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May 5, 2017
Aiken Presents Nursing’s Impact on Patient Outcomes

Dr. Linda Aiken (l) and NINR director Dr. Patricia Grady
Dr. Linda Aiken (l) and NINR director Dr. Patricia Grady

Dr. Linda Aiken recently presented the first NINR Director’s Lecture of 2017. In her talk, “Nursing’s Impact on Patient Outcomes,” Aiken described her program of research that has shown that nurses with higher levels of qualifications, fewer patients to care for and improved working environments have better patient outcomes.

Aiken is the Claire Fagin leadership professor of nursing, professor of sociology and director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania.

“With NINR’s support, we have created the field of nursing outcomes research,” said Aiken of the work she and her team have conducted over the past quarter century.

She seeks to determine “to what extent modifiable organizational features of nursing determine patient outcomes in different settings/patients” by surveying nurses across hospitals—thus collecting data on an entire population of organizations instead of on a single institution.

This approach has led to Aiken’s discovery that each one-patient increase in nurses’ workload is associated with a 7 percent increase in mortality following general surgery. Additionally, Aiken showed that every 10 percent increase in the proportion of nurses with a bachelor’s degree is associated with a 5 percent decline in patient mortality.

These and other findings from Aiken’s team have influenced policy makers. For instance, regulators in California and Massachusetts have cited Aiken’s work in their recommendations regarding nurse/patient ratios.

In introductory remarks, NINR director Dr. Patricia Grady highlighted the “astonishing” global reach of Aiken’s work, which has included more than 30 countries. Indeed, citing studies conducted in Europe, Aiken demonstrated that her research has influence around the world, not just in the U.S.

For instance, she replicated her work on nurse/patient ratios at National Health Service hospitals in England. Subsequently, Wales and Ireland adopted legislation for nurse/patient ratios; similar legislation is under consideration in Scotland and England. Additionally, nurse/patient ratios have also been legislated in Queensland, Australia.

Noting that nursing is associated with “every performance measure that anybody cares about” in hospital outcomes, Aiken’s team now is developing methods to prove causality—not simply association—between nursing and outcomes.

The video of Aiken’s lecture is now available on NINR’s YouTube channel at

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