Linda Aiken’s pioneering research has created an evidence base showing the importance of nurses caring for fewer patients each, having most nurses with bachelor’s or higher qualifications, and improving nurse work environments. Dr. Aiken documented that 30-day mortality after common surgical procedures increased by 7 percent for each additional patient added to a nurse’s workload, and that for each 10 percent increase in nurses with BSN degrees, there was a 5 to 7 percent decline in risk-adjusted mortality. She has also demonstrated that organizations that support professional nursing practice by involving nurses in decision-making have better patient outcomes than matched organizations with poor work environments.
Dr. Aiken has received the major research awards in her field of health services and policy research. In 2014, she received the Gustav O. Lienhard Award from the National Academy of Medicine for her research, which has impacted practice and policy in the United States and abroad. She has received the top awards in health services research, including the Distinguished Investigator Award from AcademyHealth and the Baxter Graham Health Services Research Prize from the Association of University Programs in Health Administration. Dr. Aiken was an Inaugural Awardee in the Sigma Theta Tau International Nurse Researcher’s Hall of Fame.
Research: Improving Health Outcomes through Research and Policy
California’s development of state-mandated nurse-to-patient ratios in hospitals and public reporting of these ratios in other states were influenced by Dr. Aiken’s research. Beyond the U.S., her research was key to the adoption of safe nurse staffing mandates in Wales, Ireland, and the state of Queensland, Australia. The National Academy of Medicine’s 2010 recommendation that 80 percent of U.S. nurses have a bachelor’s degree by 2020, and the European Parliament’s 2013 decision to recognize a bachelor’s degree educational pathway for nurses in the European Union, reflect her research.
Dr. Aiken is founding director of Penn Nursing’s Center for Health Outcomes and Policy Research. RN4CAST, one of the center’s projects and based on Dr. Aiken’s research, is the largest study of its kind on nursing care and patient outcomes in the United States, Europe, Asia, South Africa, Australia, and Chile. RN4CAST has been implemented in 30 countries and funded by many sources, including NIH and the European Commission.
In another recent center study, Dr. Aiken and colleagues from Penn Nursing and Penn’s Leonard Davis Institute of Health Economics demonstrated that better nurse work environments produce higher value care by achieving lower mortality with similar or lower costs, especially for higher-risk surgical patients. Dr. Aiken led the effort to improve clinical work environments for nurses when she was president of the American Academy of Nursing in 1979. This led to the development of the Magnet Recognition Program®, a voluntary accreditation program for nursing that represents a high-quality working environment for nurses that results in better patient outcomes. Dr. Aiken is also an authority on nurse shortages around the world.