HL20: Linda Aiken, PhD, RN—Advocate for Healthcare Quality and Nursing

Cheryl Clark, January 4, 2013

In our annual HealthLeaders 20, we profile individuals who are changing healthcare for the better. Some are longtime industry fixtures; others would clearly be considered outsiders. Some are revered; others would not win many popularity contests. All of them are playing a crucial role in making the healthcare industry better. This is the story of Linda Aiken, PhD, RN.

This profile was published in the December, 2012 issue of HealthLeaders magazine.

 "It doesn't cost a lot of money to change the work environment. It's the No. 1 thing hospitals should be doing rather than just throwing a lot of money into staffing without changing some of these other factors."

When researcher Linda Aiken, PhD, RN, speaks to large groups about problems hospitals face delivering quality care, she often asks the nurses in her audience about their pillows.

"I ask, 'Do you spend time looking for pillows for your patients?' And every time, they all jump up, thousands of them, waving their arms. Now isn't this a major ridiculous thing, in a multibillion-dollar business, where nurses are paid a lot of money, they're spending so much time searching for pillows, and even hoarding pillows?"

Sometimes, they need five or six pillows to position their patients to avoid pressure ulcers, or to help patients after surgery, Aiken explains. "It's the same thing for IV poles, stretchers, medications that don't show up on time, or meals that don't come. Nurses have to go looking for them. These are the things nurses troubleshoot all the time, which interrupts them mid-task and takes them away from taking care of patients."

Aiken, a former heart surgery nurse, is now professor of nursing and sociology and director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania. She also is arguably the most well-known investigator of how nursing workforce issues affect hospital quality and outcomes, specifically inpatient mortality and nursing shortages.

Her three key subject areas are patient-nurse ratios (lower them), nursing educational levels (raise them), and the nurse work environment (include nurses in decisions).



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