions, adjusted for length of stay (LOS); rates also calculated for RD modalities. There were 31,320 hospital ward admissions that had 1,230 MET-Ws, and among 149,569 radiology admissions there were 56 MET-RDs. When adjusted for LOS, the MET-RD event rate was two times higher than the MET-W rate (0.48 vs. 0.24 events/hr/1,000 admissions). Event rates differed by procedure: computed tomography (CT) had 38% of MET-RDs (event rate, 0.89), and magnetic resonance imaging (MRI) accounted for 27% of MET-RDs (event rate, 1.56). Nuclear medicine had 1% of RD admissions, but these patients accounted for 5% of MET-RD (event rate, 1.53). Interventional radiology (IR) had 6% of RD admissions but 16% of MET-RD admissions (event rate, 0.61). Although general X-ray comprised 63% of RD admissions, only 11% of MET-RD involved their care (event rate, 0.09). In conclusion, the overall MET-RD event rate was twice the MET-W event rate; CT, MRI, and IR rates were 3.7 to 6.5 times higher than on wards. RD patients are at increased risk for an MET call compared with ward patients when the time at risk is considered. Increased surveillance of RD patients is warranted.

Content validity of the Toronto Pain Management Inventory-Acute Coronary Syndrome Version.

O’Keefe-McCarthy, S., McGillion, M., Nelson, S., Clarke, S., McFetridge-Durdle, J., & Watt-Watson, J. (2014). Canadian Journal of Cardiovascular Nursing = Journal Canadien En Soins Infirmiers Cardio-Vasculaires, 24(2), 11-18.
Abstract
Abstract
Cardiac pain and/or discomfort arising from acute coronary syndromes (ACS) can often be severe and anxiety-provoking. Cardiac pain, a symptom of impaired myocardial perfusion, if left untreated, may lead to further myocardial hypoxia, which can potentiate myocardial damage. Evidence suggests that once ACS patients are stabilized, their pain may not be adequately assessed. Lack of knowledge and problematic beliefs about pain may contribute to this problem. To date, no standardized tools are available to examine nurses' specific knowledge and beliefs about ACS pain that could inform future educational initiatives. To examine the content validity of the Toronto Pain Management Inventory-ACS Version (TPMI-ACS), a 24-item tool designed to assess nurses' knowledge and beliefs about ACS pain assessment and management. Eight clinical and scientific experts rated the relevance of each item using a four-point scale. A content validity index was computed for each item (I-CVI), as well as the total scale, expressed as the mean item CVI (S-CVI/AVE). Items with an I-CVI > or = 0.7 were retained, items with an I-CVI ranging from 0.5-0.7 were revised and clarified, and items with an I-CVI < or = 0.5 were discarded. I-CVIs ranged from 0.5-1.0 and the S-CVI/AVE was 0.90, reflecting high inter-rater agreement across items. The least relevant item was eliminated. Preliminary content validity was established on the TPMI-ACS version. All items retained in the TPMI-ACS version met requirements for content validity. Further evaluation of the psychometric properties of the TPMI-ACS is needed to establish criterion and construct validity, as well as reliability indicators.

Excellence and evidence in staffing: a data-driven model for excellence in staffing (2nd edition).

Baggett, M., Batcheller, J., Blouin, A. S., Behrens, E., Bradley, C., Brown, M. J., Brown, D. S., Bolton, L. B., Borromeo, A. R., Burtson, P., Caramanica, L., Caspers, B. A., Chow, M., Christopher, M. A., Clarke, S. P., Delucas, C., Dent, R. L., Disser, T., Eliopoulos, C., … Yendro, S. (2014). Nursing Economic$, 32(3), 3-35.
Abstract
Abstract
The Patient Protection and Affordable Care Act (PPACA, 2010) and the Institute of Medicine's (IOM, 2011) Future of Nursing report have prompted changes in the U.S. health care system. This has also stimulated a new direction of thinking for the profession of nursing. New payment and priority structures, where value is placed ahead of volume in care, will start to define our health system in new and unknown ways for years. One thing we all know for sure: we cannot afford the same inefficient models and systems of care of yesterday any longer. The Data-Driven Model for Excellence in Staffing was created as the organizing framework to lead the development of best practices for nurse staffing across the continuum through research and innovation. Regardless of the setting, nurses must integrate multiple concepts with the value of professional nursing to create new care and staffing models. Traditional models demonstrate that nurses are a commodity. If the profession is to make any significant changes in nurse staffing, it is through the articulation of the value of our professional practice within the overall health care environment. This position paper is organized around the concepts from the Data-Driven Model for Excellence in Staffing. The main concepts are: Core Concept 1: Users and Patients of Health Care, Core Concept 2: Providers of Health Care, Core Concept 3: Environment of Care, Core Concept 4: Delivery of Care, Core Concept 5: Quality, Safety, and Outcomes of Care. This position paper provides a comprehensive view of those concepts and components, why those concepts and components are important in this new era of nurse staffing, and a 3-year challenge that will push the nursing profession forward in all settings across the care continuum. There are decades of research supporting various changes to nurse staffing. Yet little has been done to move that research into practice and operations. While the primary goal of this position paper is to generate research and innovative thinking about nurse staffing across all health care settings, a second goal is to stimulate additional publications. This includes a goal of at least 20 articles in Nursing Economic$ on best practices in staffing and care models from across the continuum over the next 3 years.

Improving the Employer-Regulator Partnership: An Analysis of Employer Engagement in Discipline Monitoring

Ismail, F., & Clarke, S. P. (2014). Journal of Nursing Regulation, 5(3), 19-23. 10.1016/S2155-8256(15)30056-9
Abstract
Abstract
Employers are essential partners with health professions regulators in ensuring public safety and are critical to the success of discipline monitoring programs. However, working with discipline orders and the regulatory process often causes confusion and stress for employers.This article reviews the perspectives of regulators and employers regarding discipline monitoring in nursing as well as the legal and practical considerations. The article concludes by suggesting future directions for regulators and employers.

Introduction to research

Clarke, S. (2014). In An Introduction to Theory and Reasoning in Nursing (1–, pp. 226-259). Wolters Kluwer Health Adis (ESP).

Nurses' expert opinions of workplace interventions for a healthy working environment: a Delphi survey

Doran, D., Clarke, S., Hayes, L., & Nincic, V. (2014). Nursing Leadership (Toronto, Ont.), 27(3), 40-50. 10.12927/cjnl.2015.24058
Abstract
Abstract
Much has been written about interventions to improve the nursing work environment, yet little is known about their effectiveness. A Delphi survey of nurse experts was conducted to explore perceptions about workplace interventions in terms of feasibility and likelihood of positive impact on nurse outcomes such as job satisfaction and nurse retention. The interventions that received the highest ratings for likelihood of positive impact included: bedside handover to improve communication at shift report and promote patient-centred care; training program for nurses in dealing with violent or aggressive behaviour; development of charge nurse leadership team; training program focused on creating peer-supportive atmospheres and group cohesion; and schedule that recognizes work balance and family demands. The overall findings are consistent with the literature that highlights the importance of communication and teamwork, nurse health and safety, staffing and scheduling practices, professional development and leadership and mentorship. Nursing researchers and decision-makers should work in collaboration to implement and evaluate interventions for promoting practice environments characterized by effective communication and teamwork, professional growth and adequate support for the health and well-being of nurses.