Research Centers - University of Pennsylvania School of Nursing

Linda H. Aiken, PhD, RN, FAAN, FRCN
Healing Hospitals: Improving Patient Outcomes at Home and Abroad
The Claire M. Fagin Distinguished Research Award 2007
“The purpose of the Claire Fagin
Distinguished Research Award is to honor
Dr. Fagin, to recognize our faculty, and to be
inspired by our faculty’s accomplishments,”
said Afaf I. Meleis PhD, DrPS(hon), FAAN,
FRCN, the Margaret Bond Simon Dean of
Nursing, as she introduced the Fifth Claire
M. Fagin Distinguished Research Award
lecturer.
Before an audience of family,
friends, current and former students, and
colleagues, Linda H. Aiken, HOM ’88,
PhD, RN FAAN, FRCN, the Claire M. Fagin
Leadership Professor in Nursing, Professor
of Sociology, and Director of the Center
for Health Outcomes and Policy Research
(CHOPR) presented her extensive research
regarding the international nursing shortage
and its subsequent effects on patient
care — research that has not only inspired
colleagues, but has influenced policies in the
United States and around the world.
Among those in attendance to hear
Dr. Aiken present “Healing Hospitals:
Improving Patient Outcomes at Home and
Abroad” was Dr. Fagin, PhD, FAAN, RN,
Dean Emerita and former interim Penn
President. Dr. Fagin, one of the nation’s first
nursing deans to recognize the value of
nursing research through the creation of a
funded research center, was responsible for
recruiting Dr. Aiken to Penn Nursing in 1988.
“Dr. Aiken was born a star,” said Dr. Fagin.
“She has always excelled in everything she
has done,” recently landing on the Modern
Healthcare magazine’s list of the top 100
most influential people in the number 20
spot, right behind Hillary Clinton.
Recently, Dr. Aiken’s research has
focused on the global nursing shortage and
how to alleviate it. She believes researchers
must use their findings to create a “burning
platform” that will “mobilize a broad
constituency for addressing the inter-related
problems of ailing hospitals and inadequate
global nurse workforce.”
Dr. Aiken’s long research career has
produced many important findings including
that for every one additional patient added
to a hospital staff nurse’s workload, patient
mortality after common surgery increases
by seven percent. “Hospitals with more
RNs and better patient care environments
have better patient outcomes and nurse
retention,” she said.
According to Dr. Aiken, negative
work environments and failed human
resources policies also contribute to poor
nurse retention, which then leads to an
increase in preventable patient deaths and
complications. “Nurses are not treated by
hospitals as the scarce resources they are,”
she said. “Nurses report negative work
environments in hospitals and lack of regard
for their expertise and education.”
Dr. Aiken’s team also found that each
10 percent increase in proportion of hospital
staff nurses with BSNs is associated with
a five percent decline in mortality and a
five percent decline in the risk of death of
patients with complications (also known
as failure to rescue). “More than 40,000
hospital deaths could be prevented each
year if all U.S. hospitals improved the quality
of their nurse practice environments, nurse
“The purpose of the Claire Fagin Distinguished Research Award is to honor
Dr. Fagin, to recognize our faculty, and to be inspired by our faculty’s
accomplishments,” said Afaf I. Meleis PhD, DrPS(hon), FAAN, FRCN, the
Margaret Bond Simon Dean of Nursing, as she introduced the Fifth Claire
M. Fagin Distinguished Research Award lecturer.
to patient ratios and nurse education to
the levels in the ‘better’ hospitals,” said Dr.
Aiken.
Yet, the U.S. nursing shortage is
not unique. The International Hospital
Outcomes Study (IHOS) was developed and
designed at and has been coordinated by
the School of Nursing’s CHOPR. It began as
a consortium of eight interdisciplinary nurseled
research teams in the United States,
Canada, United Kingdom, Germany, and
New Zealand studying the factors that cause
the nursing shortage and potential solutions.
In recent years, the IHOS measurement
tools and approach have been used by
teams in Switzerland, Belgium, Iceland,
Australia, Japan, Thailand, and South Korea.
Remarkable similarities have been found in
the working conditions reported by nurses
and in the connections between staffing and
other factors related to patient outcomes.
According to 2001 findings, 66 percent of
U.S. hospital nurses reported there were not
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